Cloutier S, Martin Sandra L, Poole C
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7445, USA.
J Epidemiol Community Health. 2002 Apr;56(4):265-71. doi: 10.1136/jech.56.4.265.
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 victimization 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.
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.
This investigation focuses on the study participants in the 1997 survey.
The sample includes 2109 women who responded to the sexual assault questions in the 1997 North Carolina BRFSS interview.
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).
This study shows associations between sexual victimization 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 victimization 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 victimization.
性侵犯在发生时具有创伤性，而且还可能对身体健康产生长期的负面影响。将特定健康问题与性侵犯受害情况联系起来的许多研究都采用了特殊人群的样本。本研究的目的是估计北卡罗来纳州有代表性的女性样本中性侵犯的患病率，并研究性侵犯与女性发病和死亡主要原因的特定健康风险因素之间的关系。
北卡罗来纳州行为风险因素监测系统（BRFSS）是一项通过随机数字拨号对18岁及以上非机构化成年人进行的家庭电话调查。
本调查聚焦于1997年调查中的研究参与者。
样本包括2109名在1997年北卡罗来纳州BRFSS访谈中回答了性侵犯问题的女性。
性侵犯的终生患病率为19%（95%置信区间为17%至20%），其中73%的受害者经历过或受到过强迫性交的威胁。性侵犯受害者，尤其是强迫性交或其威胁的受害者，更有可能认为自己的总体健康状况为一般或较差（比值比=2.3，95%置信区间为1.5至3.4），并且在过去一个月中更有可能身心健康状况不佳（身体健康不佳，比值比=2.1，95%置信区间为1.6至2.8；心理健康不佳，比值比=2.6，95%置信区间为1.9至3.5）。在控制了社会人口统计学因素和医疗保健覆盖情况后，强迫性交或其威胁的受害者更有可能吸烟（比值比=2.0，95%置信区间为1.4至2.8）、患有高血压（比值比=1.5，95%置信区间为1.1至2.2）、患有高胆固醇（比值比=1.7，95%置信区间为1.2至2.5）以及肥胖（比值比=1.7，95%置信区间为1.3至2.4）。
本研究显示了在全州非临床女性人群中性侵犯与健康风险因素之间的关联。未来的研究应确定在各种医疗保健环境中对女性进行性侵犯受害史的临床筛查和识别是否会引发有效的干预措施，以帮助女性成功应对这些暴力经历。还需要进一步研究，通过评估受害前后的身体健康状况来调查性侵犯与随后健康结果的时间顺序。
