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How to enquire and respond to domestic violence and abuse in sexual health settings
  1. N Pathak1,2,
  2. A Sohal3,
  3. G S Feder2
  1. 1Women's Health Research Unit, Queen Mary University of London, London, UK
  2. 2Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, London, UK
  3. 3Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
  1. Correspondence to Dr Neha Pathak, Women's Health Research Unit, Centre for Primary Care and Public Health, Yvonne Carter Building, 58 Turner Street, London E1 2AB, UK; n.pathak{at}

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Domestic violence and abuse (DVA) is a violation of human rights with profound physical, emotional and socioeconomic costs to the individual, families, communities and society as a whole. In the UK, 28.3% of women and 14.7% of men had experienced any domestic abuse since the age of 16.1 DVA costs the National Health Service £1.7 billion annually, excluding mental health costs; the estimated overall annual cost of DVA in the UK is £15.7 billion.2 The prevalence of all DVA is higher among women than men. Women also experience much more sexual abuse, as well as more severe and repeated physical abuse and more coercive control.1 The majority of epidemiological and intervention research on DVA has been in women in heterosexual relationships not men or lesbian, gay, bisexual and transgender (LGBT) communities, though they are also affected by DVA.

What is domestic violence and abuse?

The UK cross-government definition of DVA is any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass, but is not limited to, psychological, physical, sexual, financial and emotional.3 Intimate partner violence (IPV) forms the majority of DVA and is defined as any behaviour within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship.4 It is not necessary to be cohabiting for IPV to occur.

Health impact

DVA damages physical and psychological health. In the UK, two women are killed by their current or former male partner each week5 and is tallied by the ‘Counting Dead Women’ twitter campaign in the UK.6 In the USA, 5.3 million episodes of IPV occur each year, causing 2 million injuries, with 550 000 victims requiring medical treatment. …

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  • Twitter Follow Neha Pathak at @nxpathak

  • Contributors NP drafted and revised the manuscript. AS and GSF provided guidance to NP and revised drafts. NP, AS and GSF are all researchers involved in IRIS ADViSE (an adaptation of the aforementioned IRIS model for sexual health services).

  • Competing interests NP and AS were funded by the NIHR for their academic clinical fellowship and academic clinical lectureship, respectively, during the preparation of this manuscript. GSF is a consultant for the IRIS programme for which the University of Bristol receives a fee.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement The corresponding author can be contacted about data from the as yet unpublished IRIS ADViSE study.