Talking with healthcare providers about intimate partner violence: Perspectives of women primary care patients

Increasingly, professional associations are recommending that healthcare providers (HCPs) screen women for experience of intimate partner violence (IPV). Questions remain, however, about patients' experiences with, and perspectives on, talking with HCPs about IPV. In face-to-face interviews, we asked 249 women patients, age 18-64, receiving care at a VA medical center about: a) their experiences with HCPs asking about IPV and telling HCPs about IPV; b) their perspectives on effective ways of screening for IPV in the healthcare setting; and c) barriers and facilitators to disclosing IPV to HCPs. 55% of the participants said that a HCP had asked them about “safety, violence, or stress in relationships”; 27% said that they had told a HCP about relationship violence or safety concerns. Rates of asking and telling about IPV were highest with encounters with mental health providers, followed by primary care providers and gynecologists. The majority of participants (83%) said that they think HCPs should ask patients about IPV; 6% said HCPs should not ask, and 11% said that they were not sure if HCPs should ask, or that it depends on visit characteristics (e.g., purpose of visit), patient characteristics (e.g., presence of risk factors, bruises), and/or provider characteristics (e.g., sensitive and professional demeanor). Participants' perspectives on what has and has not worked well for them and ways that they think healthcare settings could support women who are experiencing, or have experienced, violence in relationships, hold implications for design and implementation of IPV screening and response protocols in healthcare settings.