Statement of Purpose Using a large, nationally-representative sample, we examine the burden, as well as lifetime prevalence and associated sexual healthcare utilization, of sexual violence (SV) experienced by bisexual women.

Methods/Approach We used data from female respondents aged 18–44 (N=14,309) in the 2011–2017 National Survey of Family Growth. Using sexual orientation components (identity, attraction, and lifetime sexual behavior) as separate main predictors, multivariable logistic regressions (adjusted for age, race, education, and poverty) compared male-perpetrated SV experience (forced vaginal, oral, or anal sex) and healthcare utilization among bisexual versus non-bisexual women.

Results Lifetime prevalence of SV was higher, compared to non-bisexual women, among women who identified as bisexual (prevalence ratio/PR=2.69), had same and opposite sex attraction (PR=2.56), or reported same and opposite sex sexual behavior (PR=2.89) (all p<0.001). Bisexual women experienced sexual initiation earlier than non-bisexual women (16.36 vs 17.66 years old, p<0.001) but were also more likely to experience SV earlier in adolescence (16.16. vs 17.29, p<0.001). Compared to non-bisexual women with a history of SV, bisexual women, on average, received more sexual health services (3.11 vs 2.83, p=0.04) and were more likely to have been treated for sexually-transmitted diseases (PR=1.49, p=0.05) in the 12 months prior to the survey.

Conclusion Across all sexual orientation components, prevalence of male-perpetrated SV is consistently higher among bisexual women compared to non-bisexual women. Bisexual women tend to experience SV earlier in adolescence and utilize more healthcare services for associated health outcomes. Ultimately, comprehensive interventions across the social ecology are needed to stop SV among this population.

Significance and Contributions to Injury and Violence Prevention Science Despite increasing acceptance of same-sex behavior, the same changes in attitude have not extended to bisexual individuals (Dodge et al., 2016). SV appears to be common among bisexual women, and more attention and public health efforts are needed to address the role of gender norms and attitudes toward bisexuality in SV prevention.