P92 Routine enquiry for domestic violence, alcohol and drug use in a sexual health clinic
Background Addressing domestic violence (DV) against women is highlighted in the 2011/12 NHS Operating Framework. Genitourinary medicine is cited as one of the services where victims of abuse may present. Alcohol and drug use are recognised as factors affecting sexual risk taking behaviour. Routine enquiry for DV (women only) and drug and alcohol use was implemented in this service in June 2011.
Aims To audit if routine enquiry for DV, alcohol and drug use was done and identify interventions when DV was disclosed or if risk taking was found to be affected by drug or alcohol use.
Methods A casenote review was done on all new and rebook (attending again after 3 months or more for a new episode of care) patients who attended during the first week of September 2011. The history proforma included questions on DV, alcohol consumption, recreational drug use and if they felt this affected their risk taking. Asymptomatic patients for screening were excluded as no detailed history was taken.
Results The history proforma was filled out for 55 women and 22 men. All were heterosexuals. The median age was 25. 26 attended for contraception, 44 for sexual health screen and 7 for both. 21 were rebook patients. 38/55 (69%) women were asked about DV. Five gave a history of DV, four were historic, one unspecified. 63 (82%) and 62 (81%) were asked their alcohol and drug use respectively. One man disclosed drinking >21 units/week and that it affected his risk taking. 10 used drugs: six cannabis, one cocaine and three unspecified. None were referred to other agencies. Of those not asked about DV, alcohol or drug use, no reason was documented.
Discussion The relatively low rate of enquiry for DV may increase with training and awareness raising. Only one patient considered his risk taking affected by alcohol. This may be due to the lack of sensitivity of direct questioning. Closer working with supporting agencies for DV, alcohol and drug use may increase referrals.