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Mental and Physical Health Correlates of Sex Partnership in U.S. Women Veterans
Booth BM, Cheney AM, Mengeling M, Torner J, Sadler A. Mental and Physical Health Correlates of Sex Partnership in U.S. Women Veterans. Poster session presented at: International Association for Women's Mental Health Biennial World Congress; 2013 Mar 7; Lima, Peru.
Purpose: To identify the mental health and physical health correlates of sex partnership in U.S. women veterans.
Methods: 1004 women veterans registered in databases associated with a U.S. Midwestern Veterans Affairs (VA) Medical Center participated in telephone interviews to ascertain health issues focused on women's health. The study interview, all administered by trained women interviewers, included information regarding sexual assault history, including rape occurring in the military, mental health including depression, post-traumatic stress disorder (PTSD), substance use disorder, current health status measured by the Physical Health Component of the SF-12 (PCS-12), and lifetime sex partnership (pre-military, in-military, post-military, women only, men only, both men and women).
Results: 11% reported women as sex partners (WSW) at some time in their lives. In bivariate analysis, history of WSW was significantly (p < 0.05) associated with: lower PCS-12 (4 points), childhood/adolescent rape (50.4% v. 28.6%), in-military rape (35.1% v. 23.3%), and post-military rape (19.8% v 10.0%), depression (45.9% v 28.3%), and PTSD (36.9% v 23.1%), chronic pain ((83.6% v 68.9%) and lifetime substance use disorder (SUD, 66.7% v 30.5%). Multivariate analysis found that WSW was significantly associated with lifetime SUD (OR = 3.6, CI = 2.3, 5.7) but not PCS-12, both adjusting for demographics, rape history, and mental health problems. Chronic pain mediated the relationship between WSW and PCS-12 as well as between childhood rape, depression, and current SUD and PCS-12.
Conclusions: Clinicians evaluating U.S. women veterans' physical and mental health should obtain careful sexual histories (both for lifetime/in-military rape and sex partnership) and query associated comorbidities, including chronic pain, substance abuse, depression, and PTSD. Clinicians also need to be aware that chronic pain history may point to a history of depression, PTSD, and sexual abuse in women veterans. They should also be aware that US women veterans may be reluctant to report histories of either WSW or in-military rape, given possible concerns regarding adverse career and interpersonal consequences, such as discrimination.