Screening

The World Health Organization recommends against universal screening for violence of women attending health care but encourages healthcare professionals to talk about it to a woman who presents with injuries or conditions that may be related to violence.[55] The US Preventive Services Task Force (USPSTF) recommends that clinicians screen for intimate partner violence in women of reproductive age, and provide or refer women who screen positive to ongoing support services.[56]​ The USPSTF identifies several validated brief screening instruments that can be incorporated into practice: Humiliation, Afraid, Rape, Kick (HARK); Hurt, Insult, Threaten, Scream (HITS); Extended-Hurt, Insult, Threaten, Scream (E-HITS); Partner Violence Screen (PVS); and Woman Abuse Screening Tool (WAST).[56]

One alternative approach to the initial identification and management of intimate partner violence in adults is "universal education" which differs from a more traditional approach to screening. The focus is on providing education and information on intimate partner violence followed by support and referral to appropriate services following disclosure.[57]​ One example is the PEARR model (Provide Privacy, Educate, Ask, Respect, and Respond).[58]​ Universal education and resource provision may take place in a number of different medical settings (e.g., during birth hospitalization, primary care, emergency department, or during an inpatient or outpatient appointment).[57]

In children, routine genital exam may be undertaken at routine childhood screening visits. However, because most exams in sexually abused children are normal, the genital exam is not considered to be a sensitive screen for sexual abuse.[59]

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