Military Women Research Articles

Sexually Transmitted Infections in U.S. Military Women: A Scoping Review 2000–2018

High rates of sexually transmitted infections (STIs) have been documented among U.S. military servicemembers. The purpose of this scoping review is to evaluate the literature to determine what is known about the risk factors, preventive measures, and health outcomes regarding STIs among active duty servicewomen. A search of six bibliographic databases and the grey literature identified articles published from January 1, 2000, to December 31, 2018. A two-level review process was used to evaluate the inclusion of articles. Fifty-six articles were included. The majority of studies (n=47) were descriptive (95%). The primary STIs of focus were chlamydia (66%) and gonorrhea (38%), with a lesser focus on herpes simplex virus 1 and 2 (17%) and syphilis (11%). There were no studies on chancroid or pubic lice. Chlamydia and gonorrhea were highly prevalent. Age, race, and gender were nonmodifiable risk factors, whereas behaviors, beliefs, socioeconomic level, marital status, and concomitant or repeat infections were modifiable risk factors. Educational programs and studies evaluating efficacious STI prevention methods were lacking. STI diagnoses occurred in servicewomen at their home stations as well as in deployed settings. STIs remain an ongoing public health challenge with insufficient research to guide military and health care leaders. Future research should focus on prospective designs that leverage identified risk factors and at-risk populations where the most impact can be made to promote reproductive health.

Hardiness protects against problematic alcohol use in male, but not female, soldiers.

Military service members are at high risk for problematic substance use compared with the general population; deployment and combat exposure further increases this risk. It is thus critical to identify resiliency factors that can buffer the negative effects of military experiences and potentially prevent problematic alcohol use. The current research examines the extent to which psychological hardiness predicts lower risk of problematic alcohol use and explores potential sex differences in this association. Data are from Operation: SAFETY, an ongoing study of U.S. Army Reserve/National Guard soldiers. Negative binomial regression models examined the relation between baseline hardiness, assessed by the 15-item Dispositional Resiliency Scale, and problematic alcohol use at the 1-year follow-up, assessed by the Alcohol Use Disorders Identification Test (N = 260), controlling for baseline combat exposure (Combat Exposure subscale, Deployment Risk and Resilience Inventory-2) and baseline quantity and frequency of alcohol use. To examine the impact of hardiness on men and women, models were stratified by sex. In final, adjusted models, hardiness predicted lower risk of problematic alcohol use (adjusted risk ratio = 0.98; p < .05) for male soldiers and was unrelated to alcohol use for female soldiers (adjusted risk ratio = 1.01; p > .05). Post hoc analyses explored the impact of each dimension of hardiness (i.e., commitment, control, and challenge) on problematic alcohol use. Hardiness assessment may complement existing screening tools to identify high-risk populations; interventions to promote hardiness may help in preventing problematic alcohol use, particularly among male soldiers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Scoping Review of Cervical Cancer Risk Factors, Prevention, Diagnosis, and Treatment in U.S. Active Duty Military Women.

Maintaining military readiness requires integration and delivery of appropriate sex-specific health care services for active duty servicewomen (ADSW). Cervical cancer screening (CCS) provides early detection, intervention, and treatment, allowing for reductions in human papillomavirus (HPV) infections and cervical cancer cases. This scoping review examines existing cervical cancer evidence related to ADSW and identifies research gaps, leverage points, and policy recommendations within the context of the social ecological model for military women's health. We conducted a scoping literature search using both indexed databases and nonindexed sources. We managed retrieved records from 2000 to 2018 with Endnote reference and DistillerSR systematic review software. Of 1,006 records from indexed databases and 208 records from nonindexed resources retrieved, 40 publications met the inclusion criteria. Cervical cancer research addressing ADSW is limited. Servicewomen have high rates of known cancer risk factors and face challenges related to deployments and change of duty station that affect continuity of health care and timely follow-up for abnormal CCS. Multimodal interventions with stakeholder support can encourage CCS adherence and increase HPV vaccination rates. Maintaining military readiness among ADSW requires robust evidence-based prevention efforts to address risk factors that are reportedly higher among servicewomen, as well as challenges to continuity in health care delivery that may increase the likelihood of cervical cancer incidence. Recognizing the role of HPV vaccination as cancer prevention, collaborations and partnerships, research, best practices, and creative solutions to close ADSW's sex-specific health gaps will help to ensure a fit and ready force.

