title: Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care.
abstract: The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics.
  
  
  
  This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey.
  
  
  
  A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study.
  
  
  
  Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via self-report and VHA administrative data.
  
  
  
  The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% - 25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers.
  
  
  
  The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social services and MST-related care.
authors.affiliation: Department of Veterans Affairs, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA. Rachel.Kimerling@va.gov.|Department of Veterans Affairs, Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA. Rachel.Kimerling@va.gov.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
authors.affiliation: Department of Veterans Affairs, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
authors.affiliation: Department of Veterans Affairs, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA.|Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Dichter
authors.affiliation: Department of Veterans Affairs, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Rodriguez
authors.affiliation: Department of Veterans Affairs, Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.
authors.forename: Ava
authors.initials: A
authors.lastname: Wong
authors.affiliation: Department of Veterans Affairs, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Pavao
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence / Q000517:prevention & control / Q000523:psychology* / Q000639:trends; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods* / Q000639:trends; D012189:Retrospective Studies; D013179:Spouse Abuse / Q000517:prevention & control / Q000523:psychology / Q000639:trends; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000639:trends; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
keywords: domestic violence; primary care; veterans; women’s health