Sexual harassment, stress and suicide attempt among international college students in the USA

BMJ Public Health. 2026 Apr 9;4(2):e003136. doi: 10.1136/bmjph-2025-003136. eCollection 2026.

ABSTRACT

INTRODUCTION: Sexual harassment is a significant public health concern on US college campuses, yet limited research has examined its prevalence and correlates among international students. This study investigates the prevalence of sexual harassment among international college students and examines associations with stress and suicide attempts.

METHODS: A cross-sectional secondary data analysis was conducted using the 2022 American College Health Association-National College Health Assessment . The analytic sample included 13 242 international students. Sexual harassment in the past 12 months served as the primary outcome. Predictor variables included stress level, suicide attempt in the past year, number of sexual partners, academic level and sex assigned at birth. Descriptive statistics, univariate logistic regression and a final multivariate logistic regression model were used to examine associations.

RESULTS: Among 13 242 international college students, 6.1% (n=799) reported sexual harassment in the past 12 months. In the adjusted logistic regression model, moderate to high stress was associated with higher odds of sexual harassment (adjusted odds ratio (AOR) =1.800, 95% CI 1.470 to 2.205), and past-year suicide attempt was associated with higher odds of reporting sexual harassment (AOR=4.112, 95% CI 3.035 to 5.570).

CONCLUSION: The study underscores the need for targeted interventions and policies that account for gender-specific and population-specific vulnerabilities. International students face unique stressors, underscoring the need for comprehensive support systems at multiple levels. Limitations include self-reported data and a cross-sectional design. Future research should employ longitudinal designs and diverse samples to deepen understanding and strengthen support mechanisms, thereby fostering safer educational environments.

PMID:42006745 | PMC:PMC13084918 | DOI:10.1136/bmjph-2025-003136