title: Gang and multiple rapes during military service: health consequences and health care.
abstract: OBJECTIVE
  We aimed to determine whether there were differences in women veteran's health status and use of health care services by type of rape that occurred during military service.
  
  
  METHODS
  We conducted a national cross-sectional survey of women veterans who served in Vietnam and subsequent eras and were listed in Department of Veterans Affairs comprehensive women's health care registries. We used structured telephone interviews to gather socioeconomic information, violence history, use of outpatient health care services, and health status for a random sample, stratified by region and era of service.
  
  
  RESULTS
  Five hundred forty women completed the interview, 28% of whom reported being raped during military service. Nineteen percent reported a single rape, 5% reported repeated rape (range 2-36), and 5% reported gang rape. Women who reported repeated and gang rapes had significantly impaired physical and emotional health compared with women with a single or no rape (p < or = .05). Repeatedly raped women were more likely to use inpatient and outpatient mental health services (p < or = .05). Gang-rape survivors reported the most severe impairment in physical functioning and general health and demonstrated a trend to seek outpatient medical services.
  
  
  CONCLUSIONS
  Simply asking a woman if she has been raped is not sufficient to detect the level of consequences. More than a decade after military discharge, women who experienced repeated or gang rape during their military service had significant impairment of physical and emotional health compared with women with no or a single rape. The differential health effects associated with severe violence supports the public health importance of sexual violence screening, treatment, and prevention.
authors.affiliation: Psychology Service, Iowa City Veterans' Affairs Medical Center, USA.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Sadler
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D030881:Disclosure; D005260:Female; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D011902:Rape / Q000523:psychology* / Q000706:statistics & numerical data*; D012008:Recurrence; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D014932:Women's Health Services / Q000706:statistics & numerical data*