Military Sexual Trauma, Intimate Partner Violence, and Pain in Female Veterans in Primary Care

Transgender patients are at elevated risk of intimate partner violence (IPV), but national guidelines do not recommend routine screening for this population. This paper explores the feasibility and effectiveness of routine IPV screening of transgender patients in a primary care setting by describing an existing screening program and identifying factors associated with referral and engagement in IPV-related care for transgender patients. An IPV “referral cascade” was created for 1,947 transgender primary care patients at an urban community health center who were screened for IPV between January 1, 2014 to May 31, 2016: (a) Of those screening positive, how many were referred? (b) Of those referred, how many engaged in IPV-specific care within 3 months? Logistic regression identified demographic correlates of referral and engagement. Of the 1,947 transgender patients screened for IPV, 227 screened positive. 110/227 (48.5%) were referred to either internal or external IPV-related services. Of those referred to on-site services, 65/103 (63.1%) had an IPV-related appointment within 3 months of a positive screen. IPV referral was associated with being assigned male at birth (AMAB) versus assigned female at birth (AFAB) (AOR = 2.69, 95% CI 1.52, 4.75) and with nonbinary, rather than binary, gender identity (AOR = 2.07, 95%CI 1.09, 3.73). Engagement in IPV-related services was not associated with any measured demographic characteristics. Similar to published rates for cisgender women, half of transgender patients with positive IPV screens received referrals and two-thirds of those referred engaged in IPV-specific care. These findings support routine IPV screening and referral for transgender patients in primary care settings. Provider training should focus on how to ensure referrals are made for all transgender patients who screen positive for IPV, regardless of gender identity, to ensure the benefits of screening accrue equally for all patients.

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Intimate Partner Violence: Perspectives on Universal Screening for Women in VHA Primary Care

Women s Health Issues ◽

10.1016/j.whi.2012.12.004 ◽

2013 ◽

Vol 23 (2) ◽

pp. e73-e76 ◽

Cited By ~ 11

Author(s):

Alison C. Sweeney ◽

Julie C. Weitlauf ◽

Elizabeth A. Manning ◽

Jocelyn A. Sze ◽

Angela E. Waldrop ◽

...

Keyword(s):

Primary Care ◽

Intimate Partner Violence ◽

Partner Violence ◽

Universal Screening ◽

Intimate Partner

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The Impact of Substance Use, Sexual Trauma, and Intimate Partner Violence on Sexual Risk Intervention Outcomes in Couples: A Randomized Trial

Annals of Behavioral Medicine ◽

10.1007/s12160-012-9455-5 ◽

2012 ◽

Vol 45 (3) ◽

pp. 318-328 ◽

Cited By ~ 14

Author(s):

Deborah L. Jones ◽

Deborah Kashy ◽

Olga M. Villar-Loubet ◽

Ryan Cook ◽

Stephen M. Weiss

Keyword(s):

Intimate Partner Violence ◽

Substance Use ◽

Randomized Trial ◽

Sexual Risk ◽

Partner Violence ◽

Sexual Trauma ◽

Intimate Partner ◽

The Impact

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Exploring Intimate Partner Violence Among Women Attending Malaysian Primary Care Clinics

Journal of Interpersonal Violence ◽

10.1177/0886260519839426 ◽

2019 ◽

pp. 088626051983942 ◽

Cited By ~ 1

Author(s):

Sajaratulnisah Othman ◽

Choo Wan Yuen ◽

Norhasmah Mohd Zain ◽

Azah Abdul Samad

Keyword(s):

Primary Care ◽

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Primary Care Clinics

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Understanding and managing intimate partner violence in the pediatric primary care setting

Current Opinion in Pediatrics ◽

10.1097/mop.0000000000000818 ◽

2019 ◽

Vol 31 (5) ◽

pp. 683-690 ◽

Cited By ~ 2

Author(s):

Amanda Y. Wang ◽

Melissa Pannell

Keyword(s):

Primary Care ◽

Intimate Partner Violence ◽

Partner Violence ◽

Care Setting ◽

Primary Care Setting ◽

Intimate Partner ◽

Pediatric Primary Care

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Encouraging Asian Immigrant Women to Disclose Intimate Partner Violence in Primary Care Settings

Journal of Interpersonal Violence ◽

10.1177/0886260520959642 ◽

2020 ◽

pp. 088626052095964

Author(s):

Paula Tavrow ◽

Danny Azucar ◽

Dan Huynh ◽

Caroline Yoo ◽

Di Liang ◽

...

Keyword(s):

Primary Care ◽

Intimate Partner Violence ◽

Partner Violence ◽

Immigrant Women ◽

Cultural Beliefs ◽

Primary Care Clinic ◽

The United States ◽

Intimate Partner ◽

Asian Immigrant ◽

Care Clinic

Risks of intimate partner violence (IPV) often are higher among immigrant women, due to dependency, language barriers, deportation fears, cultural beliefs, and limited access to services. In the United States, Asian immigrant women experiencing IPV often are reluctant to disclose abuse. Viewing videos that depict IPV survivors who have successfully obtained help might encourage disclosure. After conducting formative research, we created brief videos in four Asian languages (Korean, Mandarin Chinese, Thai, and Vietnamese) for use in primary care clinic consultation rooms. We then conducted in-depth interviews with 60 Asian immigrant women in California to get their perspectives on how helpful the videos might be in achieving disclosure. Most participants believed the videos would promote disclosure in clinics, although those who had been abused seemed more skeptical. Many had stereotyped views of victims, who they felt needed to be emotive to be credible. Videos should be upbeat, highlighting the positive outcomes of escaping violence and showing clearly each step of the process. Various types of IPV should be described, so that women understand the violence is not exclusively physical. Victims would need reassurance that they will not be arrested, deported, or forced to leave their abusers. Discussing the benefits of escaping violence to children could be influential. Victims also must be convinced that providers are trustworthy, confidential, and want to help. To assist immigrant populations to disclose IPV to a health provider, videos need to be culturally relevant, explain various types of violence, allay fears, and show clear processes and benefits.

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