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Abstract
A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks and seroprevalence among women receiving outpatient mental health care at a Veterans Affairs (VA) medical center. Each woman completed an assessment interview composed of validated measures that queried childhood sexual trauma; substance use; and risk behaviors, including trading sex for money, drugs, shelter, food, or other things. History of MST was derived from mandated VA screening results and chart notes. Overall, 19.7% reported a history of trading sex. Those who reported trading sex had a higher rate of MST than those who did not report trading sex (87.2% vs. 62.9%, respectively). A multivariable logistic regression model examined the relationship between trading sex and MST, controlling a priori for substance abuse and childhood sexual trauma (both associated with trading sex in civilian samples) and education, which was associated with trading sex in our sample. In this adjusted model, MST was associated with trading sex: odds ratio = 3.26, p = .025, 95% confidence interval = [1.16, 9.18]. To our knowledge, this is the 1st report of an association between MST and trading sex. Results extend previously observed associations between sexual trauma and trading sex in civilian cohorts and underscore the pernicious influence of sexual victimization across the lifespan.
Acknowledgments
Dr. Butterfield died on June 26, 2006, after a courageous 5-year battle with breast cancer. The authors would like to acknowledge her work on the research described in this report and celebrate her many significant contributions to the field of psychiatry and the care of the nation's veterans. They would also like to acknowledge the hard work of Ms. Patricia Spivey and Dr. Mary Becker in gathering these data and Ms. Susan O'Loughlin in assisting with literature searches and manuscript formatting. This study was partially funded by Department of Veteran Affairs Research Career Development Awards to Jennifer L. Strauss, Christine E. Marx, Julie C. Weitlauf, and Marian I. Butterfield. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.