title: The Veterans Health Administration and military sexual trauma.
abstract: OBJECTIVE
  We examined the utility of the Veterans Health Administration (VHA) universal screening program for military sexual violence.
  
  
  METHODS
  We analyzed VHA administrative data for 185,880 women and 4139888 men who were veteran outpatients and were treated in VHA health care settings nationwide during 2003.
  
  
  RESULTS
  Screening was completed for 70% of patients. Positive screens were associated with greater odds of virtually all categories of mental health comorbidities, including posttraumatic stress disorder (adjusted odds ratio [AOR]=8.83; 99% confidence interval [CI] = 8.34, 9.35 for women; AOR = 3.00; 99% CI = 2.89, 3.12 for men). Associations with medical comorbidities (e.g., chronic pulmonary disease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged.
  
  
  CONCLUSIONS
  The VHA policies regarding military sexual trauma represent a uniquely comprehensive health care response to sexual trauma. Results attest to the feasibility of universal screening, which yields clinically significant information with particular relevance to mental health and behavioral health treatment. Women's health literature regarding sexual trauma will be particularly important to inform health care services for both male and female veterans.
authors.affiliation: Veterans Administration Health Care System, Palo Alto, Calif, USA. rachel.kimerling@va.gov
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
authors.forename: Kristian
authors.initials: K
authors.lastname: Gima
authors.forename: Mark W
authors.initials: MW
authors.lastname: Smith
authors.forename: Amy
authors.initials: A
authors.lastname: Street
authors.forename: Susan
authors.initials: S
authors.lastname: Frayne
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D012742:Sex Offenses / Q000517:prevention & control* / Q000706:statistics & numerical data; D017406:Sexual Harassment / Q000517:prevention & control* / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs