sex & violence the health implications dr olwen williams consultant sexual health clinical...
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Sex & Violencethe Health Implications
Dr Olwen WilliamsConsultant Sexual Health
Clinical Director Amethyst SARC North WalesMember EHRC Wales
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WHO Definition Sexual Violence
• any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work
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• Rape by strangers; rape within marriage or dating relationships • systematic “war rape" during armed conflict; • unwanted sexual advances or sexual harassment, including
demanding sex in return for favours;
• sexual abuse of mentally or physically disabled people; • sexual abuse of children; • Forced marriage or cohabitation, including the marriage of children
• denial of the right to use contraception or to adopt other measures to protect against sexually transmitted diseases;
• Forced abortion• violent acts against sexual integrity, including genital mutilation and
obligatory inspections for virginity; • forced prostitution & trafficking of people for the purpose of sexual
exploitation
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Interlinked domestic abuse /sexual violence
1:4 Worldwide lifetime risk of sexual assault 1:20 of UK women have experienced rape (estimated)
• 45% Sexual Assault committed by current partner• 74% Sexual Assault occurs in the persons own home• Attacks by partners double risk of physical injury British Crime Survey 2000
• North Wales Police report increase of 3.8% in Sexual Assault in 2011
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Potential Health Consequences Medical
Injuries sustained during the assault
Sexually transmitted infections
HIV & other Blood Born Viruses
Pregnancy and gynaecological complications
Psychosocial Higher prevalence of mental health issues
Socially ostracised
Impact on family, partner and friends
Effects on children of witnessing sexual violence
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Risk Assessment at disclosure
• Establish recent or historic sexual assault• Assess need for medical intervention• Assess individuals physical safety
• Are there any Child protection issues?
• Explain options available
• Respect individuals wishes
• Be supportive…………………………
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Amethyst SARC
A one-stop facility to provide a
comprehensive and coordinated response to
all victims of rape and sexual assault
regardless of whether or not a report is
made to the police
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Police Referral
Refer individual to Police where assault took place
In North Wales, specialist police teams for dealing with sexual offence allegations based at SARC/Amethyst Centre
The police refer to the local sexual assault referral centre (SARC) for forensic medical examination (FME) Evidence managed by the police Follow-up at the SARC
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Non-police referral to a SARC
Patient, Sexual Health, A+E , Maternity Services contact the SARC
- to refer
- for advice
SARC discusses options with client
- Appointment made for FME or F/U only depending on patient consent and timing
- Not a walk-in service, by appointment only
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10 Key Elements of a SARC
24 hour access
Crisis Workers
Gender Choice of FME
AppropriatelyTrained
FME
Dedicated Forensically Approved Premises
Risk Assessment
PEPSEEmergency Contraception
Referral for FU
ISVACo-ordinated Interagency
arrangements
Core TeamNHS Standards of
Clinical Governance
DataCollection
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Contact Details
[email protected] Tel: 01492 805072Mobile: 07799342695Amethyst Centre1 Bryn Eirias CloseColwyn BayLL29 8AB
olwen.williams@
wales.nhs.uk
01978725924
07799342725