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2019 HSR&D/QUERI National Conference Abstract

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1118 — Sexual assault in military is associated with increased odds of sexual pain among women veterans

Lead/Presenter: Carey S Pulverman,  VISN 17 Center of Excellence
All Authors: PULVERMAN CS (VISN 17 Center of Excellence), Pulverman CS (VISN 17 Center of Excellence, Dell Medical School of the University of Texas at Austin), Creech SK (VISN 17 Center of Excellence, Dell Medical School of the University of Texas at Austin) Mengeling MA (University of Iowa Carver College of Medicine, Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) Iowa City Veterans Affairs Health Care System, VA Office of Rural Health) Torner JC (University of Iowa Carver College of Medicine, University of Iowa College of Public Health) Syrop CH (University of Iowa Carver College of Medicine) Sadler AG (University of Iowa Carver College of Medicine, Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System)

Objectives:
Sexual violence experiences at any stage throughout the lifespan can be detrimental to women's mental and sexual health. Studies on civilian women have indicated that childhood sexual abuse (CSA) is associated with a greater risk of sexual dysfunction than adulthood sexual assault, yet it is unknown if this same pattern applies to women veterans. The objective of this study is to examine whether the relationship between CSA and sexual function in civilian women is also found among women veterans, and consider the additional impact of sexual assault in military (SAIM).

Methods:
Using a retrospective cohort design, participants (N = 1,004) from two Midwestern VA medical centers and associated clinics completed a telephone-assisted interview on sexual assault, sexual pain, and mental health. Binary logistic regression was used to compare the rates of sexual pain between women with no sexual assault history, histories of CSA alone, histories of SAIM alone, and histories of CSA and SAIM.

Results:
Women veterans with histories of CSA and SAIM reported the highest rates of sexual pain, post-traumatic stress disorder (PTSD), and depression; followed by women with SAIM histories alone, CSA histories alone, and women with no sexual assault.

Implications:
The relationship between sexual assault and sexual pain in women veterans is distinct from their civilian peers. For women veterans, SAIM is more detrimental to sexual function (specifically sexual pain) than CSA alone, and the combination of CSA and SAIM confers the greatest risk for sexual pain.

Impacts:
Given this difference in sexual health, treatments for sexual dysfunction related to a history of CSA in civilian women may not be adequate for women veterans. Women veterans may require a targeted treatment approach that takes into account the particular nature and consequences of SAIM.