Genital Injury and Intimate Partner Violence as Determinants of Women's Reproductive Healthcare Utilization 1-Year Post-Sexual Assault Medical-Forensic Examination

Abstract

The purpose of this study was to understand the impact of anal/vaginal injury and intimate partner violence (IPV) on women's (n = 679) reproductive healthcare utilization in the year following a sexual assault medical-forensic examination. A significant main effect of IPV on reproductive healthcare visits was found such that experiencing IPV was associated with an increase in the incidence rate for count of obstetrics-gynecology/sexually transmitted infection visits across anal/vaginal injury models. Further, IPV was not found to significantly moderate the relationship between anal/vaginal injury and reproductive healthcare utilization. Implications surrounding sexual assault survivors long-term are discussed.

Keywords

sexual assault women intimate partner violence reproductive care healthcare utilization

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References

Anderson

D. K.

Saunders

D. G.

(2003). Leaving an abusive partner: An empirical review of predictors, the process of leaving, and psychological well-being. Trauma, Violence, & Abuse, 4(2), 163–191. https://doi.org/10.1177/1524838002250769

Bair-Merritt

M. H.

Lewis-O’Connor

Goel

Amato

Ismailji

Jelley

Lenahan

Cronholm

(2014). Primary care-based interventions for intimate partner violence: A systematic review. American Journal of Preventive Medicine, 46(2), 188–194. https://doi.org/10.1016/j.amepre.2013.10.001

Basile

K. C.

Smith

S. G.

Liu

Kresnow

M. J.

Fasula

A. M.

Gilbert

Chen

(2018). Rape-related pregnancy and association with reproductive coercion in the US. American Journal of Preventive Medicine, 55(6), 770–776. https://doi.org/10.1016/j.amepre.2018.07.028

Black

M. C.

Basile

K. C.

Breiding

M. J.

Smith

S. G.

Walters

M. L.

Merrick

M. T.

Chen

Stevens

M. R.

(2011). National intimate partner and sexual violence survey: 2010 summary report. National Criminal Justice Reference Service, 237027. https://www.ojp.gov/ncjrs/virtual-library/abstracts/national-intimate-partner-and-sexual-violence-survey

Bodner

T. E.

(2008). What improves with increased missing data imputations? Structural Equation Modeling, 15(4), 651–675. https://doi.org/10.1080/10705510802339072

Brookmeyer

K. A.

Beltran

Abad

(2017). Understanding the effects of forced sex on sexually transmitted diseases acquisition and sexually transmitted disease care: Findings from the national survey of family growth (2011–2013). Sexually Transmitted Diseases, 44(10), 613–618. https://doi.org/10.1097/OLQ.0000000000000651

Brown

S. J.

Goetzmann

Ibbotson

R. G.

Ross

S. A.

(1992). Survivorship bias in performance studies. The Review of Financial Studies, 5(4), 553–580. https://doi.org/10.1093/rfs/5.4.553

Budd

K. M.

Rocque

Bierie

D. M.

(2019). Deconstructing incidents of campus sexual assault: Comparing male and female victimizations. Sexual Abuse, 31(3), 296–317. https://doi.org/10.1177/1079063215594376

Campbell

J. C.

Baty

M. L.

Ghandour

R. M.

Stockman

J. K.

Francisco

Wagman

(2008). The intersection of intimate partner violence against women and HIV/AIDS: A review. International Journal of Injury Control and Safety Promotion, 15(4), 221–231. https://doi.org10.1080/17457300802423224 https://doi.org/10.1080/17457300802423224

10.

Coulter

R. W.

Mair

Miller

Blosnich

J. R.

Matthews

D. D.

McCauley

H. L.

(2017). Prevalence of past-year sexual assault victimization among undergraduate students: Exploring differences by and intersections of gender identity, sexual identity, and race/ethnicity. Prevention Science, 18(6), 726–736. https://doi.org/10.1007/s11121-017-0762-8

11.

Dworkin

E. R.

Menon

S. V.

Bystrynski

Allen

N. E.

(2017). Sexual assault victimization and psychopathology: A review and meta-analysis. Clinical Psychology Review, 56, 65–81. https://doi.org/10.1016/j.cpr.2017.06.002

12.

Edwards

K. M.

Mauer

V. A.

Huff

Farquhar-Leicester

Sutton

T. E.

Ullman

S. E.

(2023). Disclosure of sexual assault among sexual and gender minorities: A systematic literature review. Trauma, Violence, & Abuse, 24(3), 1608–1623. https://doi.org/10.1177/15248380211073842

13.

Edwards

K. M.

Sylaska

K. M.

Neal

A. M.

(2015). Intimate partner violence among sexual minority populations: A critical review of the literature and agenda for future research. Psychology of Violence, 5(2), 112–121. https://doi.org/10.1037/a0038656

14.

