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Wright EN, Miyamoto S, Anderson J. "Having One Person Tell Me I Didn't Do the Wrong Thing": The Impact of Support on the Post-Sexual Assault Exam Experience. Violence Against Women 2024; 30:2721-2742. [PMID: 36794461 PMCID: PMC11292967 DOI: 10.1177/10778012231156153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Social support following a sexual assault (SA) may help minimize or prevent the myriad of negative sequelae impacting individuals who experience SA. Receiving a SA exam may provide initial support during the SA exam and set up individuals with needed resources and supports post-SA exam. However, the few individuals who receive a SA exam may not stay connected to resources or support post-exam. The purpose of this study was to understand individuals' post-SA-exam social support pathways including individuals' ability to cope, seek care, or accept support following a SA exam. Interviews were conducted with individuals who experienced SA and then received a SA exam through a telehealth model. The findings revealed the importance of social support during the SA exam and in the months that followed. Implications are discussed.
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Affiliation(s)
| | - Sheridan Miyamoto
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
- The Child Maltreatment Solutions Network, The Pennsylvania State University, University Park, PA, USA
| | - Jocelyn Anderson
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
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2
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Healey LM, Hutchinson JL, Pfeiffer MN, Garton L, Hatten B, Dobbie M, Simpson L, Templeton DJ. The challenge of providing medical follow-up for sexual assault victims: can we predict who will attend? A retrospective cross-sectional study. Sex Health 2023; 20:475-477. [PMID: 37599505 DOI: 10.1071/sh22180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/21/2023] [Indexed: 08/22/2023]
Abstract
This study examined the impact of a pathway between a sexual assault service and a public sexual health service developed to improve rates of post-sexual assault medical follow-up. Follow-up attendances improved in the first 12months of the pathway (2014) compared with attendances in 2013 (17.8%vs 9.6%, P =0.01). Factors independently associated with attendance at follow-up were being prescribed HIV post-exposure prophylaxis and knowing the assailant. Those with physical injuries were less likely to attend. The prevalence of sexually transmissible infections in this cohort, 8% at the acute presentation and 5% at follow-up, suggests a need for alternatives to clinic-based follow-up.
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Affiliation(s)
- L M Healey
- Department of Sexual Health Medicine, Community Health, Sydney Local Health District, Sydney, NSW, Australia
| | - J L Hutchinson
- The Kirby Institute, University of NSW Australia, Sydney, NSW, Australia
| | - M N Pfeiffer
- Sexual Assault Medical Service, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - L Garton
- Department of Sexual Health Medicine, Community Health, Sydney Local Health District, Sydney, NSW, Australia; and The Kirby Institute, University of NSW Australia, Sydney, NSW, Australia
| | - B Hatten
- Department of Sexual Health Medicine, Community Health, Sydney Local Health District, Sydney, NSW, Australia
| | - M Dobbie
- Sexual Assault Medical Service, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - L Simpson
- Sexual Assault Counselling Service, Community Health, Sydney Local Health District, Sydney, NSW, Australia
| | - D J Templeton
- Department of Sexual Health Medicine, Community Health, Sydney Local Health District, Sydney, NSW, Australia; and The Kirby Institute, University of NSW Australia, Sydney, NSW, Australia; and Sexual Assault Medical Service, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; and Central Clinical School, The Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Wright EN, Anderson J, Phillips K, Miyamoto S. Help-Seeking and Barriers to Care in Intimate Partner Sexual Violence: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1510-1528. [PMID: 33685295 DOI: 10.1177/1524838021998305] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner sexual violence (IPSV) is a prevalent phenomenon, yet an under-researched topic. Due to the complex nature of balancing love and fear, individuals who experience IPSV have unique needs and face unique barriers to seeking care. The purpose of this systematic review was to examine the literature on help-seeking and barriers to care in IPSV. Articles were identified through PubMed, CINAHL, PsycINFO, and Web of Science. Search terms included terms related to IPSV, intimate partner violence (IPV), domestic violence, sexual assault, and rape. The review was limited to the United States, and articles that were included needed to specifically measure or identify sexual violence in an intimate relationship and analyze or discuss IPSV in relation to help-seeking behaviors or barriers to care. Of the 17 articles included in this review, 13 were quantitative studies and four were qualitative studies. Various definitions and measurements of IPSV across studies included in this review make drawing broad conclusions challenging. Findings suggest that experiencing IPSV compared to experiencing nonsexual IPV (i.e., physical or psychological IPV) may increase help-seeking for medical, legal, and social services while decreasing help-seeking for informal support. Help-seeking can also reduce risk of future IPSV and decrease poor mental health outcomes. Barriers to seeking care in IPSV included social stigma, fear, and difficulty for individuals in identifying IPSV behaviors in their relationships as abuse. More inclusive research is needed among different populations including men, non-White individuals, nonheterosexual, and transgender individuals. Suggestions for research, practice, and policies are discussed.
