Intimate partner violence and women's physical, mental, and social functioning

OBJECTIVE: To describe the relationship between women's health and the timing, type, and duration of intimate partner violence (IPV) exposure. METHODS: A telephone interview was completed by 3429 women aged 18 to 64 randomly selected from a large health plan, to assess IPV exposure and heath status (response rate 56.4%). Questions from the Behavioral Risk Factor Surveillance System and the Women's Experience with Battering scale were used to construct IPV exposures: (1) recent (past 5 years) and remote (before past 5 years only) IPV exposure of any type (physical, sexual, or non-physical); (2) recent (past 5 years) IPV exposure to physical and/or sexual or non-physical only; and (3) IPV duration (0 to 2 years, 3 to 10 years, and >10 years). Health outcomes were measured using the Short Form-36 survey (SF-36), the Center for Epidemiologic Studies Depression scale, and the National Institute of Mental Health Presence of Symptoms survey. RESULTS: In adjusted models, compared to women with no IPV in their adult lifetime, more-pronounced adverse health effects were observed for women with recent (vs remote) IPV; for physical and/or sexual (vs non-physical) IPV; and for longer IPV exposure. Compared to women who never experienced IPV, women with any recent IPV (physical, sexual, or non-physical) had higher rates of severe (prevalence ratio [PR]=2.6; 95% confidence interval [CI]=1.9-3.6) and minor depressive symptoms (PR=2.3; 95% CI=1.9-2.8); higher number of physical symptoms (mean, 1.0; 95% CI=0.7-1.2); and lower SF-36 mental and social functioning scores (range, 4.3-5.5 points lower across subscales). Women with recent physical and/or sexual IPV were 2.8 times as likely to report fair/poor health, and had SF-36 scores that ranged from 5.3 to 7.8 points lower, increased risk of depressive symptoms (PR=2.6) and severe depressive symptoms (PR=4.0), and more than one additional symptom. Longer duration of IPV was associated with incrementally worse health. CONCLUSIONS: Women's health was adversely affected by the proximity, type, and duration of IPV exposure.     

Physical health consequences of physical and psychological intimate partner violence

BACKGROUND: Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV. OBJECTIVE: To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview. RESULTS: Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV. CONCLUSIONS: Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.     

Sexual assault among North Carolina women: prevalence and health risk factors

STUDY OBJECTIVE: 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. DESIGN: 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. SETTING: This investigation focuses on the study participants in the 1997 survey. PARTICIPANTS: The sample includes 2109 women who responded to the sexual assault questions in the 1997 North Carolina BRFSS interview. MAIN RESULTS: 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). CONCLUSIONS: 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.     

Help-seeking for intimate partner violence and forced sex in South Carolina

PURPOSE: In this population-based, random-digit-dial, cross-sectional survey, we assessed the lifetime victimization of intimate partner violence (IPV) and forced or coerced sex among 556 women and men in South Carolina, and the help-seeking behaviors of victims. RESULTS: Among women, 25.3% experienced IPV (sexual, physical, or emotional violence) compared with 13.2% of men. Although women were significantly more likely to report physical or sexual IPV (17.8%) than were men (4.9%), men (8.3%) were as likely as women (7.4%) to report perceived emotional abuse without physical or sexual IPV. One half of men and women with annual incomes <$15, 000 reported IPV. Among women experiencing physical or sexual IPV, 53% sought community-based or professional services for IPV; women with higher education levels and those experiencing more severe violence were most likely to seek services. CONCLUSIONS: These data show that IPV is common and that most victims do not receive services to address this violence.     

Sexual Risk Factors Associated with Intimate Partner Violence Against Women in Rwanda: A Couples-Based Analysis

The goal of this study was to measure the prevalence of intimate partner violence (IPV) against women and to examine the independent association of sexual risk factors of women and their husbands/partners with IPV. We used data from 2,169 couples from the 2005 Rwanda Demographic and Health Survey. Face-to-face interviews were conducted, and multiple logistic regression was used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI). A total of 560 (29.2%), 415 (22.2%), and 233 (12.4%) women reported any physical, psychological, or sexual IPV, respectively. History of genital ulcer in women was significantly associated with psychological IPV (AOR: 2.77; 95% CI: 1.67–4.59), whereas history of genital ulcer reported by husbands/partners was significantly associated with sexual IPV (AOR 2.80, 95% CI: 1.08–7.29). The number of lifetime sexual partners of husbands was positively associated with increasing odds of their wives being exposed to psychological IPV (p = 0.025) and physical IPV (p = .017). In a representative sample of couples, husbands/partners’ sexual risk factors were associated with IPV reported by their wives. Genital ulcer appeared to be a risk marker for the presence of IPV victimization/perpetration.     

