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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.092999v1 97/12/2160    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kimerling, R. Articles by Frayne, S. Search for Related Content PubMed PubMed Citation Articles by Kimerling, R. Articles by Frayne, S. Related Collections Gender Health Care Facilities/Services Screening

Rachel Kimerling, PhD, Kristian Gima, BA, Mark W. Smith, PhD, Amy Street, PhD and Susan Frayne, MD, MPH

Rachel Kimerling and Kristian Gima are with the Veterans Administration Health Care System, Palo Alto, Calif. Mark W. Smith and Susan Frayne are with the Veterans Administration Health Care System, Palo Alto, and also with the Center for Primary Care and Outcomes Research at the Stanford University School of Medicine, Palo Alto. Susan Frayne is also with the Division of General Internal Medicine, Department of Medicine, at Stanford University, Palo Alto. Amy Street is with the Veterans Administration Health Care System in Boston, Mass, and the Department of Psychiatry, Boston University School of Medicine, Boston.

Correspondence: Requests for reprints should be sent to Rachel Kimerling, PhD, National Center for PTSD, VA Palo Alto Health Care System PTSD-334, 795 Willow Rd, Menlo Park, CA 94025 (e-mail: rachel.kimerling{at}va.gov).

Objectives. We examined the utility of the Veterans Health Administration (VHA) universal screening program for military sexual violence.

Methods. We analyzed VHA administrative data for 185 880 women and 4139888 men who were veteran outpatients and were treated in VHA health care settings nationwide during 2003.

Results. Screening was completed for 70% of patients. Positive screens were associated with greater odds of virtually all categories of mental health comorbidities, including posttraumatic stress disorder (adjusted odds ratio [AOR]=8.83; 99% confidence interval [CI] = 8.34, 9.35 for women; AOR = 3.00; 99% CI = 2.89, 3.12 for men). Associations with medical comorbidities (e.g., chronic pulmonary disease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged.

Conclusions. The VHA policies regarding military sexual trauma represent a uniquely comprehensive health care response to sexual trauma. Results attest to the feasibility of universal screening, which yields clinically significant information with particular relevance to mental health and behavioral health treatment. Women’s health literature regarding sexual trauma will be particularly important to inform health care services for both male and female veterans.