Sexual violence is highly prevalent in the United States and is associated with a host of negative physical and mental health outcomes. Specifically, sexual violence is associated with increased rates of cervical cancer, one of the most common cancers found in women. Furthermore, sexual violence survivors report reduced participation in preventive healthcare behaviors (e.g., Pap tests) which may reduce individuals’ risk of developing reproductive health conditions such as cancer. Sexual violence exposure is also associated with increased symptoms of posttraumatic stress disorder (PTSD) and reduced trauma-coping self-efficacy (TCSE), two factors that may impact trauma-exposed individuals’ level of avoidance of cervical cancer screens. Current research on the connection between sexual violence and reproductive healthcare often fails to examine potential underlying mechanisms behind this association, nor does it account for confounding factors such as healthcare accessibility and need. Accordingly, the present study tested a proposed moderated mediation model to explore the association between sexual violence and cervical cancer screening participation, including analysis of the indirect effect of TCSE and potential moderation of this effect by PTSD symptoms. Participants were 554 participants who reported experiences of sexual violence on Amazon’s Mechanical Turk. Severity of sexual violence was significantly associated with reduced likelihood of participation in recommended cervical cancer screening. TCSE did not mediate nor did PTSD moderate this association. Findings of this study suggest that individuals’ reproductive healthcare behaviors are influenced by their experiences of sexual trauma, as well as by structural factors such as insurance and income. Limitations, directions for future research, and clinical implications of study findings are discussed.

中文翻译：

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创伤、创伤后应激障碍和自我效能：性暴力幸存者宫颈癌筛查的预测因素


性暴力在美国非常普遍，并与许多负面的身心健康结果相关。具体来说，性暴力与宫颈癌发病率增加有关，宫颈癌是女性最常见的癌症之一。此外，性暴力幸存者报告减少了对预防性医疗行为（例如巴氏涂片检查）的参与，这可能会降低个人患癌症等生殖健康疾病的风险。性暴力暴露还与创伤后应激障碍（PTSD）症状的增加和创伤应对自我效能（TCSE）的降低有关，这两个因素可能会影响遭受创伤的个体避免宫颈癌筛查的程度。目前关于性暴力与生殖保健之间联系的研究往往未能检验这种关联背后的潜在潜在机制，也没有考虑到医疗保健可及性和需求等混杂因素。因此，本研究测试了拟议的调节中介模型，以探索性暴力与宫颈癌筛查参与之间的关联，包括分析 TCSE 的间接影响以及 PTSD 症状对该影响的潜在调节。参与者有 554 名在亚马逊 Mechanical Turk 上报告过性暴力经历的参与者。性暴力的严重程度与参与推荐的宫颈癌筛查的可能性降低显着相关。 TCSE 没有调节这种关联，PTSD 也没有调节这种关联。这项研究的结果表明，个人的生殖保健行为受到性创伤经历以及保险和收入等结构性因素的影响。 讨论了研究结果的局限性、未来研究方向以及临床意义。