The risk of gynecological and sexual health problems — such as sexually transmitted infections, painful sex, vaginal bleeding, and recurrent urinary tract infections — is three times higher in women who have suffered domestic violence and abuse (DVA).
In addition, 47 percent of women who seek services at sexual health clinics will have experienced DVA at some point in their lives.
Now a new study by researchers at Queen Mary University of London (QMUL) and the University of Bristol finds that training clinicians at sexual health clinics to proactively ask patients about domestic violence may help increase referrals to specialist services.
Sexual health services can be the first point of contact for women who have experienced DVA, and were listed by the National Institute for Health and Care Excellence (NICE) as a setting in which all patients should be asked about this type of abuse. However, most sexual health professionals have had minimal training in identifying and responding to DVA.
“Women attend sexual health clinics for care of their sexual health but little thought is given to whether the relationship with the person that a woman has sex with directly harms her health,” said lead researcher Dr. Alex Sohal at QMUL.
“Without training, system level changes and senior managerial support, clinicians end up ignoring DVA in consultations or have an arbitrary approach that fails many women affected by DVA.”
The study, which involved over 4,300 women, investigated the practicality of sexual health clinics adopting a program called IRIS (Identification and Referral to Improve Safety). The program was originally aimed at encouraging general practitioners to ask patients whether they were experiencing DVA and to make referrals to specialist domestic violence services.
The researchers tested the intervention in two female walk-in sexual health services: an east London clinic serving an inner-city multi-ethnic population, and a Bristol clinic serving an urban population.
In the east London clinic over seven weeks, 267 out of 2,568 women attending were asked about DVA. Overall, 16 women (four percent) reported that they were affected by abuse. Of these, eight (50 percent) were referred to specialist services.
In the Bristol clinic over twelve weeks, 1,090 out of 1,775 women attending were asked about DVA. Of these, 79 (seven percent) reported being affected by abuse. Eight of the women affected by abuse (10 percent) were referred to the specialist services.
“Not only is this a feasible intervention for a sexual health clinic setting, but we also found that clinical leads and busy local DVA service providers were incredibly supportive, with many people understanding the importance of making this work,” said Sohal.
Source: Queen Mary University of London