The Veterans Health Administration Response to Military Sexual Trauma

Women at War ◽  
2015 ◽  
pp. 321-328 ◽  
Author(s):  
Margret E. Bell ◽  
Susan J. McCutcheon
Keyword(s):  
Sexual Trauma ◽  
Veterans Health Administration ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration

scholarly journals The Veterans Health Administration and Military Sexual Trauma

2007 ◽  
Vol 97 (12) ◽  
pp. 2160-2166 ◽  
Author(s):  
Rachel Kimerling ◽  
Kristian Gima ◽  
Mark W. Smith ◽  
Amy Street ◽  
Susan Frayne
Keyword(s):  
Sexual Trauma ◽  
Veterans Health Administration ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration

scholarly journals 1353. Gonorrhea and Chlamydia Testing and Case Rates Among Women Veterans in the Veterans Health Administration

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S763-S764
Author(s):  
Shimrit Keddem ◽  
Marissa Maier ◽  
Carolyn Gardella ◽  
Joleen Borgerding ◽  
Elliott Lowy ◽  
...  
Keyword(s):  
Sexual Trauma ◽  
Women Veterans ◽  
Veterans Health Administration ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration ◽  
Infection Rates ◽  
Factors Associated ◽  
Chlamydia Testing ◽  
Case Rate

Abstract Background United States (US) rates of sexually transmitted infection (STI) in women, especially gonorrhea and chlamydia, have increased over the past decade. Women Veterans have many risk factors associated with STIs, including high rates of childhood sexual assault, military sexual trauma and intimate partner violence. Despite the availability of effective diagnostic tests and evidence-based guidelines for annual screening among sexually active women under age 25, screening rates for gonorrhea and chlamydia remain low in the US and among Veterans. Methods We performed a retrospective cohort study of all women Veterans in Veterans Health Administration (VHA) care between January 1, 2018 and December 31, 2019 to examine patient characteristics and health system factors associated with gonorrhea and chlamydia testing and case rates among women Veterans in the VHA in 2019. Results Among women under age 25, 21.3% were tested for gonorrhea or chlamydia in 2019. After adjusting for demographic and other health factors, predictors of testing in women under age 25 included Black race (aOR: 2.11 CI: 1.89, 2.36), rural residence (aOR: 0.84, CI: 0.74, 0.95), and cervical cancer screening (aOR: 5.05 CI: 4.59, 5.56). Women under age 25 had the highest infection rates, with an incidence of chlamydia and gonorrhea of 1,950 and 267 cases/100,000, respectively. Incidence of gonorrhea and chlamydia was higher for women with a history of military sexual trauma (MST) (Chlamydia case rate: 265, Gonorrhea case rate: 97/100,000) and those with mental health diagnoses (Chlamydia case rate: 263, Gonorrhea case rate: 72/100,000.) Over a third of chlamydia cases (35.2%) and gonorrhea cases (35.5%) occurred in women who resided in the South Atlantic census division. Chlamydia cases per 100,000 women Veterans seen in VHA (2019) Gonorrhea cases per 100,000 women Veterans seen in VHA (2019) Conclusion Gonorrhea and chlamydia testing remains underutilized among women in the VHA and infection rates are high among younger women. Patient-centered, system-level interventions are urgently needed to address low testing rates. Disclosures All Authors: No reported disclosures

The influence of gender on suicidal ideation following military sexual trauma among Veterans in the Veterans Health Administration

2016 ◽  
Vol 244 ◽  
pp. 257-265 ◽  
Author(s):  
Lindsey L. Monteith ◽  
Nazanin H. Bahraini ◽  
Bridget B. Matarazzo ◽  
Holly R. Gerber ◽  
Kelly A. Soberay ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Sexual Trauma ◽  
Veterans Health Administration ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration

scholarly journals Patient Characteristics Associated With the Receipt of Hormone Therapy Among Transgender Patients in the Veterans Health Administration

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A794-A794
Author(s):  
Denise H Wong ◽  
Varsha G Vimalananda ◽  
Joel I Reisman ◽  
Sowmya R Rao ◽  
Jillian C Shipherd ◽  
...  
Keyword(s):  
Gender Identity ◽  
Hormone Therapy ◽  
Sexual Trauma ◽  
Patient Characteristics ◽  
Veterans Health Administration ◽  
Sex Characteristics ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration ◽  
Social Stressors

