High Prevalence of Intimate Partner Violence among Women Veterans – Up to Age 55 – Using VA Primary Care
BACKGROUND:
The US Preventive Services Task Force recommends screening women of childbearing age for current intimate partner violence (IPV) experiences, as early intervention can mitigate the health impact of IPV. VA is in the early stages of implementing a national IPV screening program that is integrated with a broad range of healthcare programs across the system, and identifying the prevalence of past-year IPV among women can inform the development and evaluation of screening and intervention programs. Therefore, this retrospective cohort study sought to identify the prevalence of past-year IPV among women Veterans utilizing VA primary care, and to document associated demographic, military, and primary care characteristics. Investigators used data from the WOMAN (Women's Overall Mental Health Assessment of Needs) survey – a telephone survey conducted in 2012 with a national sample of 6,046 women Veterans. The primary measure was past-year IPV; other measures included patient demographics and military characteristics (i.e., combat exposure). Investigators used self-report and VA data to assess primary care use (VA and non-VA).
FINDINGS:
- The prevalence of past-year IPV among women Veterans who used VA primary care services was 19%, with higher rates (22% to 26%) among women up to age 55. Most women (77%) who experienced IPV identified a VA provider as their usual healthcare provider.
- Women who were not employed full-time, received public assistance, had been homeless within the past year, or had an annual income of less than $25,000 were more likely to have experienced IPV.
- Women who identified as lesbian or bisexual also were more likely to report IPV than heterosexual women, as were those who were the parent/guardian of a child younger than 18 years old.
- Age-adjusted military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of military sexual trauma (MST).
LIMITATIONS:
- Screening measures are not a substitute for a comprehensive assessment of violence history and current safety afforded by a clinical encounter.
- Data were collected via telephone survey, and IPV non-response associated with privacy or safety concerns resulted in a small degree of uncertainty around prevalence estimates.
IMPLICATIONS:
- The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VA as a source of healthcare, reinforces the importance of screening all women for IPV in VA primary care settings.
AUTHOR/FUNDING INFORMATION:
This study was partly supported by HSR&D (SDR 12-196). Dr. Kimerling is part of HSR&D's Center for Innovation to Implementation (Ci2i): Fostering High-Value Care. Dr. Iverson is an HSR&D Career Development Awardee and part of HSR&D's Center for Healthcare Organization and Implementation Research (CHOIR) and the National Center for PTSD, and Dr. Dichter is an HSR&D Career Development Awardee and part of HSR&D's Center for Health Equity Research and Promotion (CHERP).
Kimerling R, Iverson K, Dichter M, et al. Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care. Journal of General Internal Medicine. August 2016;31(8):888-94.
