番茄社区

MILWAUKEE -- Nearly three of four women who experienced sexual assault had new or worse pain a week later and in most cases that pain persisted for weeks, researchers said here.

One week after sexual assault, 76% of women had clinically significant new or worsening pain, reported Samuel McLean, MD, MPH, of the University of North Carolina at Chapel Hill, and colleagues, at the 2019 American Pain Society Scientific Meeting. Six weeks later, 54% of women still were in pain.

The findings are from the first large-scale prospective study of women evaluated soon after presenting at a sexual assault care center, McLean told 番茄社区. While many women who have experienced sexual violence have reported persistent pain, no major longitudinal studies of these women have been conducted to date.

"This research is critical to accurately understand the health consequences of sexual assault and the lives of sexual assault survivors," McLean said.

A 2010 CDC survey showed that women with a were more likely to have difficulty sleeping, activity limitations, chronic pain, and frequent headaches than women without a sexual violence history. Cross-sectional analyses also have demonstrated that women who have been sexually assaulted have chronic musculoskeletal pain, McLean noted.

In this study, McLean and colleagues enrolled 549 female patients at one of 13 sexual assault care centers in the throughout the country. When a patient presented to receive emergency care from a sexual assault nurse examiner at the center, an on-call research associate was paged. The associate approached the patient for her initial agreement; full consent occurred a week later.

Participants agreed to share medical records about the assault and to complete web-based follow-up survey assessments at weeks 1 and 6. The assessments included evaluations of pain severity using the (NRS) of 0 (no pain) to 10 (worst pain imaginable) and pain locations using an adapted version of the .

Women in the study were an average age of 28. Most (76%) reported clinically significant new or worsening pain -- an increase of ≥2 on the NRS -- compared with pain levels recalled during the month before the assault at 1 week after the assault. More than half (54%) reported clinically significant new or worsening pain at 6 weeks.

At both 1 week and 6 weeks, most women with new or worse pain had a pain severity score ≥4 on the NRS, indicating moderate to severe pain.

Women reported pain in an average of eight body regions at 1 week and five regions at 6-week follow-up. The most common locations of clinically significant new or worsening pain 6 weeks after assault were in the upper or lower back (49%), neck (43%), and head and face (41%). Nearly one in six women had persistent generalized pain 6 weeks after assault and pain in the genital region was not uncommon.

"This study demonstrates that the great majority of women sexual assault survivors have clinically significant pain in the immediate aftermath of assault, and more than half of woman sexual assault survivors continue to have such pain at 6 weeks," McLean said. "It is critical to understand the biology of how these pain symptoms develop, so that we can develop effective preventive interventions."

The findings are part of a study to evaluate genetic, psychosocial, and environmental factors that may influence health outcomes of women after sexual assault. In recent decades, risk assessment methods and interventions have been developed to prevent post-assault pregnancy and infection; similar methods and interventions are needed to prevent chronic pain after sexual assault, McLean noted.

Comment