From research to practice: ADViSE helps sexual health services support those experiencing domestic abuse

A programme to help sexual health services support and refer people experiencing domestic abuse and sexual violence is being rolled out in Bristol and South Gloucestershire. ADViSE (Assessing for Domestic Violence and Abuse in Sexual Health Environments) is already being piloted in Greater Manchester, and discussions are underway to commission it in six other regions.

ADViSE is an evidence-based training and referral programme evaluated by the National Institute for Health and Care Research Applied Research Collaboration (NIHR ARC West). It has been endorsed by the British Association for Sexual Health and HIV (BASHH).

NIHR ARC West worked on the ADViSE programme with IRISi, a social enterprise that promotes and improves the healthcare response to domestic violence and abuse. ADViSE is based on IRISi’s successful IRIS model used in primary care.

ARC West researchers evaluated the ADViSE pilot in Bristol and East London. They found it was acceptable and welcome to patients and staff. The researchers used the findings to refine ADViSE, in collaboration with domestic violence and abuse survivors, commissioners, sexual health staff and the IRISi team. They also helped develop a commissioning prospectus (PDF) to support the programme’s roll out.

According to the Office for National Statistics (ONS), between April 2020 and March 2021, the police recorded 845,734 domestic abuse-related crimes in England and Wales. This was an increase of 6 per cent compared with the previous year. Sexual health services, like GP practices, can be an important point of contact for people experiencing domestic abuse.

The first region to adopt ADViSE was Greater Manchester, where the roll out began in October 2021. IRISi worked with the Northern Contraception, Sexual Health and HIV Service at Manchester Royal Infirmary to roll out ADViSE across its sexual health clinics in Manchester, Stockport, Tameside and Trafford. They partnered with local domestic abuse specialists including Manchester Women’s Aid, Stockport Without Abuse, Trafford Domestic Abuse Services and JIGSAW support.

Bristol and South Gloucestershire will be the second region to adopt the programme in summer 2022. IRISi will work with Unity Sexual Health to roll out ADViSE across their services.

Medina Johnson, Chief Executive of IRISi, said:

“Working in partnership with ARC West was key to the transition of ADViSE from research into practice.

“We worked together to run focus groups with all our key stakeholders. The patient and public involvement (PPI) lead at the ARC was essential in setting up and running our expert by experience group. The feedback from these sessions fed into and helped to shape our co-produced commissioning prospectus.

“ARC West colleagues were able to use existing relationships with BASHH and local commissioners to promote the evidence-based programme. This helped to secure endorsement from BASHH and has also been instrumental in our onward conversations. This has meant the programme has been commissioned and will soon be running in several regions across England.”

A sexual health service consultant involved in the ADViSE pilot said:

“An easy referral route into a dedicated service saved time and created a fluid transfer into a specialist service. The offer of a named ADViSE Advocate Educator who could meet the patient in our familiar clinic setting helped some patients accept a referral.

“The specialist service provided was developed to incorporate the complexities that domestic abuse brings into the lives of victims and their children – physical safety, emotional wellbeing, safe accommodation, a co-ordinated support approach with criminal and civil justice systems. A quick referral could reassure the sexual health practitioner that a holistic specialised service would contact the victim and use this critical opportunity for an earlier intervention.”

Jeremy Horwood, Professor of Social Sciences and Applied Health Research at University of Bristol and NIHR ARC West, said:

“Sexual health problems are common for people experiencing domestic violence and abuse. Sexual healthcare staff can have a key role in supporting patients’ access to advocacy services, but most staff have not had much training in identifying and responding to domestic violence and abuse. Our findings demonstrated that ADViSE can help sexual healthcare staff support patients experiencing domestic violence and abuse.

“Our collaboration with IRISi to develop and refine ADViSE has been fundamental to the success of the programme. We hope the ADViSE commissioning prospectus we helped develop will enable its wider roll out.”