Rachel Kimerling ^1*, Kristian Gima ¹, Mark W. Smith ¹, Amy Street ², Susan Frayne ¹

¹ VA Palo Alto Health Care System
² VA Boston Health Care System

^* To whom correspondence should be addressed. E-mail: rachel.kimerling{at}va.gov.

	Abstract

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.

Key Words: Gender, Health Care Facilities/Services, Screening, Women's Health