title: Lifetime Sexual Assault and Sexually Transmitted Infections Among Women Veterans.
abstract: Women veterans report a high prevalence of sexual assault. Unfortunately, there are limited data on the reproductive health sequelae faced by these women. Our objective was to evaluate the association between completed lifetime sexual assault (LSA) and sexually transmitted infections (STIs) among a cohort of women veterans, adjusting for sexual risk behaviors.
  
  
  
  We conducted a retrospective study among women veterans aged 51 years or younger who enrolled for care at two Veterans Administration (VA) healthcare sites between 2000 and 2008. Participants completed a telephone interview assessing reproductive health and sexual violence history. We compared the frequencies of past STI diagnoses among those who had and had not experienced LSA. We used logistic regression to assess the effect of sexual assault with history of an STI diagnosis after adjusting for age, sexual risk behaviors, and substance abuse treatment.
  
  
  
  Among 996 women veterans, a history of STIs was reported by 32%, including a lifetime history of gonorrhea (5%), chlamydia (15%), genital herpes infection (8%), and human papillomavirus infection (15%), not mutually exclusive; 51% reported LSA. Women with a history of LSA were significantly more likely to report a history of STIs (unadjusted odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45-2.50; adjusted OR 1.49, 95% CI 1.07-2.08).
  
  
  
  Women veterans who have experienced LSA are at increased risk for lifetime STI diagnoses. To adequately address the reproductive health needs of the growing population of women veterans, STI risk assessments should include queries of military service and LSA histories.
authors.affiliation: 1 South Texas Veterans Health Care System , San Antonio, Texas.
authors.forename: Vinita
authors.initials: V
authors.lastname: Goyal
authors.affiliation: 2 Comprehensive Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Health Care System , Iowa City, Iowa.|3 VA Office of Rural Health, Veteran Rural Health Resource Center , Iowa City, Iowa.|4 Department of Internal Medicine, University of Iowa Carver College of Medicine , Iowa City, Iowa.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mengeling
authors.affiliation: 5 Center for Mental Healthcare Outcomes and Research, Central Arkansas Veterans Healthcare System , Little Rock, Arkansas.|6 Department of Psychiatry, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
authors.affiliation: 7 Department of Epidemiology, University of Iowa College of Public Health , Iowa City, Iowa.|8 Department of Neurosurgery and Surgery, University of Iowa Carver College of Medicine , Iowa City, Iowa.
authors.forename: James C
authors.initials: JC
authors.lastname: Torner
authors.affiliation: 9 Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine , Iowa City, Iowa.
authors.forename: Craig H
authors.initials: CH
authors.lastname: Syrop
authors.affiliation: 2 Comprehensive Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans Health Care System , Iowa City, Iowa.|10 Department of Psychiatry, University of Iowa Carver College of Medicine , Iowa City, Iowa.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Sadler
mesh_terms: D000328:Adult; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D011902:Rape; D012189:Retrospective Studies; D012742:Sex Offenses / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000382:microbiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: sexual assault; sexual risk veteran; sexually transmitted infection