Fighting for a Seat at the Table: Women’s Military Service and Political Representation

Military service has long been seen as a path to political leadership and elevation of status in public life. Public opinion polls steadily show that the American people trust military veterans to be principled leaders and model public citizens. Combat veterans are held in particularly high regard as model and trustworthy citizens. For military women in the United States, the wars in Iraq and Afghanistan have ushered in a new era in combat arms participation. However, to the detriment of both women’s political and economic equality, gendered perceptions about military participation and the identity of combat veterans have been slow to change. Despite women’s participation in combat, they have been denied the elevated citizen status frequently enjoyed by their male peers with similar experiences. This bodes poorly for lasting peace and security. Research increasingly indicates that the involvement of women in public life leads to more peaceful and stable outcomes, and enduring peace and stability. While the US has been a leader in the adoption of official UN Resolutions that call for women’s equality in all facets of governance and the passage of the 2017 Women, Peace, and Security Act; women are still heavily under-represented in all levels of government.

Fighting for a Seat at the Table: Women’s Military Service and Political Representation

Military service has long been seen as a path to political leadership and elevation of status in public life. Public opinion polls steadily show that the American people trust military veterans to be principled leaders and model public citizens. Combat veterans are held in particularly high regard as model and trustworthy citizens. For military women in the United States, the wars in Iraq and Afghanistan have ushered in a new era in combat arms participation. However, to the detriment of both women’s political and economic equality, gendered perceptions about military participation and the identity of combat veterans have been slow to change. Despite women’s participation in combat, they have been denied the elevated citizen status frequently enjoyed by their male peers with similar experiences. This bodes poorly for lasting peace and security. Research increasingly indicates that the involvement of women in public life leads to more peaceful and stable outcomes, and enduring peace and stability. While the US has been a leader in the adoption of official UN Resolutions that call for women’s equality in all facets of governance and the passage of the 2017 Women, Peace, and Security Act; women are still heavily under-represented in all levels of government.

Gender Differences in the Extended Theory of Planned Behaviour on Smoking Cessation Intention in Young Soldiers.

Background: The theory of planned behaviour (TPB) explanation of smoking cessation intentions consists of gender differences. The purpose of this study is to adopt the extended TPB to discuss factors influencing the smoking cessation intentions of young adult volunteer soldiers and to further compare the respective factors for both genders. Methods: This is a cross-sectional study. Data were collected from 139 and 165 male and female volunteer soldiers who smoked, respectively. Research participants completed a self-administered questionnaire that comprised items pertaining to the participants’ demographic characteristics, smoking behaviours, smoking cessation experiences, social environments, and TPB variables. Results: Subjective norms (friends) are a positive key factor for young adult male (β = 0.033, p = 0.012) and female (β = 0.076, p < 0.001) volunteer soldiers’ smoking cessation intentions, and perceived behavioural control is a key factor for male young (β = 0.226, p = 0.040) adult volunteer soldiers’ smoking cessation intention. The extended TPB accounted for 27.9% and 53.2% of the variance in the intention to quit smoking in the male and female volunteer soldiers, respectively. Conclusions: We suggest that smoking cessation strategies can reinforce gender-specific intervention strategies to assist young adult volunteer soldiers in smoking cessation.

