Barriers to Seeking Medical Care Among Youth Victims of Sexual Violence

Abstract

Purpose: Youth victims of sexual violence often experience physical health problems but are unlikely to receive medical care. However, victims' reasons for not accessing medical care have been understudied. We examined barriers to seeking medical care among youth victims who contacted the National Sexual Assault Online Hotline.

Methods: We used archival data about one-on-one chat sessions with youth victims between June 2018 and February 2020. Hotline staff described victims' reasons for not accessing medical care via an online assessment. We coded and qualitatively examined these reasons using data about 520 victims with physical health concerns who had not received medical care.

Results: Victims' barriers were rooted in individual beliefs and contextual realities reflected in three categories: (1) perception that medical care was not needed, (2) anticipated consequences of seeking medical care, and (3) inability to physically access medical care. Victims who perceived care as unnecessary did not understand the health implications of abuse or minimized their need for care. Anticipated consequences included privacy and control over disclosure, stigmatization, retaliation from the perpetrator, family disruptions, and retraumatizing medical treatment. Victims unable to physically access care were uncertain how to access care independently, lacked social support, or were prevented from care by the perpetrator.

Discussion: Medical treatment can ameliorate acute health concerns and increase safety, but youth victims perceived numerous barriers to care. Several barriers implied unintended consequences of child maltreatment policies, including mandatory reporting. Trauma-informed policy and practice are critical for improving victims' access to medical care and other support services.

Keywords: Barriers to care; Help-seeking; Postassault medical care; Sexual violence.