Psychosocial issues affecting the clients attending a novel
sexual health service for the Homeless
T. M. Groom, A. McLellan, M. Kennedy, A. H.
Brown
Sandyford Initiative, Glasgow, UK
Background Over 50,000
Homeless presentations are made to local authorities in Scotland each year.
Previous work has demonstrated an unmet sexual health need. A Homeless sexual
health service was set up locally in order to provide a flexible and accessible
service for this vulnerable group and to establish links to mainstream services.
Objective To look at psychosocial issues affecting clients attending the
service to improve understanding of the needs of the client group.
Method
Electronic records and case notes from our first service users were examined and
information regarding addictions; domestic, physical and sexual violence; mental
health issues, and prostitution were extracted. The primary reason for
attendance was also recorded.
Results Forty-six clients, 10 men and 36 women average
age 27.7yrs(range 17-44). 27 clients (60%) had a history of intravenous dug use,
12 of 40(30%) clients asked had problems with alcohol, 24of 32(75%) of women and
4 of 9 (44%) of men had suffered sexual violence.18 of 30(60%) women asked had
experienced domestic violence, and 7 of 10 men serious physical assault.13 of 30
(43%) women asked had also been involved in prostitution. 23 of 42(55%) clients
had mental health problems. These first clients made 72 attendances (range 1-4)
and failed to attend for 63 appointments (range 0-5 per client). 20/46(43%)
attended for a sexual health screen. 8/46(17%) attended for contraception, 4
women had gynaecological concerns, 4 had concerns regarding pregnancy, one
attended following a sexual assault and 4 for miscellaneous reasons.
Conclusion
Clients attending our service have a complex range of health and social issues.
Effective work with this client group will require an understanding and flexible
service.