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Sex & Violence the Health Implications Dr Olwen Williams Consultant Sexual Health

Sex & Violence the Health Implications Dr Olwen Williams Consultant Sexual Health Clinical Director Amethyst SARC North Wales Member EHRC Wales. WHO Definition Sexual Violence

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Sex & Violence the Health Implications Dr Olwen Williams Consultant Sexual Health

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  1. Sex & Violencethe Health Implications Dr Olwen Williams Consultant Sexual Health Clinical Director Amethyst SARC North Wales Member EHRC Wales

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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…………………………

  7. 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

  8. 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

  9. 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

  10. Core Team NHS Standards of Clinical Governance Co-ordinated Interagency arrangements ISVA Dedicated Forensically Approved Premises Gender Choice of FME 24 hour access 10 Key Elements of a SARC Appropriately Trained FME Crisis Workers Risk Assessment Data Collection PEPSE Emergency Contraception Referral for FU

  11. Sarah.Staveley@ nthwales.pnn.police.uk Tel: 01492 805072 Mobile: 07799342695 Amethyst Centre 1 Bryn Eirias Close Colwyn Bay LL29 8AB olwen.williams@ wales.nhs.uk 01978725924 07799342725 Contact Details

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