No abstract

BackgroundObtaining perspectives from those seeking healthcare after sexual violence on care and how it is delivered is important.ObjectivesTo systematically identify any existing patient-reported outcome and experience measures (PROMs and PREMs) for patients attending healthcare services after sexual violence. Also, to identify key themes regarded by patients as priorities for delivering a high-quality service.DesignSystematic review (PROSPERO registration RD42016050297).Data sourcesEight electronic bibliographic databases from inception to March 2017. ‘Grey’ literature also searched. Search words included patient view, patient experience, PROM/PREM, sexual violence, rape.Review methodsStudies of any design, with participants of any gender and aged 13 years or older were included; studies only assessing the views of service providers were excluded. Appraisal tools assessed for study quality. Healthcare outcome data were assessed across the quantitative studies and key experiences across qualitative papers; Framework Analysis was used to synthesise the qualitative studies.ResultsFrom 4153 identified papers, 20 fulfilled criteria for inclusion: 10 qualitative, 8 quantitative and 2 mixed methods. No validated measure of assessing patient experience or outcome was identified. The synthesis of qualitative studies led to the assignment of two overarching themes around the importance of patient-focused and trauma-focused communication, and of care which enhances patient empowerment. A paucity of research within certain patient groups who experience sexual violence, in particular men and LGBT (lesbian, gay, bisexual and trans) patients was noted.LimitationsA broad definition of ‘healthcare setting’ incorporated a wide variety of venues limiting the applicability of findings in specific settings.ConclusionA validated and standardised approach to assess patient experience and outcome in healthcare settings after sexual violence is needed. Themes identified should be incorporated into PROM or PREM development. The review also suggests the need for a change in approach towards those who attend for healthcare after sexual violence to ensure patient autonomy.

Human T lymphotropic virus type 1 (HTLV-1) is recognised as an STI with serious manifestations of the disease in approximately 10% of those infected. This case report is the first to describe the short interval from sexual acquisition of HTLV-1 to the onset of HTLV-1-associated myelopathy and rapid progression to spastic paraparesis. The number of adult infections in the UK per annum is unknown, but surveillance data indicate that around 30% of newly diagnosed infections are occurring in persons born in the UK, rather than in migrants from HTLV-1-endemic regions. Despite this, and despite the risk of chronic debilitating disease, HTLV-1 infection is not part of sexual health screening in the UK, with the consequence that patients requesting sexual health screens are not informed of their carrier status and transmission from asymptomatic carriers to the partners will continue.

This is a protocol for a Cochrane Review (qualitative). The objectives are as follows:This review will gather and synthesise the experiences of interventions for survivors of sexual abuse and violence, their families, as well as the professionals who deliver them. Specifically, this review seeks to:Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis (Protocol)

No abstract