Psychosocial Effects of Physical and Verbal Abuse in Postmenopausal Women

PURPOSE The purpose of this study was to examine the psychological effects of physical and verbal abuse in a cohort of older women.METHODS This observational cohort study was conducted at 40 clinical sites nationwide that are part of the Women’s Health Initiative (WHI) Observational Study. We surveyed 93,676 women aged 50 to 79 years using the mental health subscales and the combined mental component summary (MCS) score of the RAND Medical Outcomes Study 36-item instrument.RESULTS At baseline, women reporting exposure to physical abuse only, verbal abuse only, or both physical and verbal abuse had a greater number of depressive symptoms (1.6,1.6, and 3 more symptoms, respectively) and lower MCS scores (4.6, 5.4, and 8.1 lower scores, respectively) than women not reporting abuse. Compared with women who had no exposure to abuse, women had a greater increase in the number of depressive symptoms when they reported a 3-year incident exposure to physical abuse only (0.2; 95% confidence interval [CI], −0.21 to 0.60), verbal abuse only (0.18; 95% CI, 0.11 to 0.24), or both physical and verbal abuse (0.15; 95% CI, −0.05 to 0.36); and they had a decrease in MCS scores when they reported a 3-year incident exposure to physical abuse only (−1.12; 95% CI, −2.45 to 0.12), verbal abuse only (−0.55; 95% CI, −0.75 to −0.34), and both physical and verbal abuse (−0.44; 95% CI, −1.11 to −0.22) even after adjustment for sociodemographic characteristics.CONCLUSION Exposure to abuse in older, functionally independent women is associated with poorer mental health. The persistence of these findings suggests that clinicians need to consider abuse exposure in their older female patients who have depressive symptoms. Clinicians caring for older women should identify women at risk for physical and verbal abuse and intervene appropriately.     

Actions Taken by Women in Response to Intimate Partner Violence and Intimate Partner Violence Status at 1-Year Follow-Up

BackgroundIntimate partner violence (IPV) is a pervasive public health issue with significant physical and mental health sequelae. A longer duration and greater severity of abuse are associated with adverse health outcomes and increased risk of revictimization. Current research has identified a variety of strategies used by women in response to abuse, but has not established whether the use of these strategies is associated with decreased IPV over time. For this study, we analyzed the associations between the use of specific actions in response to abuse—placating, resistance, informal or formal network help-seeking, safety planning, and substance use—and IPV victimization at the 1-year follow-up.MethodsNinety-five women with past-year IPV at baseline participated in a 1-year follow-up survey measuring their use of specific actions in response to IPV and subsequent IPV status. IPV victimization at the 1-year follow-up was analyzed as a function of types of actions taken and sociodemographic variables.ResultsAmong women with past-year IPV at baseline (N = 95), 53% reported no further IPV victimization at the 1-year follow-up. In bivariate analysis, social support was associated with decreased risk of IPV victimization (odds ratio, 0.43; 95% confidence interval [CI], 0.18–0.99). In multivariable analyses, high use of placating (adjusted odds ratio, 9.40; 95% CI, 2.53–34.9), formal network help-seeking (adjusted odds ratio, 7.26; 95% CI, 1.97–26.74), and safety planning (adjusted odds ratio, 2.98; 95% CI, 1.02–8.69) strategies were associated with an increased risk of IPV victimization at the 1-year follow-up.ConclusionsOur data demonstrate that IPV exposure can change over time and that the use of specific actions in response to IPV can be indicators of risk of subsequent victimization. Abuse severity is an important potential confounder of action efficacy.     

Intimate Partner Violence Among Men Having Sex with Men,Women, or Both: Early-Life Sexual and Physical Abuse as Antecedents

Little is known about the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) or about childhood adversity as a predictor of IPV among MSM. Studies have documented high rates of childhood sexual abuse among MSM. To evaluate associations of early-life sexual and physical abuse with IPV among African American heterosexual men or MSM, prevalence of early-life (≤21 years) sexual and physical abuse was measured among 703 nonmonogamous African American men. Men were classified as (1) MSM who disclosed male sex partners; (2) MSM who initially denied male sex partners but subsequently reported oral-genital and anal-genital behaviors with men; (3) non-MSM. MSM who initially disclosed male sex partners reported significantly (P < 0.0001) higher rates of early physical abuse (36%) and lifetime abuse (49%) compared with non-MSM (15 and 22%), respectively. These MSM reported significantly higher rates of sexual abuse by age 11, age 21, and over a lifetime compared with non-MSM (P < 0.0001). Being an MSM who initially disclosed male sex partners (OR: 2.1; 95% CI: 1.2, 3.6) and early-life sexual abuse (OR: 2.8; 95% CI: 1.8, 4.3) was associated with IPV victimization in current relationships. Similarly, being an MSM with early-life physical and sexual abuse was associated (0.0004 ≤ P ≤ 0.07) with IPV perpetration. Early-life physical and sexual abuse was higher among MSM who disclosed male sex partners compared with heterosexual men; however, all MSM who experienced early-life abuse were more likely to be IPV victims or perpetrators.     

