A patient screening program designed by a Perth sexual health clinic is helping to better support survivors of reproductive coercion and abuse.
Under the program, all people aged 16 years and over visiting Sexual Health Quarters (SHQ) in Northbridge are asked to complete a screening questionnaire in a private area to determine their exposure to violence.
The doctors who introduced the program said it provided the opportunity for clinicians to offer much needed support to patients as soon as possible.
Typically perpetrated against women, reproductive coercion and abuse (RCA), along with intimate partner violence (IPV), refers to a deliberate attempt to dictate a person’s reproductive choices or interfere with their reproductive autonomy. It can include behaviours like pressure, manipulation, emotional blackmail and physical, emotional and sexual abuse.
Data from SHQ over a 12-month period show 17.3% (454 people) reported having been exposed to IPV and/or RCA at some stage in their lives, according to a study published in the Medical Journal of Australia.
Of the 2,623 women who took part in the study, 3.5% reported experiencing some form of IPV or RCA in their current relationship at the time of screening. Some 84% of women who reported IPV also reported RCA.
Dr Mariana Galrao, public health physician at SHQ and co-author of the study, said the prevalence of intimate partner violence and reproductive coercion was “alarmingly high”.
“None of the disclosures were identified because the patients presented with any overt signs of physical or emotional abuse, they were identified because the patients were all asked a set of questions in the waiting room on a confidential paper-based screening form, before seeing their clinician,” she said.
“In other words, the clinician would have never known about the exposure to violence if the patients had not been specifically asked these questions in a self-administered questionnaire format.”
Other findings show that women born in Australia, those aged between 35-54, those living in postcodes associated with less social disadvantage, those who identify as being Aboriginal and those with same-sex partners were more likely to report intimate partner violence.
But Dr Galrao said the most surprising finding was that women were willing to disclose this violence and coercion in the screening programme.
“Clinicians are often advised that, before asking their patients personal or intimate questions, they need to build rapport and trust with their patient,” she said.
“This willingness to share such personal information to any clinician, even one they may be seeing for the first time, suggests women do want their health professional to know about their exposure to violence.
“This also provides the opportunity for the health professional to provide assistance once a disclosure has been made.”
SHQ has since developed the Intimate Partner Violence and Reproductive Coercion and Abuse eLearning program community services workers to support those experiencing violence.
The course is designed for doctors, nurses and midwives, medical students, counsellors and psychologists, social workers, allied health professionals, clinical support staff and others interested in supporting patients experiencing violence.
Dr Galrao said the SHQ screening tool can be easily implemented elsewhere, adding that by undergoing professional development to implement screening, GPs and other clinicians are ideally placed to provide early intervention and prevent escalation of abuse.
There are a range of resources available to clinicians on IPV and RCA, including the Royal Australian College of GPs White Book, Clinician Assist WA, 4Choice and the SHQ e-learning program.
https://shq.org.au/education/clinical-education/ipv-rca-education/
https://clinicianassistwa.org.au/login/
https://shq.org.au/education/clinical-education/ipv-rca-education/