The effect of Sexual violence on women’s suicide risk. A mediation analysis based on the nationally-representative 2017 French Health Barometer survey

Abstract Objectives The experience of sexual violence has been associated with a host of mental health problems, especially among women. However, data on this association from a large sample of general population is surprisingly limited. Also, no study quantifies sex-differences in the effect of sexual victimization on suicide risk. Methods The French “Health Barometer” (Baromètre Santé) is a cross-sectional phone survey, which recruited a nationally representative sample of French adults aged 18 to 75 years in 2017 (n = 25319). Data were weighted to be representative of the French adult population. The Experience and timing of lifetime physical sexual violence, as well as suicide risk were measured for all participants. We conducted adjusted mediation analyses, using the counterfactual approach, to evaluate the contribution that lifetime sexual victimisation has in the association between sex and suicide risk. Results The median age for the first experience of sexual violence was 12. Women were around five times more likely to report lifetime sexual violence compared to men (9.1% vs 1.9%), and were more at risk of any suicidal ideation (Ora =1.20 (95%CI: 1.07-1.36)) and suicidal imagery (Ora=1.39 (95%CI: 1.20 -1.61)). We estimated that 47% of the increased risk of suicidal ideation in the preceding year women have compared to men is mediated by lifetime sexual assault. Lifetime sexual assault also explained 39% of the association between sex and having imagery of suicide. Discussion Our findings reiterate the importance of the prevention of sexual violence and an adequate care for sexual assault victims, especially women, in public health and mental health policies and initiatives.