Buller Ana Maria, Ferrari Giulia, Bleile Alexandra, Feder Gene S, Brzank Petra J, Bacchus Loraine J
London School of Hygiene & Tropical Medicine, Department of Global Health and Development, London, United Kingdom.
London School of Economics and Political Science Centre for Peace, Women and Security, London, United Kingdom.
PLoS One. 2025 Jan 8;20(1):e0312807. doi: 10.1371/journal.pone.0312807. eCollection 2025.
Domestic violence and abuse (DVA) is a violation of human rights that damages the health and well-being of-gay, bisexual and other men who have sex with men (gbMSM). Sexual health services provide a unique opportunity to assess for DVA and provide support. This study explores the feasibility and acceptability of Healthcare Responding to Men for Safety (HERMES), a pilot intervention aimed to improve the identification and referral of gbMSM experiencing DVA in a London NHS Trust.
The before and after mixed method evaluation of the intervention included semi-structured interviews with 21 sexual health practitioners, 20 matched pre-post questionnaires, and an audit of 533 patient records to assess identification and referral of gbMSM experiencing DVA.
HERMES increased practitioners' self-reported preparedness and confidence in enquiring, identifying and responding to gbMSM experiencing DVA. HERMES increased staff awareness of DVA among these patients, which led to higher identification practices in their work. There was a significant increase in the identification and reporting practices of trained staff (0% to 30%), with 6 (5%) DVA cases identified. However, as far as we could determine, none of these patients contacted the support agency.
HERMES proved successful in raising staff awareness, provided tools that increased identification and a referral pathway to an external specialist DVA service for the LGBT community. However, the poor uptake of the referral service indicates a need for further exploration of the help-seeking behaviour of gbMSM experiencing DVA and whether they would prefer to receive support within a sexual health service. Reinforcement training and clinical supervision is needed to sustain positive changes in practice over time and address potential challenges posed by staff turnover. Initial training should be conducted through face-to-face sessions with a combination of in-person and e-learning materials and followed by in-person and online reinforcement activities.
家庭暴力与虐待（DVA）是一种侵犯人权的行为，会损害男同性恋者、双性恋者及其他与男性发生性行为的男性（gbMSM）的健康和福祉。性健康服务提供了一个评估家庭暴力与虐待情况并提供支持的独特机会。本研究探讨了“医疗保健促进男性安全应对（HERMES）”的可行性和可接受性，这是一项试点干预措施，旨在改善伦敦一家国民保健服务信托机构中遭受家庭暴力与虐待的gbMSM的识别和转诊情况。
对该干预措施进行前后混合方法评估，包括对21名性健康从业者进行半结构化访谈、20份匹配的前后调查问卷，以及对533份患者记录进行审核，以评估遭受家庭暴力与虐待的gbMSM的识别和转诊情况。
HERMES提高了从业者自我报告的在询问、识别和应对遭受家庭暴力与虐待的gbMSM方面的准备程度和信心。HERMES提高了工作人员对这些患者中家庭暴力与虐待情况的认识，这导致他们在工作中有更高的识别率。经过培训的工作人员的识别和报告率显著提高（从0%提高到30%），共识别出6例（5%）家庭暴力与虐待病例。然而，据我们所能确定的，这些患者中没有一人联系支持机构。
HERMES被证明在提高工作人员意识方面取得了成功，提供了增加识别率的工具，并为LGBT社区建立了通往外部专业家庭暴力与虐待服务机构的转诊途径。然而，转诊服务的利用率较低，这表明需要进一步探索遭受家庭暴力与虐待的gbMSM的求助行为，以及他们是否更愿意在性健康服务机构内获得支持。需要进行强化培训和临床监督，以随着时间的推移维持实践中的积极变化，并应对人员流动带来的潜在挑战。初始培训应通过面对面授课结合现场和电子学习材料进行，并随后开展现场和在线强化活动。