Ending Impunity for Forced Marriage in Conflict Zones

Abstract Countless women and girls have been abducted, raped, forcibly assigned as ‘wives’ to combatants and held captive within such forced marriages in conflict zones around the world. Forced marriage as an international crime remains controversial because it (i) is not codified in any international criminal statute, (ii) involves conduct overlapping with already-enumerated crimes against humanity and (iii) is inconsistently defined. Legal protections for girls in forced marriage reside in historical proscriptions against various forms of slavery — banned by jus cogens norms, international human rights and humanitarian law — including the crimes against humanity of sexual slavery and enslavement. Yet, despite similarities between forced marriage and numerous forms of slavery, international criminal courts have not yet prosecuted or convicted forced marriage as enslavement, and even its conviction as sexual slavery insufficiently captures the unique, multi-layered injuries its youngest victims suffer. International tribunals confronting evidence of very young girls captured as ‘wives’ and of female child soldiers serving as sex slaves have failed to adequately recognize or redress the egregious harms girl endure through forced marriage. Competing judicial and academic views on its proper classification have obscured courts’ oversight of forced marriage’s most vulnerable victims — female children. This article argues that, to advance justice for girls in conflict zones and end impunity for these atrocities, greater judicial emphasis is needed on the constellation of internationally recognized fundamental human rights of children violated by forced marriage, whether prosecuted as an ‘other inhumane act’ or slavery-related crime against humanity.

Bra-body armour integration, breast discomfort and breast injury associated with wearing body armour

This study investigated whether female soldiers experience bra integration or breast discomfort/injuries related to body armour use and whether these issues were associated with breast size. Ninety-seven Australian Defence Force female soldiers completed a questionnaire and had their breast volume assessed (range: 91–919 ml/breast) using three-dimensional scanning. Twenty-two percent (n = 21) of participants reported integration issues between their bra and body armour, 63% (n = 61) reported breast discomfort while wearing body armour and 27% (n = 26) reported experiencing a breast injury related to wearing body armour. Although bra-body armour integration was not dependent upon breast size, female soldiers with medium-large breasts reported significantly more breast discomfort and injuries when using body armour compared to participants with small breasts. These findings highlight the importance of developing body armour systems that cater to the range of breast sizes of female soldiers in order to improve bra-body armour integration and reduce breast discomfort and injury. Practitioner Summary: This exploratory research provides evidence of bra integration issues, breast discomfort and breast injury experienced by female soldiers when wearing body armour. Given the growing representation of women in military organisations, strategies to alleviate these issues for female users of body armour, particularly those with larger breast sizes, are required.

From UNSCR 1325 and the Korean and the Japanese National Action Plan to the Solution of the Problem of the Japanese Military Comfort Women

The United Nations Security Council adopted resolution 1325 on women-peace-security on 31 October 2000 while reaffirming women s important role in preventing and resolving conflicts, peace negotiations, peace-building, and peacekeeping and in post-conflict reconstruction, and requiring their equal participation in the significant process relating to peace and security. This essay aims to introduce the background and contents of UNSCR 1325 and to present a method of solution of the problem of the Japanese military comfort women after comparing the Korean and the Japanese national action plan. As a research method, I study the background of adopting UNSCR 1325 and the following resolutions and the matters to execute and then compare the two national action plans of Korea and Japan while observing the process of establishing and executing them. The conclusion says that the woman representatives of the two countries, according to their action plans, should negotiate the historical problem prior to the governmental officials on the basis of the female fellowship.

Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis.