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Affiliation(s)
- Elizabeth N Wright
- College of Nursing, 8082The Pennsylvania State University, University Park, PA, USA
| | - Jocelyn Anderson
- College of Nursing, 8082The Pennsylvania State University, University Park, PA, USA
| | - Kathleen Phillips
- College of Nursing, 8082The Pennsylvania State University, University Park, PA, USA
| | - Sheridan Miyamoto
- College of Nursing, 8082The Pennsylvania State University, University Park, PA, USA
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Gilmore AK, Leone RM, Hahn CK, Oesterle D, Davidson TM. Barriers to Accessing Mental Health Care After a Sexual Assault Medical Forensic Examination. JOURNAL OF FORENSIC NURSING 2021; 17:84-92. [PMID: 33756526 PMCID: PMC8387315 DOI: 10.1097/jfn.0000000000000321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Research indicates low rates of accessing mental health care following sexual assault; however, barriers associated with accessing care are not well understood. DESIGN Participants (N = 37) were recruited from a local hospital following a sexual assault medical forensic examination (SAMFE). Hierarchical linear regressions models examined the effects of age, racial identity, student status, insurance status, relationship to perpetrator, time since assault, problematic drinking, and posttraumatic stress symptoms on (a) barriers to accessing care and (b) the likelihood of seeking mental health treatment at no charge. RESULTS Lack of insurance was associated with more barriers to accessing mental health care and a higher likelihood of seeking post-SAMFE care at no charge. Posttraumatic stress symptoms were associated with more barriers to accessing care (p = 0.038). Identifying as a student (p = 0.026) and engaging in problematic drinking (p = 0.047) were associated with a lower likelihood of seeking post-SAMFE care, whereas increased symptoms of posttraumatic stress were associated with a greater likelihood of seeking post-SAMFE care (p = 0.007). CONCLUSIONS Providing post-SAMFE care, irrespective of insurance, may be a needed first step in addressing the mental health needs of individuals with recent sexual assault. Secondary prevention programs targeted toward alcohol misuse may also be warranted.
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Affiliation(s)
- Amanda K. Gilmore
- Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University
| | - Ruschelle M. Leone
- Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University
| | - Christine K. Hahn
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina
| | - Dan Oesterle
- Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University
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Gilmore AK, Flanagan JC. Acute mental health symptoms among individuals receiving a sexual assault medical forensic exam: the role of previous intimate partner violence victimization. Arch Womens Ment Health 2020; 23:81-89. [PMID: 30762148 PMCID: PMC6733667 DOI: 10.1007/s00737-019-0947-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/28/2019] [Indexed: 01/02/2023]
Abstract
Sexual assault and intimate partner violence (IPV) are common in the USA, and they often co-occur. Individuals with multiple victimization experiences have more severe mental health outcomes compared to those with one victimization. The current study examined mental health symptoms and their association with IPV victimization history among a sample of individuals who experienced a recent sexual assault and received a sexual assault medical forensic examination. A total of 82 participants (92.70% female) completed a post-sexual assault survey as part of clinical care to coordinate follow-up services. IPV history and prior sexual assault were assessed as well as mental health symptoms including acute stress and depressive symptoms. It was found that individuals with an IPV history reported more acute stress and depressive symptoms compared to those without an IPV history. No differences were found based on prior sexual assault history. These findings highlight the importance of screening for IPV history during the sexual assault medical forensic examination to coordinate care.
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Affiliation(s)
- Amanda K Gilmore
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Julianne C Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Hahn CK, Jaffe AE, Stanton K, Gilmore AK. The Association Between Type of Sexual Assault and Post-Assault Alcohol Misuse Is Moderated by Avoidance Among Recipients of a Sexual Assault Medical Forensic Examination. J Stud Alcohol Drugs 2019; 80:507-514. [PMID: 31603751 PMCID: PMC6811726 DOI: 10.15288/jsad.2019.80.507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/02/2019] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE The purpose of this study was to examine the association between the type of sexual assault (intoxicated vs. non-intoxicated) and post-assault avoidance on post-assault alcohol misuse among people who experienced a recent sexual assault. METHOD The sample included 72 adults aged 18-58 who completed a follow-up phone screen within 30 days of completing a sexual assault medical forensic examination. Participants reported demographics, prior sexual assault, if they were intoxicated from alcohol or other drugs during the sexual assault that preceded receipt of a sexual assault medical forensic examination, post-assault avoidance symptoms, and post-assault alcohol misuse. RESULTS Post-assault alcohol misuse was higher among participants with intoxicated (vs. non-intoxicated) sexual assault, prior sexual assault (vs. none), and who identified as White. There was a significant interaction between the type of sexual assault and avoidance symptoms on post-assault alcohol misuse. There was a significant association between avoidance symptoms and alcohol misuse (b = 0.82, p = .003) among participants who experienced a non-intoxicated sexual assault, but not among those who reported intoxication during the recent sexual assault (b = -0.33, p = .468). CONCLUSIONS Intoxicated sexual assault and post-assault avoidance may be influential factors contributing to post-assault alcohol misuse among people who are recently sexually assaulted. Interventions targeting post-sexual assault alcohol misuse should be tailored based on the type of recent assault and post-assault avoidance.
