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Women Veterans: In-military Rape and VA Health Care Need, Perception, and Use

Mengeling M, Sadler AG, Torner J, Booth B. Women Veterans: In-military Rape and VA Health Care Need, Perception, and Use. Paper presented at: VA HSR&D Field-Based Women's Health Meeting; 2010 Jul 16; Washington, DC.

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Objectives: Identify differences in need, perception, and use of VA health care in women veterans by sexual trauma history. Methods: 1004 women veterans (ages 20 - 52) participated in a retrospective study of current health, health risk behaviors, sexual assault history and health care utilization. Participants had enrolled in Iowa City, Des Moines VAMCs or their outlying clinics within the 5 years preceding research interview. Results: Over half (62%) of participants reported attempted and/or completed sexual assault during lifetime. 32% experienced Military Sexual Trauma (MST) with 37% reporting repeated occurrences of MST. Women experiencing a sexual trauma were more likely to be depressed (39% vs 16%, p < .0001) or to have a PTSD diagnosis (35% vs 11%) compared to their non-assaulted peers; 22% of those experiencing a sexual trauma were diagnosed with both PTSD and depression. Compared to non-victimized peers, women reporting MST were significantly less likely to believe they can feel safe from sexual harassment at a VAMC (74% vs 81%), and more likely to want separate waiting areas for women (13% vs 7%), a female "chaperone" during a physical examination (51% vs 40%), health services specific to women's needs (92% vs 85%), and a choice of male or female provider (64% vs 43%) (p < .01). Women who receive all of the medical care at a VA health care facility are more likely to have experienced a lifetime sexual assault (70% vs 58%) (p < .001) and MST (39% vs 29%) (p < .01). Conclusions: Our findings suggest that women who have experienced MST are more likely to have PTSD and depression and to receive their medical care at VAMCs. Women who have experienced MST and seek health care at a VAMC place importance on separate waiting areas for men and women, having female chaperones during a physical examination, having health care services specific to women's needs, and having a choice of a male or female health care provider. Impacts: Women seeking VA health care have specific environment of care concerns and needs. To meet the needs of a priority care MST population, differences in environment and resources are required to provide optimal care for women veterans.

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