Intimate partner violence and cervical neoplasia

Intimate partner violence (IPV) is associated with a range of adverse physical health outcomes, including chronic and infectious diseases. An emerging literature suggests that partner violence and specifically sexual violence may be associated with an increased risk of cervical neoplasia. To assess the risk of preinvasive and invasive cervical cancer in a cross-sectional study of women screened for IPV by type, frequency and duration, 1152 women ages 18-65 were recruited from family practice clinics in 1997-1998. They were screened for IPV during a brief in-clinic interview, and health history and current status were assessed in a follow-up interview. Of 1152 women surveyed, 14 (1.2%) reported cervical cancer, and 20. 3% (n = 234) reported treatment for cervical neoplasia. Ever experiencing IPV was associated with an increased risk of invasive cervical cancer (adjusted relative risk [aRR] = 4.28; 95% CI 1.94, 18.39) and with preinvasive cervical neoplasia (aRR = 1.47; 95% CI 1. 16, 1.82). This association was stronger for women experiencing physical or sexual IPV than for women experiencing psychological IPV. Women with cervical cancer reported being in violent relationships longer and experiencing more frequent physical and sexual assaults and more IPV-associated injuries than did controls. This exploratory study suggests that IPV may increase a woman's risk of cervical neoplasia. The mechanism by which IPV effects cervical neoplasia may be indirect through psychosocial stress or negative coping behaviors or direct through sexual assaults and transmission of human papillomavirus (HPV).     

Childhood physical and sexual abuse experiences associated with post-traumatic stress disorder among pregnant women

PurposeWe sought to evaluate the extent to which childhood physical and/or sexual abuse history is associated with post-traumatic stress disorder (PTSD) during early pregnancy and to explore the extent to which the childhood abuse-PTSD association is mediated through, or modified by, adult experiences of intimate partner violence (IPV).MethodsIn-person interviews collected information regarding history of childhood abuse and IPV from 2,928 women aged 18-49 years old prior to 16 weeks of gestation. PTSD was assessed using the PTSD Checklist-Civilian Version. Multivariate logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsCompared to women with no childhood abuse, the odds of PTSD were increased 4.31-fold for those who reported physical abuse only (95% CI, 2.18–8.49), 5.33-fold for sexual abuse only (95% CI, 2.38–11.98), and 8.03-fold for those who reported physical and sexual abuse (95% CI, 4.10–15.74). Mediation analysis showed 13% of the childhood abuse-PTSD association was mediated by IPV. Furthermore, high odds of PTSD were noted among women with histories of childhood abuse and IPV compared with women who were not exposed to either (OR = 20.20; 95% CI, 8.18–49.85).ConclusionsChildhood abuse is associated with increased odds of PTSD during early pregnancy. The odds of PTSD were particularly elevated among women with a history of childhood abuse and IPV. Efforts should be made to prevent childhood abuse and mitigate its effects on women's mental health.     

Intimate Partner Violence/Abuse and Depressive Symptoms among Female Health Care Workers: Longitudinal Findings

Intimate partner violence and abuse (IPV/A) have been shown to have a major impact on mental health functioning. This study assessed the longitudinal association between recent IPV/A and depressive symptoms to identify potential targets for preventive interventions for women. Random effects models were used to examine four waves of data collected at 6-month intervals from a cohort of 1,438 female health care workers. IPV/A (e.g., sexual and physical violence, psychological abuse) in the past 5 years was associated with higher Center for Epidemiologic Studies Depression Scale (CES-D) 10 scores across four waves after adjustment for age, time, marital status, and childhood trauma. Women who reported IPV/A in the past 5 years had higher CES-D 10 scores (β, 1.31; 95% confidence interval, 0.79–1.82; p < .0001) than nonabused women. This association was generally constant with time, suggestive of a cross-sectional association across all four waves of data. Additionally, recent IPV/A was associated with change in depressive symptoms over time among the full cohort and those with CES-D 10 scores below 10 (the threshold for likely depression) at baseline. Recent IPV/A was independently associated with depressive symptoms both cross-sectionally and longitudinally. The longitudinal association was stronger among those not depressed at baseline. Implications for health care settings and workplace policies addressing IPV/A are discussed.     

