title: Is military sexual trauma associated with trading sex among women veterans seeking outpatient mental health care?
abstract: A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks and seroprevalence among women receiving outpatient mental health care at a Veterans Affairs (VA) medical center. Each woman completed an assessment interview composed of validated measures that queried childhood sexual trauma; substance use; and risk behaviors, including trading sex for money, drugs, shelter, food, or other things. History of MST was derived from mandated VA screening results and chart notes. Overall, 19.7% reported a history of trading sex. Those who reported trading sex had a higher rate of MST than those who did not report trading sex (87.2% vs. 62.9%, respectively). A multivariable logistic regression model examined the relationship between trading sex and MST, controlling a priori for substance abuse and childhood sexual trauma (both associated with trading sex in civilian samples) and education, which was associated with trading sex in our sample. In this adjusted model, MST was associated with trading sex: odds ratio = 3.26, p = .025, 95% confidence interval = [1.16, 9.18]. To our knowledge, this is the 1st report of an association between MST and trading sex. Results extend previously observed associations between sexual trauma and trading sex in civilian cohorts and underscore the pernicious influence of sexual victimization across the lifespan.
authors.affiliation: Health Services Research & Development, Durham VA Medical Center, Durham, North Carolina 27705, USA. jennifer.strauss@duke.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Strauss
authors.forename: Christine E
authors.initials: CE
authors.lastname: Marx
authors.forename: Julie C
authors.initials: JC
authors.lastname: Weitlauf
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.forename: Kristy
authors.initials: K
authors.lastname: Straits-Troster
authors.forename: Ayaba W
authors.initials: AW
authors.lastname: Worjoloh
authors.forename: Christina B
authors.initials: CB
authors.lastname: Sherrod
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.forename: Marian I
authors.initials: MI
authors.lastname: Butterfield
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015528:HIV Seroprevalence; D006306:Health Surveys; D006801:Humans; D008605:Mental Health Services; D008875:Middle Aged; D015999:Multivariate Analysis; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D011477:Sex Work / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data