Health Services Research & Development

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Pulverman CS, Creech SK, Mengeling MA, Torner JC, Syrop CH, Sadler AG. Sexual Assault in the Military and Increased Odds of Sexual Pain Among Female Veterans. Obstetrics and gynecology. 2019 Jul 1; 134(1):63-71.
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Abstract: OBJECTIVE: To examine whether the relationship between childhood sexual abuse and sexual function in civilian women is also found among female veterans, and to consider the additional effects of sexual assault in the military. METHODS: Using a retrospective cohort design, participants (N=1,004) from two midwestern Department of Veterans Affairs 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 childhood sexual abuse alone, histories of sexual assault in the military alone, and histories of childhood sexual abuse and sexual assault in the military. RESULTS: Female veterans with histories of childhood sexual abuse and sexual assault in the military reported the highest rates of sexual pain ( (3)=40.98, P<.001), posttraumatic stress disorder (PTSD, (3)=88.18, P<.001), and depression ( (3)=56.07, P<.001), followed by women with sexual assault in the military histories alone, women with childhood sexual abuse histories alone, and women with no sexual assault. Female veterans with histories of childhood sexual abuse and sexual assault in the military were 4.33 times more likely to report sexual pain, 6.35 times more likely to report PTSD, and 3.91 times more likely to report depression than female veterans with no sexual assault. CONCLUSION: The relationship between sexual assault and sexual pain in female veterans is distinct from their civilian peers. For female veterans, sexual assault in the military is more detrimental to sexual function (specifically sexual pain) than childhood sexual abuse alone, and the combination of childhood sexual abuse and sexual assault in the military confers the greatest risk for sexual pain. Given this difference in sexual health, treatments for sexual dysfunction related to a history of childhood sexual abuse in civilian women may not be adequate for female veterans. Female veterans may require a targeted treatment approach that takes into account the particular nature and consequences of sexual assault in the military.