Survivors of domestic sexual violence and abuse can experience major impacts on their physical and mental health. The signs of this trauma can easily be missed by health care professionals during consultations.
Some survivors of domestic violence would like to disclose information to a health professional, but often do not feel confident or comfortable raising concerns on their own. Many even fear they will not be believed. Attempting to change this, IRISi have launched a new intervention, called ADViSE, which is now running in sexual health clinics across Bristol and South Gloucestershire.
ADViSE stands for “Assessing for Domestic Violence and Abuse in Sexual Health Environments”. As it suggests, the programme supports sexual health staff to identify and respond to the signs of both Domestic and Sexual Violence and Abuse – and enables them to directly refer patients to a specialist service for support.
It builds on the successful evidence-based model, ‘IRIS’ (Identification and Referral to Improve Safety), which is IRISi’s flagship programme in GP practices nationwide. This new service is jointly commissioned by Bristol City Council and South Gloucestershire Council and will be delivered locally at Unity Sexual Health clinics in collaboration with Next Link, a local specialist domestic abuse support service.
According to a study published by the World Health Organisation in 2012, women affected by domestic abuse and sexual violence are three times more likely to have gynaecological and sexual health problems. Another paper, “Domestic violence in a genitourinary medicine setting–an anonymous prevalence study in women”, reports that 47% of women attending sexual health services will have experienced domestic abuse and sexual violence at some point in their lives and these services can be the first point of contact for support.
While we know that domestic and sexual violence are gendered issues that predominantly affect women, violence can occur in all relationships, across all genders and sexualities. Sexual Health clinics are safe places for LGBTQ+ communities, who may not feel comfortable attending their GP or non-specialist health settings. So, ADViSE is essential in addressing domestic and sexual violence and abuse within these settings.
But how does it work?
ADViSE provides a holistic approach based on on-going training and support for sexual health clinic staff, giving them confidence and knowledge to spot the signs of domestic sexual violence and abuse.
A domestic and sexual violence expert, called an ‘Advocate Educator’ (AE), works alongside an ADViSE clinical lead (CL), a sexual health practitioner committed to improving the response to domestic abuse and sexual violence. Together they provide specialist training for the sexual health clinic staff, teaching them to create an environment that is a safe space for survivors to be heard and to disclose experiences.
The AE also provides advice and consultancy for the sexual health team, they are also the point of contact for patients who would like support and advocacy around domestic abuse and sexual violence. The AE becomes embedded in the sexual health clinics, thus giving patients essential access to both health and domestic abuse and sexual violence services.
This service is available to all Unity Sexual Health clinics across Bristol and South Gloucestershire, serving a population of nearly a million people. The launch of ADViSE means more survivors will have access to vital support. It also shows the importance of commitment from public investors to establish a robust and well-integrated model to address the needs of domestic abuse and sexual violence survivors in a holistic and sustainable way.