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Correlates of Sexual Functioning in Women Veterans: Mental Health, Gynecological Health, Health Status, and Sexual Assault History

Mengeling M, Sadler AG, Fraley SS, Torner J, Booth B. Correlates of Sexual Functioning in Women Veterans: Mental Health, Gynecological Health, Health Status, and Sexual Assault History. Poster session presented at: AcademyHealth Annual Research Meeting; 2012 Jun 23; Orlando, FL.

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Research Objective: To describe US women veteran's sexual satisfaction and functioning and to identify specific correlates associated with sexual functioning that could alert healthcare providers to further explore these sensitive topics and address treatment needs. Study Design: A retrospective cohort design. Participants completed a computer-assisted telephone interview, which included questions on demographics, military characteristics, trauma exposures, physical and mental health, and sexual functioning domains. Population Studied: Women < 52 years of age, enrolled at two Midwestern Veterans Affairs (VA) Health Care Systems or outlying clinics within the five years preceding study interview (63% response rate). VA enrollment could have been initiated to receive health care, complete a disability claim, enroll in a registry, or respond to veteran outreach. At the time of enrollment in VA, all women had either been discharged from active duty military service or were Reserve or National Guard servicewomen eligible for services and classified as military veterans. Principal Findings: Half experienced at least one completed sexual assault during their lifetime. Most (68%) reported sex was important in their lives and three-quarters (74%) indicated that they had engaged in sex with a partner during the past six months. Almost one quarter of sexually active participants reported painful sexual intercourse and approximately one third (35%) acknowledged using lubricants often to make sex comfortable. Mental health disorders (post-traumatic stress disorder, depression, substance use disorder), gynecologic injuries resulting from completed sexual assault, and poor health related quality of life were common in this sample and associated with compromised sexual functioning. Most sexually active women endorsing these correlates were more likely to report not being emotionally satisfied with their main partner. Problems with sexual functioning and pain during intercourse were associated with even a single completed lifetime sexual assault (cLSA). Conclusions: Military women are a unique population with occupational and lifetime health risks that may influence their sexual health. Results of this study extend prior research by demonstrating that cLSA, mental health disorders (PTSD, depression, SUD), gynecologic injuries resulting from sexual trauma, and poorer health-related quality of life were common in this sample of U.S. women veterans and were associated with compromised sexual functioning. Implication for Policy, Delivery or Practice: While women of reproductive age are often targeted for sexual violence screening and related health consequences, our data indicate that adverse sexual functioning outcomes, including pain during sex, can be chronic, remaining problematic several years after a cLSA. Sexual functioning and associated correlates are sensitive topics that require clinicians to have good communication skills, supportive interactions, and personal comfort discussing sexual issues. It is also essential to build sufficient rapport so that patient and provider can openly discuss sexuality.

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