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Affiliation(s)
- Christine K. Hahn
- National Crime Victims Research & Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Anna E. Jaffe
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Kimberley Stanton
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Amanda K. Gilmore
- Mark Chaffin Center for Healthy Development and Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
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7
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Hahn CK, Jaffe AE, Stanton K, Gilmore AK. The Association Between Type of Sexual Assault and Post-Assault Alcohol Misuse Is Moderated by Avoidance Among Recipients of a Sexual Assault Medical Forensic Examination. J Stud Alcohol Drugs 2019; 80:507-514. [PMID: 31603751 PMCID: PMC6811726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/02/2019] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine the association between the type of sexual assault (intoxicated vs. non-intoxicated) and post-assault avoidance on post-assault alcohol misuse among people who experienced a recent sexual assault. METHOD The sample included 72 adults aged 18-58 who completed a follow-up phone screen within 30 days of completing a sexual assault medical forensic examination. Participants reported demographics, prior sexual assault, if they were intoxicated from alcohol or other drugs during the sexual assault that preceded receipt of a sexual assault medical forensic examination, post-assault avoidance symptoms, and post-assault alcohol misuse. RESULTS Post-assault alcohol misuse was higher among participants with intoxicated (vs. non-intoxicated) sexual assault, prior sexual assault (vs. none), and who identified as White. There was a significant interaction between the type of sexual assault and avoidance symptoms on post-assault alcohol misuse. There was a significant association between avoidance symptoms and alcohol misuse (b = 0.82, p = .003) among participants who experienced a non-intoxicated sexual assault, but not among those who reported intoxication during the recent sexual assault (b = -0.33, p = .468). CONCLUSIONS Intoxicated sexual assault and post-assault avoidance may be influential factors contributing to post-assault alcohol misuse among people who are recently sexually assaulted. Interventions targeting post-sexual assault alcohol misuse should be tailored based on the type of recent assault and post-assault avoidance.
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Affiliation(s)
- Christine K. Hahn
- National Crime Victims Research & Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Anna E. Jaffe
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Kimberley Stanton
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Amanda K. Gilmore
- Mark Chaffin Center for Healthy Development and Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
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Gilmore AK, Davidson TM, Leone RM, Wray LB, Oesterle DW, Hahn CK, Flanagan JC, Gill-Hopple K, Acierno R. Usability Testing of a Mobile Health Intervention to Address Acute Care Needs after Sexual Assault. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3088. [PMID: 31450676 PMCID: PMC6747119 DOI: 10.3390/ijerph16173088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 02/07/2023]
Abstract
Sexual assault is associated with a range of poor mental health outcomes. To enhance access to care by this population, technology-based mental health interventions have been implemented in the emergency room; however, more accessible and easily disseminated interventions are needed. The aim of the present study was to test the usability of a mobile health intervention targeting alcohol and drug misuse, suicide prevention, posttraumatic stress symptoms, coping skills, and referral to formal assistance for individuals who have experienced sexual assault. Feedback on the usability of the intervention was collected from individuals who received a sexual assault medical forensic examination (n = 13), and feedback on the usability and likelihood of recommending the application was collected from community providers (n = 25). Thematic analysis was used to describe qualitative data. Content themes related to aesthetics, usability, barriers to resources, and likes/dislikes about the intervention arose from interviews following the intervention. Participants found the intervention to be user friendly and endorsed more likes than dislikes. Providers rated the intervention as being helpful and would recommend it to survivors of sexual assault. Findings suggest that the intervention is usable and fit for future effectiveness testing, filling an important gap in treatment for individuals who experience sexual assault.
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Affiliation(s)
- Amanda K Gilmore
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA.
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Tatiana M Davidson
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Ruschelle M Leone
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Lauren B Wray
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Daniel W Oesterle
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Christine K Hahn
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Julianne C Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Kathleen Gill-Hopple
- Forensic Nursing Services, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Ron Acierno
- Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA
- Department of Psychiatry, University of Texas Health Science Center, Houston, TX 77030, USA
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