Gilmore

A. K.

McKee

Flanagan

J. C.

Leone

R. M.

Oesterle

D. W.

Kirby

C. M.

Short

Gill-Hopple

(2022). Medications at the emergency department after recent rape. Journal of Interpersonal Violence, 37(15-16), NP12954–NP12972. https://doi.org/10.1177/0886260521997434

15.

Hullenaar

K. L.

Frisco

(2020). Understanding the barriers of violence victims’ healthcare use. Journal of Health and Social Behavior, 61(4), 470–485. https://doi.org/10.1177/0022146520961481

16.

IBM Corp. Released. (2021). IBM SPSS Statistics for Windows, Version 28.0. IBM Corp.

17.

Kaiser Family Foundation . (2021). Women’s sexual and reproductive health services: Key findings from the 2020 KFF Women’s Health Survey. https://www.kff.org/womens-health-policy/issue-brief/womens-sexual-and-reproductive-health-services-key-findings-from-the-2020-kff-womens-health-survey/

18.

Kamimura

Bybee

Yoshihama

(2014). Factors affecting initial intimate partner violence–specific health care seeking in the Tokyo metropolitan area, Japan. Journal of Interpersonal Violence, 29(13), 2378–2393. https://doi.org/10.1177/0886260513518842

19.

Kapur

N. A.

Windish

D. M.

(2011). Health care utilization and unhealthy behaviors among victims of sexual assault in Connecticut: Results from a population-based sample. Journal of General Internal Medicine, 26(5), 524–530. https://doi.org/10.1007/s11606-010-1614-4

20.

Kazmerski

McCauley

H. L.

Jones

Borrero

Silverman

J. G.

Decker

M. R.

Tancredi

Miller

(2015). Use of reproductive and sexual health services among female family planning clinic clients exposed to partner violence and reproductive coercion. Maternal and Child Health Journal, 19(7), 1490–1496. https://doi.org/10.1007/s10995-014-1653-2

21.

Keeling

Birch

(2004) The prevalence rates of domestic abuse in women attending a family planning clinic. Journal of Family and Reproductive Health, 30(2), 113–114. https://doi.org/10.1783/147118904322995500

22.

Kennedy

K. M.

(2013). Heterogeneity of existing research relating to sexual violence, sexual assault and rape precludes meta-analysis of injury data. Journal of Forensic and Legal Medicine, 20(5), 447–459. https://doi.org/10.1016/j.jflm.2013.02.002

23.

Lathan

E. C.

Koon-Magnin

Selwyn

C. N.

Isaak

Langhinrichsen-Rohling

(2023). Rape myth acceptance and other barriers to formally reporting sexual assault among college students with and without sexual assault histories. Journal of Interpersonal Violence, 38(9-10), 6773–6797. https://doi.org/10.1177/08862605221137703

24.

Little

R. J. A.

(1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198–1202. https://doi.org/10.1080/01621459.1988.10478722

25.

Long

J. S.

(1997). Regression models for categorical and limited dependent variables, vol. 7. In Advanced quantitative techniques in the social sciences (pp. 250–255). Sage Publications.

26.

Mengeling

M. A.

Booth

B. M.

Torner

J. C.

Sadler

A. G.

(2015). Post-sexual assault health care utilization among OEF/OIF servicewomen. Medical Care, 53(4s1), S136–S142. https://doi.org/10.1097/MLR.0000000000000267

27.

Mosley

E. A.

Prince

J. R.

McKee

G. B.

Carter

S. E.

Leone

R. M.

Gill-Hopple

Gilmore

A. K.

(2021). Racial disparities in sexual assault characteristics and mental health care after sexual assault medical forensic exams. Journal of Women’s Health, 30(10), 1448–1456. https://doi.org/10.1089/jwh.2020.8935

28.

Oesterle

D. W.

McKee

G. B.

Dworkin

E. R.

Blackburn

A. M.

Daigle

L. E.

Gill-Hopple

Gilmore

A. K.

(2024). Characteristics of sexual assault among men receiving a forensic medical examination. Journal of Child Sexual Abuse,33(3), 1–18. https://doi.org/10.1080/10538712.2023.2249890

29.

R Core Team. (2021). R: A language and environment for statistical computing. R Foundation for Statstical Computing, Vienna, Austria. https://www.R-project.org/

30.

Resnick

H. S.

Acierno

Kilpatrick

D. G.

(1997). Health impact of interpersonal violence. 2: Medical and mental health outcomes. Behavioral Medicine, 23(2), 65–78. https://doi.org/10.1080/08964289709596730

31.

Resnick

H. S.

Holmes

M. M.

Kilpatrick

D. G.

Clum

Acierno

Best

C. L.

Saunders

B. E.

(2000). Predictors of post-rape medical care in a national sample of women. American Journal of Preventive Medicine, 19(4), 214–219. https://doi.org/10.1016/S0749-3797(00)00226-9

32.