Intimate partner violence: prevalence and perceptions of married men in Ibadan, Nigeria

In sub-Saharan Africa rates of intimate partner violence (IPV) are high. Thus, identifying reasons for abuse is crucial in ensuring women's health. Hence, mens perception of IPV was assessed, and prevalence of abuse determined. Survey of 820 married men from six urban communities in Ibadan was done using interviewer administered questionnaire. Four focus group discussions were conducted. Lifetime prevalence of perpetration of physical abuse was 25.1%, while psychological violence was 44.4%. Two hundred and forty (29.3%) had ever perpetrated sexual violence and 23.2% economic violence. At least one of these forms of violence had been perpetrated by 44.1% of the respondents. "Being rude" (66.4%) and "insufficient care of the children" (54.3%) were common justifications for IPV. Motive of the abuse were "to make partner responsible" (60.3%) and "to obtain respect" (59.9%). Predictors of perpetrating violence were being in polygamous unions (OR 1.83, 95% CI: 1.11-3.03), consuming alcohol (AOR 1.67; 95% CI: 1.10-2.53), and being Moslem (AOR = 1.87, 95% CI: 1.21-2.910). Men with inadequate knowledge and negative attitudes had greater likelihood of perpetrating IPV (AOR = 2.11, 95% CI: 1.37-3.26 and AOR = 2.09, 95% CI: 1.33-3.27). IPV was also associated with young age. Premarital counseling on how to resolve conflict without resulting to violence and early education of boys on violence to women is recommended.     

Sexual Aggression Experiences Among Male Victims of Physical Partner Violence: Prevalence,Severity, and Health Correlates for Male Victims and Their Children

Although research has documented the prevalence and health correlates of sexual aggression among women who have experienced severe partner violence (PV), no research has documented the parallel issues among male victims of severe PV. Research also suggests that children of female victims of both physical and sexual PV have worse mental health than children of female victims of physical PV only, but no research has assessed the mental health of children whose fathers experienced both physical and sexual PV. We surveyed 611 men who experienced physical PV from their female partners and sought help. We assessed the types and extent of various forms of PV, the men’s mental and physical health, and the mental health of their oldest child. Results showed that almost half of the men experienced sexual aggression in their relationship, and 28 % severe sexual aggression. Increasing levels of severity of sexual aggression victimization was associated with greater prevalence and types of other forms of PV. In addition, greater levels of severity of sexual aggression victimization among the men was significantly associated with depression symptoms, post-traumatic stress disorder symptoms, physical health symptoms, and poor health, and attention deficit and affective symptoms among their children. These associations held after controlling for demographics and other violence and trauma exposure. Discussion focused on the importance of broadening our conceptualization of PV against men by women to include sexual aggression as well.     

Intimate partner violence among men and women--South Carolina, 1998

Few studies provide population-based estimates of intimate partner violence (IPV) for men and women, especially at the state level. IPV may result in adverse health effects for victims and perpetrators (1-3). To estimate the lifetime incidence of IPV by type of violence (e.g., physical, sexual, and perceived emotional abuse) and to explore demographic correlates of reporting IPV among men and women, the South Carolina Department of Health and Environmental Control and the University of South Carolina conducted a population-based random-digit-dialed telephone survey of adults in the state. This report summarizes the results of the survey, which indicated that approximately 25% of women and 13% of men have experienced some type of IPV during their lifetime. Although women were significantly more likely to report physical and sexual IPV, men were as likely as women to report emotional abuse without concurrent physical or sexual IPV.     

Childhood family violence history and women's risk for intimate partner violence and poor health

BACKGROUND: There is growing evidence for associations between generations in family violence and between family violence in both childhood and adulthood and women's health. Most studies focus on a subset of family violence (child abuse, witnessing intimate partner violence [IPV] as a child, and/or adult IPV), and few examine possible differences associated with the nature of abusive experiences, such as physical versus sexual abuse. METHODS: A population-based telephone survey, the 1999 and 2001 Washington State Behavioral Risk Factor Surveillance System, asked a representative sample of 3527 English-speaking, non-institutionalized adult women whether they had been physically or sexually assaulted or witnessed interparental violence in childhood, and whether they had experienced physical assault or emotional abuse from an intimate partner in the past year. The survey also asked about current general health and mental distress in the past month. RESULTS: The risks associated with childhood family violence experiences varied depending on the nature of those experiences. Women reporting childhood physical abuse or witnessing interparental violence were at a four- to six-fold increase in risk of physical IPV, and women reporting any of the experiences measured were at three- to four-fold increase in risk of partner emotional abuse. In contrast, women reporting childhood sexual abuse only were not at increased risk of physical IPV. Women reporting childhood physical abuse were at increased risk of poor physical health, and women reporting any type of childhood family violence were at increased risk of frequent mental distress. Approximately one third of women reporting poor general health and half of women reporting frequent mental distress also reported at least one of the childhood experiences measured. CONCLUSIONS: These findings underscore the role of childhood experiences of abuse and of witnessing family violence in women's current risk for IPV, poor physical health, and frequent mental distress.     

