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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2002 Apr;56(4):265–271. doi: 10.1136/jech.56.4.265

Sexual assault among North Carolina women: prevalence and health risk factors

S Cloutier 1, S Martin 1, C Poole 1
PMCID: PMC1732116  PMID: 11896133

Abstract

Study objective: Sexual assault is traumatic at the time it occurs, but it also may have longlasting negative effects on physical health. Much of the research linking specific health problems to sexual assault victimisation has used samples from special populations. The goals of this study are to estimate the prevalence of sexual assault in a representative sample of women in North Carolina and examine sexual assault in relation to specific health risk factors for leading causes of morbidity and mortality in women.

Design: The North Carolina Behavioral Risk Factor Surveillance System (BRFSS) is a household telephone survey of non-institutionalised adults, 18 years of age and older, conducted by random digit dialling.

Setting: This investigation focuses on the study participants in the 1997 survey.

Participants: The sample includes 2109 women who responded to the sexual assault questions in the 1997 North Carolina BRFSS interview.

Main results: The lifetime prevalence of sexual assault was 19% (95% CI 17% to 20%), of which 73% of victims experienced or were threatened with forced sexual intercourse. Sexual assault victims, particularly victims of forced intercourse or the threat thereof, were more likely to perceive their general health as being fair or poor (OR=2.3, 95% CI 1.5 to 3.4) and were more likely to have suffered poor physical and mental health in the past month (poor physical health, OR=2.1, 95% CI 1.6 to 2.8; poor mental health, OR= 2.6, 95% CI 1.9 to 3.5). After controlling for sociodemographic factors and health care coverage, victims of forced intercourse or the threat thereof were more likely to smoke cigarettes (OR=2.0, 95% CI 1.4 to 2.8), to have hypertension (OR=1.5, 95% CI 1.1 to 2.2), to have high cholesterol (OR=1.7, 95% CI 1.2 to 2.5), and to be obese (OR=1.7, 95% CI 1.3 to 2.4).

Conclusions: This study shows associations between sexual victimisation and health risk factors in a non-clinical statewide population of women. Future research should determine whether clinically screening for and identifying a history of sexual victimisation among women seen in a variety of health care settings leads to the initiation of effective interventions that help women successfully cope with these violent experiences. There is also a need for further research to investigate the temporal sequence of assaults and subsequent health outcomes by assessing physical health status before and after victimisation.