Abstract Background: Many transgender patients experience gender dysphoria as a result of an incongruence between their gender identity and sex assigned at birth. Gender-affirming hormone therapy improves the quality of life for transgender patients seeking to increase alignment of their secondary sex characteristics and gender identity. However, little is known about the patient factors that are associated with receipt of this therapy which is critical to identifying areas for improvement in care for transgender patients. Objective: To evaluate patient characteristics associated with transgender patients’ receipt of hormone therapy from the Veterans Health Administration (VHA). Methods: Inpatient and outpatient data were reviewed for transgender patients, identified through ICD-9/ICD-10 diagnosis codes for gender identity disorder (GID), receiving VHA health care from January 2006 to December 2018. We evaluated receipt of hormone therapy (testosterone or estrogen +/- spironolactone) from the VHA, socio-demographics, comorbidities, social stressors, military sexual trauma, and documented suicide attempts. Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (CI) were obtained from a multivariable logistic regression model used to ascertain the relationship between patient characteristics and hormone therapy. Results: Of 9,406 patients with documented GID, 5,487 (58.3%) received hormone therapy from the VHA. Compared to patients not receiving hormone therapy, a higher proportion of patients receiving hormone therapy were younger (21-29 years: 18.1% vs. 11.6%; 30-39 years: 20.0% vs. 14.6%; 40-49 years: 16.2% vs. 13.6%), had documentation of a positive military sexual trauma screening (22.2% vs. 16.2%; p<0.0001), and a suicide attempt (11.4% vs. 9.9%; p=0.0067). There were significant associations between receipt of hormone therapy and: 1) younger age (aOR: 1.33; 95% CI: 1.29-1.36; p<0.0001); 2) Black non-Hispanic patients (aOR: 0.58; 95% CI: 050-0.68; p<0.0001); 3) increasing number of comorbidities (aOR: 0.86; 95% CI: 0.84-0.88; p<0.0001); and 4) increasing number of social stressors (aOR: 0.86; 95% CI: 0.83-0.90; p<0.0001). Conclusions: Age, race/ethnicity, comorbidities, and social stressors among other factors are associated with receipt of hormone therapy among transgender patients in the VHA. Subsequent efforts should focus on understanding clinician- and site-level determinants to facilitate the design of effective quality improvement measures that optimize gender affirming hormone therapy through VHA for transgender patients.

scholarly journals Military sexual trauma survivors’ perceptions of Veterans Health Administration care: A qualitative examination.

2020 ◽  
Vol 17 (2) ◽  
pp. 178-186 ◽  
Author(s):  
Lindsey L. Monteith ◽  
Nazanin H. Bahraini ◽  
Holly R. Gerber ◽  
Brooke Dorsey Holliman ◽  
Alexandra L. Schneider ◽  
...  
Keyword(s):  
Sexual Trauma ◽  
Veterans Health Administration ◽  
Trauma Survivors ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration

scholarly journals Military-Related Sexual Trauma Among Veterans Health Administration Patients Returning From Afghanistan and Iraq

2010 ◽  
Vol 100 (8) ◽  
pp. 1409-1412 ◽  
Author(s):  
Rachel Kimerling ◽  
Amy E. Street ◽  
Joanne Pavao ◽  
Mark W. Smith ◽  
Ruth C. Cronkite ◽  
...  
Keyword(s):  
Sexual Trauma ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration

Abstract 48: Military Sexual Trauma Is Associated With Incident Hypertension In A 16-year Cohort Study Of 1.2 Million Young And Middle-aged Men And Women

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Allison E Gaffey ◽  
Lindsey Rosman ◽  
Sally G Haskell ◽  
Cynthia A Brandt ◽  
Jason J Sico ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Sexual Trauma ◽  
Lifestyle Factors ◽  
Sensitivity Analyses ◽  
Military Sexual Trauma ◽  
Veterans Health ◽  
Health Administration ◽  
Middle Aged ◽  
Incident Hypertension ◽  
Increased Risk

Introduction: Exposure to traumatic events and the sequelae [e.g., posttraumatic stress disorder (PTSD) and poor health] are linked to incident cardiovascular disease (CVD) in military and community samples. Veterans, especially women, are 3-times as likely to experience sexual harassment and assault [military sexual trauma (MST)] compared to civilian populations. It is unknown if exposure to MST is independently associated with risk of incident hypertension. Methods: We conducted a retrospective analysis to assess the effect of MST on the risk of incident hypertension, defined as a medical record diagnosis, meeting clinical threshold based on blood pressure in vital sign records, or use of antihypertensive medication, in a cohort of 1,177,944 young and middle-aged veterans (mean age= 30.2 [SD:9.2], 12% women) using nationwide data from the Veterans Health Administration from 2001 to 2017. Time-varying multivariate Cox models were computed to estimate hypertension risk by MST status while sequentially adjusting for demographics, lifestyle factors, CVD comorbidities, and psychiatric disorders. Sensitivity analyses controlled for healthcare utilization based on the number of primary care visits over two years after military discharge. Results: During 16 years of follow-up (mean=9.6 years [SD:4.0]), 33,881 veterans screened positive for MST (65% women) and 307,332 patients were diagnosed with hypertension. The overall incidence rate of hypertension was 305.1 events per 1,000-person years. MST was associated with a 30% greater risk of hypertension in unadjusted models (hazard ratio [HR], 1.30 [95% CI, 1.28-1.33]) and remained significantly associated with hypertension in models that adjusted for demographics, lifestyle factors, CVD comorbidities, PTSD, anxiety, and depression (adjusted HR, 1.10 [95% CI, 1.08-1.12]. In sensitivity analyses, the effect of MST remained significant when controlling for healthcare utilization (HR, 1.11, [95% CI, 1.09-1.13]). Conclusions: In this large prospective cohort of young adults, MST was associated with an increased risk of hypertension after controlling for established risk factors. Further research is needed to determine if early identification of MST improves cardiovascular risk management.

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