Relationship between drug abuse and intimate partner violence: a longitudinal study among women receiving methadone

OBJECTIVES: We examined whether frequent drug use increases the likelihood of subsequent sexual or physical intimate partner violence (IPV) and whether IPV increases the likelihood of subsequent frequent drug use. METHODS: A random sample of 416 women on methadone was assessed at baseline (wave 1) and at 6 months (wave 2), and 12 months (wave 3) following the initial assessment. Propensity score matching and multiple logistic regression were employed. RESULTS: Women who reported frequent crack use at wave 2 were more likely than non-drug using women to report IPV at wave 3 (odds ratio [OR]=4.4; 95% confidence interval [CI]=2.1, 9.1; P<.01), and frequent marijuana users at wave 2 were more likely than non-drug users to report IPV at wave 3 (OR=4.5; 95% CI=2.4, 8.4; P<.01). In addition, women who reported IPV at wave 2 were more likely than women who did not report IPV to indicate frequent heroin use at wave 3 (OR=2.7; 95% CI=1.1, 6.5; P=.04). CONCLUSIONS: Our findings suggest that the relationship between frequent drug use and IPV is bidirectional and varies by type of drug.     

Physical violence, intimate partner violence, and emotional abuse among adult American Indian men and women in Montana

BACKGROUND: Little is known about the experience of American Indian communities relative to physical violence (PV), intimate partner violence (IPV), and emotional abuse. METHODS: A random sample of adult American Indians living on or near the seven Montana reservations were interviewed through an adapted Behavioral Risk Factor Surveillance System telephone survey in 2001 (N = 1,006). Victimization from physical violence was defined as PV or sexual assault committed by any person. Respondents who reported experiencing PV and who reported that the perpetrator was a current or former spouse, boyfriend, girlfriend, or date were categorized as experiencing IPV. Emotional abuse was defined as fear for one's safety or being controlled by another individual. RESULTS: Nine, one, and twelve percent of men reported experiencing PV, IPV, and emotional abuse in the past year, respectively. Five percent of women reported PV in the past year, 3% reported IPV, and 18% reported emotional abuse. Men who reported PV in the past year were more likely to be younger and report more days of physical and mental health problems in the past month. Women reporting PV in the past year were more likely to be younger and have more days with mental health problems in the past month. Few men (7%) or women (12%) reported ever being assessed for PV or safety. CONCLUSIONS: Recent PV, IPV, and emotional abuse are prevalent for both American Indian men and women. Strategies to increase screening for PV and effective interventions for violence are needed.     

Sexual Abuse in Childhood and Physical and Mental Health in Adulthood: An Australian Population Study

Although childhood sexual abuse (CSA) is associated with a wide range of health problems later in life, there is also evidence of substantial individual differences. This study describes the mental and physical health of a population sample of Australians, randomly selected from the Commonwealth electoral roll, who have reported their CSA histories. Some 58% of those located from the electoral roll agreed to a telephone interview (n=1,784). Health status was measured using the Short Form 36 questionnaire. Men who had experienced non-penetrative and penetrative sexual abuse in childhood had 2.25 (95% CI=1.32-3.82) and 5.93 (95% CI=2.72-12.95) times respectively the rate of impaired mental health, but no higher rates of impaired physical health. Women who had experienced non-penetrative and penetrative sexual abuse in childhood had 1.87 (95% CI=1.19-2.95) and 3.15 (95% CI=1.87-5.33) times respectively the rate of impaired mental health and 1.87 (95% CI=1.19-2.92) and 2.31 (95% CI=1.34-3.97) times respectively the rate of impaired physical health. However, participants who had experienced CSA were no less likely than those who had not experienced CSA to be in optimum physical and mental health. None of the possible confounding or moderating variables tested appeared to mitigate the impact of CSA on health outcomes. Those with the highest levels of mental and physical health appear to be unaffected by the experience of CSA.