Rape, sex partnership, and substance use consequences in women veterans

Abstract

The association of rape history and sexual partnership with alcohol and drug use consequences in women veterans is unknown. Midwestern women veterans (N = 1,004) completed a retrospective telephone interview assessing demographics, rape history, substance abuse and dependence, depression, and posttraumatic stress disorder (PTSD). One third met lifetime criteria for substance use disorder (SUD), half reported lifetime completed rape, a third childhood rape, one quarter in-military rape, 11% sex with women. Lifetime SUD was higher for women with rape history (64% vs. 44%). Women with women as sex partners had significantly higher rates of all measures of rape, and also lifetime substance use disorder. Postmilitary rape, sex partnership, and current depression were significantly associated with lifetime SUD in multivariate models (odds ratio = 2.3, 3.6, 2.1, respectively). Many women veterans have a high need for comprehensive mental health services.

Health Disparities Among Sexual Minority Women Veterans

“…One possibility is that constellations of risk factors identified among sexual minority civilian samples (e.g., minority stress) may be amplified among sexual minority women veterans, which may be attributable to additive experiences of MST and other unique experiences related to their military service. 30,33 These experiences include increased vulnerability to investigation and discharge under DADT, relative to sexual minority men. 41 Unfortunately this dataset did not contain measures for such analyses, such as dates of service or exposure to DADT-related experiences.…”

“…Specifically, 73% of sexual minority women veterans reported lifetime rape compared to 48% of heterosexual women veterans. 33 While both rates are alarmingly high, the significant elevation in sexual minority women is striking given the known mental and physical health sequelae of sexual assault. 13 To our knowledge, no studies have examined whether health disparities identified within the general population of sexual minority women also are present among women veterans, nor whether sexual minority women veterans have distinct, unique health burdens relative to their peers who share their sexual minority status (i.e., sexual minority women non-veterans) or their veteran status (i.e., heterosexual women veterans).…”

Adverse Childhood Experiences and Adult Health Outcomes Among Veteran and Non-Veteran Women

“…1 Recent evidence suggests that women with military service history report greater burdens of ACEs than women who have never served in the military; 2 however, little research has examined if ACEs may contribute to poorer health among women veterans compared with non-veterans. The scant research about childhood abuse and women veterans has relied on clinical samples, namely women veterans using Veterans Health Administration (VHA) care, [3][4][5] though a significant proportion of veterans do not use VHA services. Consequently, health outcomes and factors related to health (i.e., ACEs) among non-VHA samples of women veterans are needed in order to more comprehensively understand the broader population of women veterans in the United States.…”

Associations between deployment, military rank, and binge drinking in active duty and Reserve/National Guard US servicewomen

“…These studies are limited in terms of focusing mostly on men (i.e., Mattiko et al, 2011) or on subsamples of AC servicewomen reporting recent alcohol use (Stahre et al, 2009) and not on a more representative community sample of servicewomen. Therefore, there is a need to extend these findings to a community sample of servicewomen in the AC and RNG given that lower rank may put some servicewomen at greater risk of experiencing gender harassment, unwanted sexual attention, sexual coercion (Buchanan et al, 2008), and perhaps associated emotional distress which may contribute to alcohol misuse (Booth et al, 2011).…”

“…Unfortunately, no studies have examined deployment in relation to alcohol misuse among U.S. servicewomen, and especially among servicewomen in the RNG who may be less prepared to cope with deployment-related stressors (Vogt et al, 2008). For example, servicewomen deployed overseas are at high risk for experiencing sexual harassment and sexual assault (LeardMann et al, 2013) which may contribute to alcohol misuse (Booth et al, 2011).…”