To determine the association of military sexual trauma (MST) with migraine and headache care.

We analyzed administrative data from the Women’s Veteran’s Cohort Study, a sample of post-9/11 US Veterans enrolled for Veterans Health Administration (VHA) care. A positive MST screen defined exposure. We extracted demographic and clinical data from administrative coding for migraine and relevant confounders, comparing subgroups with Chi-square analysis. Healthcare utilization variables designated sites of care and prescribed abortive and preventative treatments and were evaluated with multivariable logit, negative binomial (nb), and zero-inflated nb models .

Of 846,435 Veterans, 37,375 (66% female, 34% male) had a positive screen, while 80,696 had migraine.  Veterans with migraines and MST (21.7% of MST(+)) were more often non-white (45.3% vs. 38.6%, p<0.001), and ≤33 years old (55% vs. 53%, p<0.001) than Veterans with migraine alone (9% of MST(-)).  Adjusting for gender, the odds of migraine were substantially greater for MST(+) (OR 1.62, 95% CI 1.57,1.67.)    

MST(+) Veterans were more likely to receive headache abortive and preventative medications discordant with Â鶹´«Ã½Ó³»­/AHS guidelines (OR 1.29,95% CI 1.21, 1.36; OR 1.70,95% CI 1.60,1.81 respectively), especially opioids (OR 1.26,95% CI 1.19, 1.33) after adjustment for gender and comorbid conditions.  Healthcare utilization was increased among MST(+) migraine Veterans  for primary care (IRR 1.06, 95% CI 1.04, 1.08, p<0.001), and emergency room care (IRR 1.14, (95% CI 1.07, 1.22) , while neurology visits were not increased (IRR 0.97, 95% CI 0.92, 1.02) among MST(+) patients with migraine controlling for gender, comorbidities, treatments,  and other healthcare use.