Multiple internal factors, such as psychological resilience and mental health status, have been shown to contribute to overall quality of life (QoL). However, very few studies to date have examined how these factors contribute to QoL of youth and young adults in a stressful situation. Here, we studied the contribution of these factors, as well as of ecological momentary mood assessment, to QoL of young army recruits during their Basic Training Combat (BCT). To this end, we collected data from 156 male and female soldiers in a mixed-gender unit in the Israel Defense Forces (IDF). Using a mobile app installed on participants' phones, participants provided self-reports regarding their mental health status and psychological resilience at baseline, and QoL 2 weeks later. Momentary mood reporting was further collected during the 2-week interval period using a daily self-report mood scale (IMS-12). Structural equation modeling (SEM) was used to examine the interrelationships among the study variables based on a hypothesized model. We found that a model with all factors (gender, resilience, mental health status and momentary mood) provided a good fit for the data based on its fit indices [χ2(38) = 47.506, p = 0.139, CFI = 0.979, NFI = 0.910, RMSEA = 0.040, TLI = 0.964]. However, the only direct contributors to QoL were gender and momentary mood, accounting together for 61.5% of the variance of QoL. Psychological resilience and mental health status contributed to QoL only indirectly, through their associations with momentary mood. Collectively, these results highlight the importance of ecological momentary assessment of mental-health related factors such as mood to the prediction of QoL in young adults under stress. These findings may have broader implications for monitoring and improvement of well-being in young healthy populations as well as in clinical ones.

Parental suicide attempt and subsequent risk of pre-enlistment suicide attempt among male and female new soldiers in the U.S. Army.

Suicide and suicide attempts among U.S. Army soldiers are a significant concern for public health. This study examined the association of parental suicide attempt prior to age 13 of the soldier with subsequent risk of pre-enlistment suicide attempt. We conducted secondary analyses of survey data from new soldiers who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) (N=38,396). A series of logistic regression analyses were conducted. Of all new soldiers, 1.4% reported that they attempted suicide between age 13 and entering the Army, and 2.3% reported a parental suicide attempt prior to age 13. Parental suicide attempt was associated with increased odds of subsequent suicide attempt; however, this association was moderated by gender and was significant only among male soldiers. The association between parental suicide attempt and pre-enlistment suicide attempt among male soldiers was still significant after controlling for socio-demographic characteristics, soldier/parental psychopathology, and childhood adversities. These results highlight parental suicide attempt as a unique pre-enlistment risk factor for suicide attempt, especially among male new soldiers. Further studies are needed to separate the genetic and environmental contributions to intra-familial risk for suicidal behavior.

Health Profiles of Military Women and the Impact of Combat-Related Injury.

The role of women in the United States military is expanding. Women are now authorized to serve in all military occupations, including special operations and frontline combat units, which places them at increased risk of combat exposure and injury. Little is known regarding the impact of these injuries on the health of military women. We conducted a retrospective matched cohort study of women service members who were injured during combat operations in Iraq and Afghanistan. Injured women were individually matched to non-injured controls at a 1:4 ratio. Medical diagnostic codes were abstracted from outpatient encounters in electronic health records, and hierarchical clustering was conducted to identify clusters of diagnostic codes, termed "health profiles." Conditional logistic regression was used to determine whether combat-related injury predicted membership in the profiles. The study sample included 590 injured women and 2360 non-injured controls. Cluster analysis identified six post-deployment health profiles: low morbidity, anxiety/headache, joint disorders, mixed musculoskeletal, pregnancy-related, and multimorbidity. Combat-related injury predicted membership in the anxiety/headache (odds ratio, 1.73; 95% confidence interval, 1.38-2.16) and multimorbidity (odds ratio, 3.43; 95% confidence interval, 2.65-4.43) profiles. Combat-related injury is associated with adverse post-deployment health profiles among military women, and women with these profiles may experience increased health care burden. As future conflicts will likely see a greater number of women with combat exposure and injury, health outcomes research among military women is paramount for the purposes of medical planning and resource allocation.

