Factors That Influence Women to Disclose Sexual Assault History to Health Care Providers

Abstract

Objective: To examine women's experiences with sexual assault screening by health care professionals and identify factors that influence women to disclose their sexual assault history to providers.

Design: Cross-sectional descriptive survey with correlational analysis.

Setting: On-line survey distributed nationally.

Participants: One hundred forty-three women.

Methods: Participants were recruited through social media; the authors e-mailed organizations across the nation and asked them to share links to a Facebook page connected to the survey. Descriptive statistics, Spearman's rho, and contingency tables were calculated, and qualitative content analysis was performed by thematic analysis.

Results: Most (n = 103, 72.5%) participants reported that they felt comfortable with being asked about sexual assault, but only 41 (28.7%) participants were screened for sexual assault by health care professionals. Positive attitude and increased comfort level with screening were associated with increased intention to disclose past assault (p < .05). A total of 113 (82.5%) women reported intentions to disclose sexual assault to a provider if asked, whereas only 35 (24.6%) women would voluntarily disclose. Women identified prevention of medical and physical consequences as main facilitators to disclosure, and provider attitude and demeanor as the main barriers. Sixty-nine (48.9%) participants were victims of sexual assault. Women with a history of sexual assault were no more likely than women not victimized to have been screened for sexual assault.

Conclusion: Study findings suggest that women are often not screened for sexual assault despite being receptive to inquiry. Health care professionals often do not identify those who have been sexually assaulted because they do not ask. Thus, many victims do not receive needed sexual assault resources and support.

Keywords: intentions to disclose; sexual assault; sexual assault screening; theory of planned behavior.