IRISi invites you to the official launch of “The IRIS ADViSE Programme”, an initiative that supports sexual health clinician identification and response to patients affected by domestic violence and abuse to facilitate referrals to specialist services. The IRIS ADViSE Programme and commissioning prospectus will be officially launched on the 24th of March 2021, during a one-hour online webinar, from 10 to 11 am. Speakers include:
- Dr. Jeremy Horwood, from the University of Bristol and co-lead of the Behavioural and Qualitative Science Team for National Institute for Health Research Collaborations for Leadership in Applied Research Collaboration West (NIHR ARC West), who led the evaluation of IRIS ADViSE.
- Dr Judith Berry, Consultant in sexual health at Unity Sexual Health.
- And Medina Johnson, Chief Executive at IRISi.
ADViSE has originated from a successful, evidence-based programme in general practice which responded to patients affected by domestic abuse, IRIS (Identification and Referral to Improve Safety). Whilst the positive impact of IRIS was rapidly expanding, it was recognised that there were some diverse and harder to reach patient populations who may not come into contact with general practice or other primary care services. Sexual health services were seen as a potential avenue to bridge this gap and an adapted version of IRIS, IRIS ADViSE (Assessing for Domestic Violence and Abuse in Sexual Health Environments), developed.
How it works
Domestic Violence and Abuse (DVA) is a severe breach of human rights with profound health consequences, particularly for women who, compared with men, experience more sexual violence, more severe physical violence, and more coercive control from their partners.
DVA has a devastating effect on health and the individuals it affects. It has far-reaching consequences for families, children, communities, and society as a whole.
The best estimates suggest that in the UK just over 26% of heterosexual women, 32% of gay/lesbian women, 45% of bisexual women, 27% of gay men, 14% of heterosexual men and 80% of transgender people will experience domestic violence and abuse at some point in their lifetimes (ONS, 2018).
In total, 47% of women attending sexual health services will have experienced DVA at some point in their lives. Alongside gynaecological problems, sexual health is the most prevalent and persistent physical health consequence of Domestic Violence and Abuse (DVA). DVA is also associated with increased sexually transmitted infections, including HIV, and unintended pregnancy.
Sexual health services can be the first point of contact for people affected by DVA and therefore sexual health practitioners can have a key role to play in supporting those who have experienced DVA to access advocacy services. However, most sexual health professionals have had minimal training in identifying and responding to DVA.
ADViSE (Assessing for Domestic Violence and Abuse in Sexual Health Environments) adapts the IRIS programme for use in sexual health clinics. The initiative supports sexual health staff to recognise the signs and symptoms of patients affected by DVA, teaching them how to respond and provides patients with a direct referral pathway into specialist services in line with British Association for Sexual Health and HIV (BASSH) DVA guidance.
It means that ADViSE supports staff teams to recognise and respond to patients affected by domestic violence and abuse (DVA), offering them a direct referral into specialist services via a simple, local care pathway. Each local team includes an Advocate Educator (AE) and a Sexual Health Clinical Lead (CL). ADViSE has been co-developed with clinicians, commissioners, IRISi, DVA agency staff and DVA survivors.
ADViSE has been piloted in sexual health clinics in Bristol and East London, and the mixed methods evaluation found ADViSE increased DVA enquiry, response and referral, and staff confidence in recognising and responding to DVA. Since the pilot, ADViSE has been further refined in collaboration with DVA survivors, commissioners, sexual health staff and patients, and a commissioning prospectus developed. ADViSE has also been officially endorsed by BASHH.
“Without the sexual health service asking and referring her, she (young woman) may not have accessed any DVA support. She did not attend general practice very often and no other service was involved with her. Sexual health was ideally placed to identify and refer her on to specialist support with the ADViSE service”, says an ADViSE Advocate Educator.
The NICE standards around DVA state that clinicians should:
- Know how to ask about DVA.
- Know how to respond to disclosures.
- Refer survivors to specialist support services.
- Refer perpetrators to specialist support services.
IRIS ADViSE meets all of the above in one streamlined, evidence-based package.
“We invite all sexual health, commissioners of sexual health services and colleagues from frontline sexual health and DVA services to take part in this event where we will be presenting the details of the IRIS ADViSE Programme and how to bring the programme to your local area. It will be a great opportunity to learn how to improve the identification and response to patients affected by domestic violence and abuse and facilitate referral to specialist services”, explains Medina Johnson.