Rickert

V. I.

Wiemann

C. M.

Harrykissoon

S. D.

Berenson

A. B.

Kolb

(2002). The relationship among demographics, reproductive characteristics, and intimate partner violence. American Journal of Obstetrics and Gynecology, 187(4), 1002–1007. https://doi.org/10.1067/mob.2002.126649

33.

Rivara

F. P.

Anderson

M. L.

Fishman

Bonomi

A. E.

Reid

R. J.

Carrell

Thompson

R. S.

(2007). Healthcare utilization and costs for women with a history of intimate partner violence. American Journal of Preventative Medicine, 32(8), 89–96. https://doi.org/10.1016/j.amepre.2006.10.001

34.

Robohm

J. S.

Buttenheim

(1996). The gynecological care experience of adult survivors of childhood sexual abuse: A preliminary investigation. Women & Health, 24(3), 59–75. https://doi.org/10.1300/J013v24n03_04

35.

Selwyn

C. N.

Lathan

E. C.

Richie

Gigler

M. E.

Langhinrichsen-Rohling

(2021). Bitten by the system that cared for them: Towards a trauma-informed understanding of patients’ healthcare engagement. Journal of Trauma & Dissociation, 22(5), 636–652. https://doi.org/10.1080/15299732.2020.1869657

36.

Short

N. A.

Lechner

McLean

B. S.

Tungate

A. S.

Black

Buchanan

J. A.

Reese

J. D.

Reed

G. D.

Platt

M. A.

Riviello

R. J.

Rossi

C. H.

Nouhan

P. P.

Phillips

C. A.

Martin

S. L.

Liberzon

Rauch

S. A. M.

Bollen

K. A.

Kessler

R. C.

McLean

S. A.

(2020). Health care utilization by women sexual assault survivors after emergency care: Results of a multisite prospective study. Anxiety and Depression Association of America, 38(1), 67–78. https://doi.org/10.1002/da.23102

37.

Sommers

M. S.

(2007). Defining patterns of genital injury from sexual assault. Trauma, Violence, & Abuse, 8(3), 270–280. https://doi.org/10.1177/1524838007303194

38.

Sualp

Forgetta

Anderson

Revell

Godbee

(2021). “Let's not talk about it:” multiple perspectives on service barriers and recommendations for black sexual assault survivors: A mixed-methods study. Journal of Social Service Research, 47(1), 118–130. https://doi.org/10.1080/01488376.2020.1725218

39.

Taft

Watson

L. F.

(2008). Depression and termination of pregnancy (induced abortion) in a national cohort of young Australian women: The confounding effect of women's experience of violence. BMC Public Health, 8, 75. https://doi.org/10.1186/1471-2458-8-75

40.

Truong

Pho

Dinh

McAleer

(2021). Zero-inflated Poisson regression models: Applications in the sciences and social sciences. Annals of Financial Economics, 16(2), 1–19. https://doi.org/10.1142/S2010495221500068

41.

Van Buuren

Groothuis-Oudshoorn

(2011). mice: Multivariate imputation by chained equations in R. R package version 3.16.0. https://CRAN.R-project.org/package=mice

42.

Walsh

Zinzow

H. M.

Badour

C. L.

Ruggiero

K. J.

Kilpatrick

D. G.

Resnick

H. S.

(2016). Understanding disparities in service seeking following forcible versus drug- or alcohol-facilitated/incapacitated rape. Journal of Interpersonal Violence, 31(14), 2475–2491. https://doi.org/10.1177/0886260515576968

43.

Watson-Johnson

L. C.

Townsend

J. S.

Basile

K. C.

Richardson

L. C.

(2012). Cancer screening and history of sexual violence victimization among U.S. adults. Journal of Women's Health (2002), 21(1), 17–25. https://doi.org/10.1089/jwh.2011.2751

44.

Williamson

Serna

(2018). Reconsidering forced labels: Outcomes of sexual assault survivors versus victims (and those who choose neither). Violence Against Women, 24(6), 668–683. https://doi.org/10.1177/1077801217711268

45.

Wright

E. N.

Anderson

Phillips

Miyamoto

(2022). Help-seeking and barriers to care in intimate partner sexual violence: A systematic review. Trauma, Violence, & Abuse, 23(5), 1510–1528. https://doi.org/10.1177/1524838021998305

46.

Zilkens

R. R.

Smith

D. A.

Phillips

M. A.

Mukhtar

S. A.

Semmens

J. B.

Kelly

M. C.

(2017). Genital and anal injuries: A cross-sectional Australian study of 1266 women alleging recent sexual assault. Forensic Science International, 275, 195–202. https://doi.org/10.1016/j.forsciint.2017.03.013

47.

Zinzow

H. M.

Resnick

H. S.

McCauley

J. L.

Amstadter

A. B.

Ruggiero

K. J.

Kilpatrick

D. G.

(2012). Prevalence and risk of psychiatric disorders as a function of variant rape histories: Results from national survey of women. Social Psychiatry and Psychiatric Epidemiology, 47(6), 893–902. https://doi.org/10.1007/s00127-011-0397-1