Violence and gynecologic health in women <50 years old,☆☆,

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Abstract

OBJECTIVE: Our purpose was to examine, in women aged 18 to 49, the relationship of violent experiences (child abuse, violent crime, spouse abuse) to gynecologic problems. STUDY DESIGN: Data from 1599 participants in a randomized, sociodemographically representative telephone survey of U.S. women were used. Gynecologic problems were measured by self-report of receiving a physician's diagnosis of severe menstrual problems, a sexually transmitted disease, or a urinary tract infection. Statistical analyses used were the χ2 test and multiple logistic regression. RESULTS: A total of 31.5% of participants reported a diagnosis of gynecologic problems in the past 5 years. Those with problems were more likely to report childhood abuse, violent crime victimization, and spouse abuse. In logistic regression models controlling for sociodemographic factors and access to medical care, violence events remained significantly associated with gynecologic problems. CONCLUSIONS: A history of gynecologic problems may indicate that a patient has been harmed by violence. However, all women are at risk of being harmed by violence, and a violence history should be obtained as part of the intake protocol for all patients. Physicians need to be prepared to provide information about local community services, including counseling, domestic violence centers, shelters, and advocacy groups. (AM J OBSTET GYNECOL 1996;174:903-7.)

Section snippets

Sample

The data are from the Commonwealth Fund's National Survey of Women's Health, conducted via telephone between Feb. 10, 1993, and March 21, 1993, by Louis Harris and Associates. A sampling strategy that created a systematic, stratified random sample of all U.S. households was used; overall 2525 women participated in the survey (response rate 56%). There was a systematic oversampling of African-American and Latina women to ensure a diversity of women in each ethnic group were represented in the

RESULTS

One fifth (20%) of the study participants were abused as children; 7.6% reported physical abuse only, and 12.4% reported being sexually abused. In the past 5 years 13.9% of participants were the victims of violent crimes (10.2% reported nonsexual crimes only, and 3.7% reported being raped or sexually assaulted). Note that married women reported the lowest rate of rape - sexual assault in the past 5 years (1.2%) and that single or divorced women reported the highest rate (8.0%). Almost 10% of

Limitations of this study

The major limitations of this study are that it is cross-sectional and depends on retrospective reporting by the respondent. It is not possible to ascribe causality to any statistical relationships that are found, and a longitudinal study would be needed to clarify the timing between violent incidents and health effects. In addition, it is likely that traumatic events such as child sexual abuse or spouse abuse are underreported because of either recall bias or social desirability bias.

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  • Cited by (0)

    From the College of Health Sciences, Old Dominion University, Virginia,aand the Division of General Medicine, Department of Internal Medicine, Mount Sinai Hospital, New York.b

    ☆☆

    Reprint requests: Stacey B. Plichta, ScD, College of Health Sciences, Old Dominion University, 200 Science Way, Room 115, Norfolk, VA 23529-0186.

    0002-9378/96 $5.00 + 0 6/1/68743

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