(P476) Asking and Telling: addressing sexual violence in sexual health services – a national survey of practice.

Sexual abuse and violence (SV/A) are common and rates are increasing. Criminal justice data shows most (85%) do not report. The harm from sexual violence ripples across generations, impacting individuals' capacity to work, and participate in family and community life. Many survivors will seek help from sexual health services in the aftermath but most do not disclose at this point. Racially minoritised women and girls, LGBTQ+ and Trans/Gender diverse communities are more likely to be victimised yet less likely to disclose.

Sexual health services take different approaches to inquiry about SV/A and/or domestic violence (DV) with many asking about domestic abuse (abuse within relationships) but fewer specifically asking about sexual violence (perpetrated by an acquaintance). This means that the 37% victimised by someone 'known' (date, friend, neighbour, colleague or peer) fall through current DV orientated screening. A review of 22 studies found Health Professionals barriers to asking included limited time with patients, lack of privacy, a systemic lack of training, policies, response protocols and resources.

A national survey of current UK clinic DV vs SV practice was carried out in collaboration with the UK professional body for sexual health clinicians (BASHH) asking about practice, tools used, rates, support needs and referral pathways in order to create an evidence base around how disclosure around Sexual Violence needs to be developed to match that of Domestic Violence.

The results around asking and telling as well as the support mechanisms required to do this (training, referral networks, access to restorative supervision) are key to benchmark practice and evidence any gap. Of 66 clinics responding to the national survey at the time of submission. 48/66 asked routinely about Domestic Violence and 47 felt they received adequate training on this. Fewer, 40/66 routinely asked about Sexual Violence and only 25 felt they had been trained to do this.

The ongoing research around this issue in the DISH - Disclosure of sexual violence In Sexual Health services) captures the complexity of ensuring that routine asking is done well and the presentation will highlight the need for sexual health services closer collaboration with specialist sexual violence services.