If we don’t ask, we don’t know – can intimate partner violence adversely affect the sexual health of Western Australian women?

By Sarah Smith, Acting Medical Director, Sexual Health Quarters

Family, domestic and sexual violence is a major health and welfare issue, occurring across all ages, socioeconomic and demographic groups, and mainly affecting women and children.  Intimate partner violence causes more illness, disability and deaths than any other risk factor for women aged 25 to 44 years, (1) and is something that clinicians need more support in identifying signs of early on.

Over the past year, Sexual Health Quarters (SHQ) has developed and implemented an evidence-based, consumer and clinician reviewed, screening tool for Intimate Partner Violence (IPV) and Reproductive Coercion (RC).  This six question tool forms part of the usual intake paperwork that clients complete in a private waiting area (without family or support members) when attending the SHQ Clinic.  In addition, all front-line staff received training in how to respond to disclosures of such violence, and we established pathways for emergency and urgent counselling services, and for referrals to family and domestic violence services.

Funded by the Australian Government through the Women’s Leadership and Development Program, this initiative forms part of a research project that will see us collect de-identifed data from those identifying as female over 15 months, and complete statistical analysis to determine whether an association exists between IPV/RC and negative sexual health outcomes, unintended pregnancy and sexually transmitted infections.

Results from the first 440 participants show a prevalence of IPV/RC of 17 percent, meaning 1 in 6 women attending SHQ disclosed that they had been exposed to such violence. Of the 75 women who had experienced this, 16 percent stated this violence was happening in the current relationship, 17 percent accepted a same-day appointment with a counsellor, and 1.3 percent were worried for the safety of children in their care. These women had 1.5 times the risk of having a negative sexual health outcome, and 2.5 times the risk of having a current unintended pregnancy.

These preliminary results indicate there is a high prevalence of IPV/RC among female-identifying clients who attend clinical services at SHQ, and that there is a possible link between IPV/RC and negative sexual health outcomes.  We look forward to sharing the final results with our GP colleagues at the end of this research project.  We have demonstrated that it is possible to introduce a paper-based screening tool for these issues in a clinical setting, with appropriate support from counselling services and knowledge of referral pathways.  It shows the potential to identify and support women most in need, and to significantly improve their reproductive and sexual health outcomes.

Interested GPs may also like to consider the DV-alert training options funded by the Department of Social Services. For more information, visit, https://www.dvalert.org.au/

References:

  • Australian Institute of Health and Welfare 2018. Family, domestic and sexual violence in Australia 2018. Cat. No. FDV2. Canberra: AIHW

https://www.aihw.gov.au/reports/domestic-violence/family-domestic-sexual-violence-in-australia-2018/contents/summary

 

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