The biobehavioral impacts of sexual violence: Findings from an acute repeat survivor of vaginal rape.

Background: Individuals who have experienced repeat sexual violence victimization face adverse mental and physical health outcomes, including immune and stress response functioning. We aim to further understand repeat sexual violence victimization to develop responsive and appropriate treatment for survivors of sexual violence.

Methods: We present the immunological and contextual findings of a participant ( = 1) who experienced repeat sexual violence victimization during her enrollment in The THRIVE Study, a prospective case-control study of women aged 14-45 years, who have experienced recent consensual vaginal penetration ("controls") or forced vaginal penetration ("cases"). Participants complete a survey, HIV/sexually transmitted infection, and pregnancy testing, blood sampling for C-reactive protein and adrenocorticotrophic hormone, collection of cervicovaginal fluid for immunological biomarkers, and self-collection of saliva samples for cortisol measurements, across study visits (Baseline, 1, and 3 months).

Results: The case study participant, aged 18 years upon enrollment, experienced sexual trauma before four of five study visits. Trends in the mental health indicators demonstrate reciprocal fluctuations in adverse mental health and resilience in accordance with revictimization and circumstantial changes. Suppressed immune biomarkers appear to correlate with increased adverse mental health, while mental health recovery trends with immunological recovery. The participant presents with dysregulated hypothalamic-pituitary-adrenal axis diurnal profile.

Conclusions: This profile illustrates the intra-individual biobehavioral impact of experience with revictimization over the course of 6 months, capturing experiences that are rarely studied either longitudinally or with the depth of the current research. The findings underscore the value of monitoring cervicovaginal immune functioning and hypothalamic-pituitary-adrenal axis dysregulation in coordination with changes in mental health over the course of repeated sexual trauma.