Gender, Trauma and Power in China Keitetsi’s La petite fille à la Kalachnikov: Ma vie d’enfant soldat

ABSTRACT This article focuses on China Keitetsi’s memoir La petite fille à la Kalachnikov (2004) in which she describes her early childhood in Uganda as well as her experiences as a female child soldier in the Ugandan National Resistance Army (NRA) under Yoweri Museveni from 1985 to 1995. First, I briefly explore the intended objectives of her text as a crucial therapeutic step and a political act. Second, I examine her narration of her early childhood in which she evokes Ugandan women’s lack of social and economic power and denounces the intimate and sexual violence that girls and women experience. Lastly, I study how her narration of her experiences as a female child soldier provides invaluable insight into the complex experiences of female child soldiers, by showing not only the empowerment they feel as soldiers but also the sexual violence they experience as females and its effects on their psyche. Through my analysis, I demonstrate how Keitetsi not only exposes the trauma she experienced but also condemns the socio-cultural and political structures that victimised her as a girl and later as a female child soldier. Keitetsi’s memoir generates important reflections on gender and power.

Structural Equation Modeling of a Global Stress Index in Healthy Soldiers.

Accumulation of stress is a prognostic trigger for cardiovascular disease. Classical scores for cardiovascular risk estimation typically do not consider psychosocial stress. The aim of this study was to develop a global stress index (GSI) from healthy participants by combining individual measures of acute and chronic stress from childhood to adult life. One-hundred and ninety-two female and male soldiers completed the Perceived Stress Scale (PSS4), Trier Inventory for Chronic Stress (TICS), Hospital Anxiety and Depression Scale (HADS), Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale Checklist (PDS), and the Deployment Risk and Resilience Inventory (DRRI-2). The underlying structure for the GSI was examined through structural equation modeling. The final hierarchical multilevel model revealed fair fit by taking modification indices into account. The highest order had a g-factor called the GSI. On a second level the latent variables stress, HADS and CTQ were directly loading on the GSI. A third level with the six CTQ subscales was implemented. On the lowest hierarchical level all manifest variables and the DRRI-2/PDS sum scores were located. The presented GSI serves as a valuable and individual stress profile for soldiers and could potentially complement classical cardiovascular risk factors.

The Conflict of Recalling Traumatic Memories in Mariette Kalinowski's "The Train"

Traumatic experiences are characterized by its prelinguistic tendency. War fiction, however, refutes this statement when it reflects on the components of war so as to bear witness to its overwhelming nature as well as its ambiguous realities. Recalling the traumatic wounds of war, in this regard, is a testimonial avenue grounded on the desires of its narrators to be transformed from the confined scope of individuality into a more collective one. Written on the background of 2003 Iraq War, Mariette Kalinowski's "The Train" represents war's aftermath and the difficulty soldiers faced in adhering to ordinary life after being home. The conflict is a psychological one; it is shaped within the consciousness of a female soldier whose traumatized memory struggles against the ghost of past that haunts present. The study argues that Mariette Kalinowski's "The Train” follows the traumatized consciousness of an American veteran whose narrative line is marked by fragmentation, nonlinear plot, and the fluctuation between the past and the present. It also argues that the story itself is a testimonial narrative that aims at recordings individual suffering and thus placing it within a collective framework that motivates solidarity among wounded victims. The study relies on the psychological and literary aspects of trauma theory. It significantly draws on Cathy Caruth's Unclaimed Experiences, Ann Whitehead Trauma Fiction, Shoshana Felman's Crises of Witnessing in Literature, Psychoanalysis, and History, and other theorists in the field of trauma theory.

