Sexual Behaviors and Sexually Transmitted Infections in a Nationally Representative Sample of Women Veterans and Nonveterans

Abstract

Background: Women veterans are a growing population with unique characteristics and documented health disparities. Few studies have examined their sexual behaviors and rates of sexually transmitted infections (STIs), and none have compared women veterans to nonveterans to identify potential sexual health disparities. Methods: We used data from the 1999-2010 National Health and Nutrition Examination Survey, a nationally representative U.S. survey. We compared lifetime sexual history (age at first intercourse, number of partners), sexual activity in the last year, and STIs between women veterans (n = 151) and nonveterans (n = 8738), adjusting for age, race/ethnicity, education, marital status, binge drinking, and survey year. Results: Compared to nonveterans, women veterans reported a younger age at first intercourse and a greater number of female and male lifetime sexual partners, and they were more likely to have ever had sex with a woman. They were also more likely than nonveterans to have genital herpes and genital warts. Conclusions: Women veterans reported higher rates of sexual activity and STIs than nonveterans. Future research is needed to assess high-risk behaviors and determine what factors may underlie these associations. Providers should ensure thorough screening and intervention services are provided for this growing population.

Evidence Review—Social Determinants of Health for Veterans

“…While no articles examined the role of rurality in health behaviors, two medium-quality articles addressed utilization (Table 2). One article reported no differences between metropolitan and There were also two included articles 87,89 on sexual orientation both compared Veterans and non-Veterans, using data from national cohorts, included only women, had more than 1000 participants, and were medium quality; one of these examined the role of sexual orientation on mortality and also addressed trauma exposure 89 *Number of participants unclear in one article on rurality 21 non-metropolitan participants in proportion having a Bcheckup^within the prior 2 years. 137 The other article examined associations with total healthcare expenditures and found significant interaction effects between rural residence and a combined Veteran/VHA-user categorical variable (i.e., non-Veteran, Veteran VHA user, and Veteran non-VHA user); the magnitude of interaction effects was not reported.…”

Preconception Care in the Veterans Health Administration

“…35,36 Despite the fact that there are certain health and educational requirements for military service, studies generally have found that women Veterans have a greater burden of health and psychosocial comorbidities compared with their non-Veteran counterparts, many of which are important risk factors for poor pregnancy outcomes. [37][38][39][40][41][42][43][44] In addition to peer-reviewed literature, a VA report titled "Sourcebook: Women Veterans in the Veterans Health Administration" uses VA electronic medical record (EMR) to characterize the health status of women Veteran VA users. 2 ►Table 1 lists the most common diagnoses identified in the VA EMR among women Veteran VA users of reproductive age.…”

“…Women Veterans have higher rates of obesity and overweight, 37 tobacco use, 37,44 and sexually transmitted infections (STIs) 39 compared with their civilian counterparts. ►Appendix 1 provides a summary of selected studies using national data sources to compare health of women Veterans or women with a military service history to non-Veterans.…”

Reproductive Health Management for the Care of Women Veterans

“…28 The potential implications of these findings for cervical abnormalities or cervical cancer risk are unknown. However, adhering to established sexually transmitted infection and cervical cancer screening guidelines further targets research in this area.…”