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Selected References

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  1. Dickinson L. M., deGruy F. V., 3rd, Dickinson W. P., Candib L. M. Health-related quality of life and symptom profiles of female survivors of sexual abuse. Arch Fam Med. 1999 Jan-Feb;8(1):35–43. doi: 10.1001/archfami.8.1.35. [DOI] [PubMed] [Google Scholar]
  2. Eby K. K., Campbell J. C., Sullivan C. M., Davidson W. S., 2nd Health effects of experiences of sexual violence for women with abusive partners. Health Care Women Int. 1995 Nov-Dec;16(6):563–576. doi: 10.1080/07399339509516210. [DOI] [PubMed] [Google Scholar]
  3. Felitti V. J. Childhood sexual abuse, depression, and family dysfunction in adult obese patients: a case control study. South Med J. 1993 Jul;86(7):732–736. doi: 10.1097/00007611-199307000-00002. [DOI] [PubMed] [Google Scholar]
  4. Finkelhor D., Hotaling G., Lewis I. A., Smith C. Sexual abuse in a national survey of adult men and women: prevalence, characteristics, and risk factors. Child Abuse Negl. 1990;14(1):19–28. doi: 10.1016/0145-2134(90)90077-7. [DOI] [PubMed] [Google Scholar]
  5. Glaser J. B., Hammerschlag M. R., McCormack W. M. Epidemiology of sexually transmitted diseases in rape victims. Rev Infect Dis. 1989 Mar-Apr;11(2):246–254. doi: 10.1093/clinids/11.2.246. [DOI] [PubMed] [Google Scholar]
  6. Golding J. M., Cooper M. L., George L. K. Sexual assault history and health perceptions: seven general population studies. Health Psychol. 1997 Sep;16(5):417–425. doi: 10.1037//0278-6133.16.5.417. [DOI] [PubMed] [Google Scholar]
  7. Golding J. M. Sexual assault history and headache: five general population studies. J Nerv Ment Dis. 1999 Oct;187(10):624–629. doi: 10.1097/00005053-199910000-00006. [DOI] [PubMed] [Google Scholar]
  8. Golding J. M. Sexual assault history and physical health in randomly selected Los Angeles women. Health Psychol. 1994 Mar;13(2):130–138. doi: 10.1037//0278-6133.13.2.130. [DOI] [PubMed] [Google Scholar]
  9. Golding J. M., Wilsnack S. C., Learman L. A. Prevalence of sexual assault history among women with common gynecologic symptoms. Am J Obstet Gynecol. 1998 Oct;179(4):1013–1019. doi: 10.1016/s0002-9378(98)70208-x. [DOI] [PubMed] [Google Scholar]
  10. Jenny C., Hooton T. M., Bowers A., Copass M. K., Krieger J. N., Hillier S. L., Kiviat N., Corey L., Stamm W. E., Holmes K. K. Sexually transmitted diseases in victims of rape. N Engl J Med. 1990 Mar 15;322(11):713–716. doi: 10.1056/NEJM199003153221101. [DOI] [PubMed] [Google Scholar]
  11. Kilpatrick D. G., Best C. L., Veronen L. J., Amick A. E., Villeponteaux L. A., Ruff G. A. Mental health correlates of criminal victimization: a random community survey. J Consult Clin Psychol. 1985 Dec;53(6):866–873. doi: 10.1037//0022-006x.53.6.866. [DOI] [PubMed] [Google Scholar]
  12. Koss M. P., Koss P. G., Woodruff W. J. Deleterious effects of criminal victimization on women's health and medical utilization. Arch Intern Med. 1991 Feb;151(2):342–347. [PubMed] [Google Scholar]
  13. Leserman J., Drossman D. A., Li Z., Toomey T. C., Nachman G., Glogau L. Sexual and physical abuse history in gastroenterology practice: how types of abuse impact health status. Psychosom Med. 1996 Jan-Feb;58(1):4–15. doi: 10.1097/00006842-199601000-00002. [DOI] [PubMed] [Google Scholar]
  14. Leserman J., Li Z., Drossman D. A., Hu Y. J. Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits. Psychol Med. 1998 Mar;28(2):417–425. doi: 10.1017/s0033291797006508. [DOI] [PubMed] [Google Scholar]
  15. Miranda J., Azocar F., Komaromy M., Golding J. M. Unmet mental health needs of women in public-sector gynecologic clinics. Am J Obstet Gynecol. 1998 Feb;178(2):212–217. doi: 10.1016/s0002-9378(98)80002-1. [DOI] [PubMed] [Google Scholar]
  16. Moeller T. P., Bachmann G. A., Moeller J. R. The combined effects of physical, sexual, and emotional abuse during childhood: long-term health consequences for women. Child Abuse Negl. 1993 Sep-Oct;17(5):623–640. doi: 10.1016/0145-2134(93)90084-i. [DOI] [PubMed] [Google Scholar]
  17. Plichta S. B., Abraham C. Violence and gynecologic health in women <50 years old. Am J Obstet Gynecol. 1996 Mar;174(3):903–907. doi: 10.1016/s0002-9378(96)70323-x. [DOI] [PubMed] [Google Scholar]
  18. Roberts S. J. The sequelae of childhood sexual abuse: a primary care focus for adult female survivors. Nurse Pract. 1996 Dec;21(12 Pt 1):42, 45, 49-52. doi: 10.1097/00006205-199621120-00004. [DOI] [PubMed] [Google Scholar]
  19. Salmon P., Calderbank S. The relationship of childhood physical and sexual abuse to adult illness behavior. J Psychosom Res. 1996 Mar;40(3):329–336. doi: 10.1016/0022-3999(95)00580-3. [DOI] [PubMed] [Google Scholar]
  20. Sansone R. A., Wiederman M. W., Sansone L. A. Health care utilization and history of trauma among women in a primary care setting. Violence Vict. 1997 Summer;12(2):165–172. [PubMed] [Google Scholar]
  21. Schenck-Gustafsson K. Risk factors for cardiovascular disease in women: assessment and management. Eur Heart J. 1996 Aug;17 (Suppl 500):2–8. doi: 10.1093/eurheartj/17.suppl_d.2. [DOI] [PubMed] [Google Scholar]
  22. Schwartz I. L. Sexual violence against women: prevalence, consequences, societal factors, and prevention. Am J Prev Med. 1991 Nov-Dec;7(6):363–373. [PubMed] [Google Scholar]
  23. Sorenson S. B., Stein J. A., Siegel J. M., Golding J. M., Burnam M. A. The prevalence of adult sexual assault. The Los Angeles Epidemiologic Catchment Area Project. Am J Epidemiol. 1987 Dec;126(6):1154–1164. doi: 10.1093/oxfordjournals.aje.a114753. [DOI] [PubMed] [Google Scholar]
  24. Springs F. E., Friedrich W. N. Health risk behaviors and medical sequelae of childhood sexual abuse. Mayo Clin Proc. 1992 Jun;67(6):527–532. doi: 10.1016/s0025-6196(12)60458-3. [DOI] [PubMed] [Google Scholar]
  25. Walch A. G., Broadhead W. E. Prevalence of lifetime sexual victimization among female patients. J Fam Pract. 1992 Nov;35(5):511–516. [PubMed] [Google Scholar]
  26. Wiederman M. W., Sansone R. A., Sansone L. A. Obesity among sexually abused women: an adaptive function for some? Women Health. 1999;29(1):89–100. doi: 10.1300/J013v29n01_07. [DOI] [PubMed] [Google Scholar]
  27. Wingood G. M., DiClemente R. J. Rape among African American women: sexual, psychological, and social correlates predisposing survivors to risk of STD/HIV. J Womens Health. 1998 Feb;7(1):77–84. doi: 10.1089/jwh.1998.7.77. [DOI] [PubMed] [Google Scholar]

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