ObjectivesDomestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net.DesignA series of observational studies.SettingThree outpatient clinics at the Royal Free London NHS Foundation Trust.Participants10 158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period.Main outcome measures(1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3 years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources.ResultsOf the 10 158 patients screened, 57.4% were female with a median age of 30 years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere.ConclusionsSelective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in-house domestic violence support.

Intimate partner violence (IPV) is widespread and more prevalent in the HIV-positive population than in the general population [1]. However, there is little published work concerning IPV in this population in the UK [2]. Dhairyawan et al. [3] found a 52% lifetime prevalence of IPV in HIV-positive women in a London clinic, with 14% reporting IPV in the last year. Health care workers have been identified as professionals to whom patients might choose to disclose IPV [4].Screening for IPV is recommended in selected health care settings, and at our hospital there is a new post for an independent domestic and sexual violence advisor (IDSVA). We established screening in an out-patient HIV clinic and compared those screened with those not screened, and summarized the characteristics of those reporting current or previous IPV.Multidisciplinary staff were trained to ask the following standardized question: "Have you ever been emotionally or physically hurt by your partner, ex-partner or family member?" Those who answered positively were assessed for current or past IPV by asking, "Are you still in contact with this person and are they still causing you and your family issues?" Screening took place while the patient was alone in a private place. Patients were referred to safeguarding services if necessary and to the IDSVA. If referral to the IDVSA was declined or there was no current risk, leaflets and contact information were given.We report on the demographics of 348 screened patients. Data were collected over 5 months and recorded on a standardized sheet and linked to the HIV database by hospital number and then anonomysed. Groups were compared using the v 2 test or Fisher's exact test for categorical variables, and using the MannÀWhitney U test for continuous variables as they were not normally distributed. No formal adjustment for multiple testing was made.Ten per cent (348 of 3383) of the current clinic population were screened. Those screened had similar demographics and HIV markers to those not screened. Almost a third of participants (103 of 348; 30%) had ever experienced IPV, and were more likely to be female (P = 0.01) with a trend towards heterosexual risk group (P = 0.085) and a detectable viral load (P = 0.088). A total of 68 of 348 patients (20%) had experienced IPV in the past and 35 of 348 (10%) of those screened were experiencing current IPV or were given contact information for future self referral. Fourteen of 348 patients (4%) agreed to be referred to the IVDSA. Ten were women and seven of 14 were of black ethnicity. Other variables were similar to those of the whole population, except that seven of those referred had detectable viraemia (50% vs. 15% in the whole population). Although numbers are small, perhaps this may suggest a relationship between adherence and access to medication, which could be further explored. Among the 103 who screened positive as a group there was also a trend towards detectable viraemia (P = 0.088).There was evidence of differences also when comparing men who screened posit...