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Racial Differences in Childbearing Decisions Following Sexual Assault, Self-Reported Infertility and Associated Care

Sadler AG. Racial Differences in Childbearing Decisions Following Sexual Assault, Self-Reported Infertility and Associated Care. Poster session presented at: VA HSR&D Field-Based Equity Conference; 2010 Sep 13; Boston, MA.

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Objectives: Little is known about the impact of race on women's childbearing decisions after sexual assault, or on self-reported infertility and associated care. Methods: 1004 women less than 52 were enrolled in the Iowa City and Des Moines VAMCs and outlying clinics participated in this cross-sectional study. Consenting veterans completed a computer-assisted telephone interview assessing socio-demographic variables, sexual assault exposures, gynecologic diagnoses, procedures and care utilization. Results: Sample race/ethnicity was white (80%) and racial minority (20%): 8% Black, 6% Native American/Alaskan Native, 3% Hispanic, 1 % Asian or Pacific Islander and 2% identified as more than two racial/ethnic groups. Analyses were dichotomized as White/Racial Minority. Mean age of participants was 38 yrs (sd = 8.8), 8S% had at least some college or technical training, median income was $21 ,7S0, and 47% had private insurance. There were no statistical differences between racial groups by age, education, income, private insurance coverage. Racial minorities are significantly more likely to seek VA gynecologic care than whites (74% v 66%, p < .S). Rates of lifetime sexual assault (LSA. 62%) and sexual assault during military service were similar (32%) between whites and racial minorities. Of women experiencing LSA, 19% indicated they had decided to delay childbearing as a direct result of their victimization, but there was no racial difference. Racial minorities were significantly more likely to report they had tried have a baby but couldn't (23% v 17%, p < .OS) but there was no racial difference in the percent of those evaluated for infertility (approximately SO%). Of those who were evaluated for infertility (n = 88), whites were more likely to be treated for infertility than racial minorities (7S% v 38%, p < .01). Conclusions: The frequency of lifetime sexual assault (LSA) is high in this population and 19% of victimized women delay childbearing as a direct result of their victimization. Race has a significant impact on self-reported infertility and infertility treatment. Impact: That women veterans who are racial minorities report greater difficult having children yet receive infertility treatment significantly less frequently than white women suggests that there may be disparities in the reproductive health risks or care that are associated with race. These findings have direct implications for the emerging mental and reproductive health care needs of a priority VA population. Further research is indicated.

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