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  1. L. Laras,
  2. V. Figueroa,
  3. D. Camacho
  1. University of Puerto Rico Medical Sciences Campus, V. Edwards, Center for Disease Control and Prevention, San Juan, Puerto Rico


Purpose of the Study The identification of sexual and domestic violence, frequent among women, depends on the disposition of health professionals (1) to intervene with women referred by agencies that provide services to victims and (2) to screen for violent experiences during routine clinical services. PASOS de las Mujeres, within the Puerto Rico Women and Health Center, a DHHS-designated National Center of Excellence in Women's Health, provides forensic medical services by request of individuals, POLICE, family services, and others. The service promotes routine screening for violent experiences. The purpose of the study is to develop a profile of the clinic's patients as it relates to violence and its possible impact on health. From April 2002 to February 2005, 208 survivors were evaluated, which constitutes 39% of the total new patients seen. There is limited information about women survivors who access ambulatory health services. This information is important for service planning, professional education, prevention strategy development, funds allocation, and public health policy designs.

Methods Used A medical chart review of PASOS was done for service improvement and intervention strategy development. Different variables (age, region of origin, weight, menarche, history of asthma, constipation and sleeping difficulties, relationship with offender, place of assault, signs of trauma, and HPV-related findings) were analyzed for possible associations.

Summary of Results Of the 684 new clinic patients, from April 2002 to February 2005, 27% were survivors of violence. Educational levels were diverse. The assailant was a family member in 53% of the cases and 57% of the assaults occurred in the home. In our clinic, 24% of the minors are overweight while 3% are underweight. Most of the literature is consistent in that most cases of sexual abuse have no physical findings consistent with injury. In our clinic only 29% of the cases have some finding consistent with trauma. All survivors were examined for subclinical HPV. Other related health issues observed among the survivors were constipation, asthma, and sleeping difficulties.

Conclusions In order to provide the health services needed by survivors of sexual and domestic violence, it is important to identify the participant's profile. This review shows that in Puerto Rico data are consistent with national findings. Also in the case of HPV, it demonstrates the value of colposcopy in the examination. Results emphasize that it is time to do prospective research on survivors of violence for short- and long-term health consequences if we are really going to provide services that respond to the concept of violence as a public health issue.

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