title: Abuse experiences, substance use, and reproductive health in women seeking care at an emergency department.
abstract: BACKGROUND
  Abuse experiences can have negative health consequences for women. Many women present to the emergency department for episodic, nonemergent care and may have unique needs as survivors of abuse. The purpose of this study was to describe child sexual abuse experiences, intimate partner violence, substance use, and reproductive health outcomes in a sample of adult women who were seeking care from a rural emergency department to better understand the health care needs of this unique population.
  
  
  METHODS
  One hundred forty-five adult women (18-45 years old) were recruited at an emergency department in the southeastern United States. Questionnaires were used to assess for demographic characteristics, history of child sexual abuse (CSA), intimate partner violence, reproductive health, and substance use.
  
  
  RESULTS
  In the sample, 42.8% of women (n = 62) reported a positive history of CSA and 34.7% of women (n = 49) experienced intimate partner physical violence during the past year. More than 46% of the women (n = 65) had harmful drinking patterns in the past year and more than 50% reported some type of substance use in the past 3 months. Women who experienced CSA had a significantly greater number of lifetime sexual partners, were more likely to report pain with sexual intercourse, and were more likely to report a medical history of an abnormal Papanicolaou smear.
  
  
  CONCLUSIONS
  The women in this sample had high rates of abuse, harmful drinking patterns, and substance use and were at risk for sexually transmitted infections. Through screening for lifetime violence, including sexual violence, emergency nurses can be an important liaison between women who have experienced CSA and appropriate referrals within the health care system.
authors.affiliation: William F. Connell School ofNursing, Boston College, Chestnut Hill, MA 02467, USA. Melissa.Sutherland.1@bc.edu
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Sutherland
authors.forename: Heidi Collins
authors.initials: HC
authors.lastname: Fantasia
authors.forename: Natalie
authors.initials: N
authors.lastname: McClain
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D017579:Domestic Violence / Q000706:statistics & numerical data*; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012017:Referral and Consultation; D060728:Reproductive Health / Q000706:statistics & numerical data*; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D015144:Southeastern United States / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
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