title: Sexual coercion and abuse among women with a severe mental illness in India: an exploratory investigation.
abstract: Research from the west indicates that women living with a psychiatric disorder are particularly vulnerable to sexual coercion and abuse. However, there have been no published reports of sexual abuse among female psychiatric patients in India. This exploratory study sought (1) to determine the prevalence of sexual coercion in a representative sample of female psychiatric patients in India; (2) to identify clinical and sociodemographic correlates of sexual coercion; (3) to clarify the association between sexual coercion and human immunodeficiency virus (HIV)-related risk behavior; and (4) to determine whether self-report of sexual coercion from these patients was recorded in their medical charts. Consecutive female inpatient admissions (N = 146) to a large psychiatric hospital in southern India were assessed using a structured interview and standardized measures. During these structured clinical interviews, sexual coercion was reported by 30% of the 146 women. The most commonly reported experience was sexual intercourse involving threatened or actual physical force (reported by 14% of women), and the most commonly identified perpetrator was the woman's husband or intimate partner (15%), or a person in a position of authority in their community (10%). Women with a history of abuse were more likely to report HIV-related sexual behavior (P <.001). In contrast to the 30% of women who reported sexual coercion during interviews, only 3.5% of the medical records contained this information. Thus, sexual coercion is a serious and prevalent concern among female Indian psychiatric patients, but is rarely reported in medical charts. Increased screening and reporting are indicated, as are sexual abuse prevention and treatment programs.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Prabha S
authors.initials: PS
authors.lastname: Chandra
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carey
authors.forename: Kate B
authors.initials: KB
authors.lastname: Carey
authors.forename: A
authors.initials: A
authors.lastname: Shalinianant
authors.forename: Tinku
authors.initials: T
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007297:Inpatients / Q000706:statistics & numerical data; D007406:Interview, Psychological; D008499:Medical Records / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking; D012742:Sex Offenses / Q000208:ethnology / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires