Post-traumatic stress disorder in female survivors of rape attending a genitourinary medicine clinic: a pilot study.

This study describes psychological symptomatology including post-traumatic stress disorder (PTSD) in 19 women attending a specialist sexual assault service within a genitourinary medicine (GUM) clinic. Women were interviewed within one year post-rape (mean = 12 weeks) using standardized questionnaires for PTSD and other psychological symptomatology. Seventeen (89.5%) of 19 women met full criteria for a diagnosis of PTSD. Anxiety predominated amongst other psychological symptomatology. Suicidal ideation was reported by 8 women and one made a suicide attempt following the rape. Although it is acknowledged this is a small, select sample, the high level of psychological trauma found suggests that genitourinary medicine clinics providing for sexual assault require access to mental health professionals.

Factors associated with self-disclosure of HIV serostatus to significant others.

OBJECTIVES: To examine rates and patterns of self-disclosure of HIV serostatus amongst individuals attending an out-patient HIV clinic in East London. DESIGN: A cross-sectional survey design was used. METHODS: A volunteer sample of 95 out-patient HIV clinic attendees completed a self-report questionnaire examining patterns of disclosure to self-identified significant others, reasons for disclosure and non-disclosure, satisfaction with social support (SSQ6), quality of life (MOS-30) and anxiety and depression (HADS). Self-disclosure was examined in relation to cultural background, gender, satisfaction with social support, and medical and psychological variables. RESULTS: Seventy-nine men and 16 women reported a mean disclosure rate of 68% to self-identified significant others. Five individuals had not disclosed their HIV status to anyone; 91% of individuals had informed their partner. Friends were more frequently informed (79%) than family (53%). Ethnicity (p <.001) and length of time since testing HIV seropositive (p <.05) emerged as significant predictors of disclosure. Global satisfaction with social support was negatively correlated with depression but was not associated with the total rate of HIV disclosure. Frequently reported reasons for non-disclosure included wanting to protect others from distress and fear of discrimination. CONCLUSIONS: Self-disclosure of HIV serostatus rates was highest for partners, followed by friends, and lowest for family members. Patterns of disclosure of HIV serostatus varied in relation to ethnicity. Fifteen years into the HIV epidemic, social stigma continues to contribute towards non-disclosure of diagnosis.

The prevalence of sexual assault in a genitourinary medicine clinic: service implications.

OBJECTIVE: To determine the prevalence of sexual assault amongst patients attending a department of genitourinary medicine and to investigate the circumstances of the assault. SETTING AND SUBJECTS: The Department of Genitourinary Medicine (GUM), St. Mary's Hospital, London. All patients attending the walk-in GUM Clinic over a fixed time period were invited to take part in the study. METHODS: Patients were asked to complete an anonymous questionnaire designed by the investigators. RESULTS: 351 (209 women, 142 male) usable questionnaires were returned of 370 distributed. Seventy five persons (21.4%) reported sexual assault: 59 (28.2%) women and 16 (11.3%) men. The incident occurred more than three months before presentation in the majority of persons studied (93%). Twenty one per cent reported the assault to the police, and 34% attended for medical screening. For those who did attend for medical screening, 61% informed their doctor of the assault. The main reason for non-reporting to police and medical staff was "a wish to forget". Counselling was sought by 24% after the sexual assault. CONCLUSIONS: A past history of sexual assault is common amongst GUM clinic attenders, more often disclosed amongst women. Reporting both to police and medical services is low. Clinicians need to be sensitive to the fact that a significant proportion of patients attending GUM services may have been sexually assaulted either in the present or the past and the impact that this may have on health care usage. GUM clinics maybe ideally placed to provide medical and psychological support to these individuals.