Domestic Violence and Same-Sex Domestic Violence in an HIV Ambulatory Care Setting

Domestic Violence and Same Sex Domestic Violence in an HIV ambulatory care setting Ruth Hennessy Alisa Green Damien Rivkin Albion Street Centre, Surry Hills

Overview
Background
Context
Survey
Results
Discussion

Background
2006 NSW Health Policy routine screening for DV for women presenting to antenatal, mental health & alcohol & other drug (AOD) services asks:
experienced actual violence
and/or
frightened of partner

Context
Albion Street Centre (ASC) Psychology Unit: psychological treatment for people affected by HIV (inclusive of mental health, AOD issues and relationship issues)
Majority of ASC clients are HIV+ve men in same sex relationships

Guidelines
NSW Health guidelines regarding Health Care Workers (HCWs) to refer perpetrators of DV on DV issues (includes Anger mx) to other services (primarily Relationships Australia)
Ambiguity re identification of DV / Anger mx / relationship discord

ASC Psychology
Is DV an issue for our clients?
Does HIV play a role in DV?
What assistance are people accessing?
How helpful was assistance?
What barriers, if any, to help?

Survey
Anonymous, voluntary, waiting areas
Experience of various behaviours that may be signs of DV
Whether help was accessed in cases where DV experienced
From whom assistance was sought and whether it was helpful
Barriers to help seeking

Survey
12 questions types of abusive behaviour: with current and/or past partners
4 intimidation/threat/violence
1 accusatory behaviours
1 control of money/spending
1 pertaining to isolation
2 sexual violence (unprotected sex)
1 regarding outing of sexual orientation
2 HIV-specific: threat to tell status and prevent health access

Descriptive Results
102 clients attending ASC x 2 months
92% male with 67% male partners and 8% female partners
39% 36-45 yo
82% HIV positive
35% HIV positive and 36% HIV negative partners

Results
Current relationships
46.1% reported one+ types of abusive behaviour
21.6% three or more
Past relationships
26% reported one+ types of abusive behaviour
18% three or more

Types of abuse
Most reported factors:
Jealousy (27.5%)
Indirect violent anger (21.6%)
Isolation (15.7%)
HIV: disclosure threat 8.8%, prevention health access 4.9%

Types of abuse
Controlling-jealous behaviours and social isolation were the primary abusive behaviours leading respondents to end relationship

Help Seeking
31% told someone
14% counsellors
10% police
6% GP
4% friend
66% said assistance was helpful
Barriers to seeking help:
8% concerned unsympathetic response

Discussion
Limitations:
public nature of the survey
DV itself is defined by an abusive pattern
sample bias
stigmatised context

Summary
46% experienced at least one type of abusive behaviour, 22% three or more
Forms of abuse relating to sexuality or accessing HIV Rx least prevalent forms of abuse endorsed
Less than a third sought assistance – consistent with other gay and lesbian response

Future considerations
Health / ASC Psychology:
How do we assess and identify DV?
What is our management of DV perpetrators?
Acknowledgement of same sex and other relationship status DV

Domestic Violence and Same-Sex Domestic Violence in an HIV Ambulatory Care Setting

by ACON on Oct 13, 2009

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Domestic Violence and Same-Sex Domestic Violence in an HIV Ambulatory Care Setting — Presentation Transcript