Sexual health difficulties among service women: the influence of posttraumatic stress disorder

• Published in: Journal of affective disorders Vol. 292; pp. 678 - 686
• Main Authors: Kolaja, Claire A., Schuyler, Ashley C., Armenta, Richard F., Orman, Jean A., Stander, Valerie A., LeardMann, Cynthia A.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.09.2021
• Subjects: Combat; Military service; Posttraumatic stress disorder; Sexual assault; Sexual health difficulties; Women; Women; Posttraumatic stress disorder; Military service; Sexual assault; Combat; Sexual health difficulties
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2021.05.089

•Sexual health of service women found to be negatively impacted by recent combat deployment and sexual assault.•PTSD mediated the associations of recent combat deployment and sexual assault with sexual health difficulties.•Some military factors (i.e., service branch, component, paygrade) were associated with sexual health difficulties among service women.•Findings indicate that effective treatment of PTSD may mitigate sexual health issues and more comprehensive treatment options for sexual health problems should be available for service women. Background Sexual health among service women remains understudied, yet is related to health and quality of life. This study examined if the associations between recent combat and sexual assault with sexual health difficulties were mediated by mental disorders and identified factors associated with sexual health difficulties among service women. Methods Data from two time points (2013 and 2016) of the Millennium Cohort Study, a large military cohort, were used. The outcome was self-reported sexual health difficulties. Mediation analyses examined probable posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) as intermediate variables between recent combat and sexual assault with the sexual health difficulties. Multivariable logistic regression modeling was used to examine the association of demographic, military, historical mental health, life stressors, and physical health factors with sexual health difficulties. Results Of the 6,524 service women, 13.5% endorsed experiencing sexual health difficulties. Recent combat and sexual assault were significantly associated with sexual health difficulties. Probable PTSD mediated the associations of recent combat and sexual assault with sexual health difficulties; probable MDD did not mediate these relationships. Other significant factors associated with sexual health difficulties included enlisted rank, historical mental disorders, childhood trauma, and disabling injury. Limitations Use of self-reported data, outcome not assessed using a standardized measure and future studies may benefit from examining other mediators. Conclusion Our findings that combat and sexual assault may have negative effects on service women's sexual health suggest that treatment options and insurance coverage for sexual health problems should be expanded.