Insomnia: Sex differences and age of onset in active duty Army soldiers

BackgroundThe prevalence of insomnia symptoms, insomnia diagnostic status, and age of onset compared by sex is understudied within the military population. MethodData were examined from the All Army Study to Assess Risk and Resilience in Service members (N = 21,294; 18-61 years; 11.7% female and 87.6% male). Participants were given a self-administered version of the Composite International Diagnostic Interview Screening Scales to assess psychopathology and cognitive deficits, and the Brief Insomnia Questionnaire for insomnia disorder assessment. Participants identified the age they first experienced sleep problems for 1 month or longer as part of the self-administered questionnaire. ResultsAmong this sample of Army soldiers, 22.8% met insomnia diagnostic status (22.0% of males and 28.4% of females). A binary logistic regression model revealed that insomnia diagnostic status was associated with female soldiers (OR = 1.26, P< .001, 95% CI = 1.13-1.41) compared to male soldiers, even when accounting for sociodemographic variables and mental health disorders. No significant sex differences emerged at insomnia symptom level or sleep problem age of onset. ConclusionThis study highlights the importance of examining insomnia by sex in active-duty populations. Results suggest that female active duty soldiers experience insomnia at a higher rate than their male counterparts, which may be driven by reports of daytime impairment. Given this information, more specific clinical recommendations on assessing and treating insomnia could be provided, especially when considering readiness for military duty.

Khaki and Emerald Green

A short story about a military woman struggling with family, career, and PTSD. Her perspective on her situation shifts when she visits the Canadian Museum of Human Rights with her young son.

Sizing System for Indonesian Policewomen’s Body Armour

Existing body armour sizes are focused on male users, as they are the majority of the population. The personal equipment of female and male soldiers should be separated because these groups have different sizes and matches. In other words, body armour design should correspond with user anthropometry. Good body armour must fit properly and be comfortable for the users. To solve this problem, this study develops a new sizing system. The study’s subjects were 150 with 20-to-30-year-old policewomen working in the Regional Police Department of Special Region of Yogyakarta. Data collection was performed with the simple random sampling method. Two statistical analysis methods, Principle Component Analysis (PCA) and clustering, were used to assist with the assessment of data. Analysis of the subjects indicated 15 size groups for body armour in three larger groups: S (VS, S, N, L and VL), M (VS, S, N, L and VL), and T (VS, S, N, L and VL). All size groups were validated using Euclidean distance, with an accuracy result of 66.67%.

THE REPRESENTATION OF FEMALE CHARACTER IN EDGE OF TOMORROW (2014) FILM BASED ON FEMINIST FILM CRITICS

(Title: The Representation of Female Character in “Edge of Tomorrow” (2014) Film Based on Feminist Film Critics). This research analyzes the female character in Edge of Tomorrow, Rita Vrataski. This research intends to understand how female character is described in the film and how female character is described according to feminist film critic. The method used is descriptive qualitative method. This research also uses theory character and characterization in film and theory feminist film critic. As the result, Rita is described as a female soldier who has characteristics as committed, brave, assertive, strong, muscular, intelligent and skillful soldier. Even though Rita, as the female character who has man’s characteristics, she still needs help from another male character. Rita character in this film is still passive because the one who finishes the mission in the story is the male character, William Cage. This film proves that male domination still exists in story of film. Thus, the female stereotype has been attached in film and it is difficult to change it.Keywords: female character ,women in film , feminist film critic

Reproductive health and contraception use by Ukrainian servicewomen in the current war zone: a questionnaire survey

The aim of the study is to define awareness level and use of different contraception methods by servicewomen in the current armed conflict in the East of Ukraine. Between October 2018 and September 2019, 507 military women serving in the Joint Forces Operation Zone in eastern Ukraine and 100 civilian women from the frontline region participated in the questionnaire-based survey. The survey was focused on the knowledge and use of different methods of contraception and STI preventing by military women in conditions of armed conflict in Donbas. Servicewomen reported using of different methods of contraception in 48.3±4.3% of the cases, which is 1.5 times less than civilian women (RR=1.5; 95% CI: 1.2 – 1.7, p=0.001). Among those who reported using contraception, hormonal methods were chosen by 8.2±3.4% of active duty military women, which is two times less than by civilians (RR=2.1, 95% CI: 1.1-4.1, p=0.03). The low use of effective methods of contraception by active-duty servicewomen according to results survey is one of the reasons for the disruption of female reproductive health during military deployment. The primary reserve of preserving women's health in the current war environment,besides access to modern contraceptives and counseling, is improving the education of military medics in the gender-specific issues of reproductive health and contraception.