Survivors of domestic abuse and sexual violence within sexual health services, how we responded, who is missing and what should be done?

Background Reports of domestic abuse (DA) and sexual violence (SV) continue to rise across the UK, and sexual health services are well situated to offer a safe setting for disclosure. Methods We performed a retrospective analysis of all safeguarding proformas completed between April and September 2019 across three sexual health clinics in London. Results 158 patients reported current and/or historical DA and/or SV during the collection period. 70% of cohort identified as female, 28% as male and 2% as transgender. 25% of the cohort identified as gay men. Black and Asian attendees were disproportionately represented in the survivor cohort. 86% were offered a same-day appointment with the health advisor team and assessment for onward referral to specialist services. Almost half of the cohort were asymptomatic at the time of attendance and disclosure. Discussion With changes to access due to ongoing COVID-19 restrictions, asymptomatic survivors may not receive opportunities to disclose as they are directed to online platforms. Healthcare services must adapt routine enquiry practices to ensure safe disclosure is possible to make all contacts count and expand these practices into other healthcare specialities to provide further disclosure opportunities for survivors not attending sexual health services.