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dcyphr | Prevalence of Sexual Violence and Posttraumatic Stress Disorder in an Urban African-American Population

Abstract

There is little information on exposure to sexual violence in low income urban African Americans. This study is composed on answers from 1,300 African Americans from Detroit on lifetime sexual violence and post-traumatic stress disorder (PTSD). Lifetime sexual violence was 26.3% for women and 5.1% for men, and victims reported more other traumatic events, 4 times greater unadjusted odds of PTSD, and 1.6 times greater adjusted odds of PTSD. More screening should be done in urban African American populations to decrease PTSD and sexual violence.


Introduction

Sexual violence, which includes rape and sexual assault, are reported at high amounts in the United States. 40.2% of women report sexual assault, and 18.3% report rape. 4.2% of men report sexual assault and 1.4% report rape. Demographics like minority status and low socioeconomic status are correlated with higher risk for physical violence, but few studies have focused on sexual violence. Sexual violence is most likely to be done by an acquaintance, and less likely to be reported to the police, making studies about sexual violence even more important. Exposure to rape is associated with higher levels of PTSD than physical violence like assault or robbery. This study assesses sexual violence and PTSD in African American urban-dwelling adults.


Methods

The 1306 participants were randomly chosen from a larger survey called the Detroit Neighborhood Health Study. Participants self identified if they had experienced sexual violence in the survey. DSM-5 criteria was used in a self assessment of the participants to determine if they qualified for PTSD. The age, sex, ethnicity, income level, education, marital status, and other traumatic events were recorded as well. Some of the participants engaged in a 40 minute phone call to further investigate trauma and psychopathology.


Results

16.4% of the sample reported sexual violence, and those who did tended to be younger, have lower income, and female. Those who had a GED or high school degree reported less sexual violence than those who did not complete high school or those who attended college. Women were more likely to report both rape and sexual assault, as well as lifetime or recent PTSD. The lifetime PTSD was 34.4% and the recent PTSD was 18.3% in sexual violence victims. In unadjusted models, PTSD was 4 times more likely in sexual violence victims. In the fully adjusted model, only lifetime PTSD was 1.6 times more likely.


Discussion

Two key findings of this study are that African American women reported lower sexual violence than a recent national study, and sexual violence was associated with increased rate of lifetime PTSD. The decrease we see in lower reported sexual violence was likely due to the way the questions were asked in the study, The questions specifically asked if they had experiences sexual violence. But sexual violence can be very broad, encompassing different tactics and experiences. African American women likely have similar cases of sexual violence compared to national averages, but are simply less likely to label the same experiences as violence. The level of men who reported sexual violence in this study matched national levels. 

There was a previous study done in the Detroit area that assessed sexual violence in all racial groups of the area, not just African American. In the previous study, the reported sexual violence was even lower than this study. This may be because willingness to report sexual assault has increased over time, or because of ethnic and racial differences between studies. Still, both studies associate sexual violence with young, female, and low income individuals.

Sexual violence is only associated with lifetime PTSD, not recent PTSD, when other traumatic events are taken into account. Still, victims of sexual violence reported having more of the other traumatic events, showing that these individuals had a higher risk for entering a cycle of traumatic event exposure. Despite the limitations of this study being self-reported, the results should be taken seriously in that sexual violence is happening, and is associated with lifetime PTSD and repeated trauma in low income urban African American women.