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Reply amanda Question #2 There are so many health indicators and concerns for a teen or woman who is a victim of sexual exploitation. “In a systematic review of the impact of IPV on sexual health, IPV was consistently associated with sexual risk taking, inconsistent condom use, partner non-monogamy, unplanned pregnancies, induced abortions, sexually transmitted infections and sexual dysfunction”(Chamberlin & Levenson, 2011) These are just some of the physical health concerns they may have. There are so many emotional concerns that would be linked to sexual exploitation also.  Post-traumatic stress disorder (PTSD), including flashbacks, nightmares, severe anxiety, and uncontrollable thoughts, Depression, including prolonged sadness, feelings of hopelessness, unexplained crying, weight loss or gain, loss of energy or interest in activities previously enjoyed”(Joyful Heart Foundation, 2019). Georgia specifically has a state wide domestic violence hotline. “Educational videos on temporary protective orders were distributed to Nurse Mangers in all 159 Georgia Counties and 19 Health Districts to utilize in trainings and seminars. The tapes, obtained from the Georgia Commission on Family Violence, were designed to increase the nurses’ knowledge of services available to victims of domestic and sexual assault, and to enable them to direct these women to alternatives that can help reduce their exposure to violence. Designed and developed a tri-fold pocket card (in English (Links to an external site.)Links to an external site. and Spanish (Links to an external site.)Links to an external site. ), in collaboration with the Georgia Coalition Against Domestic Violence (GCADV), that contains information on the signs of domestic violence, safety plans, options available to survivors of domestic violence, and a list community organizations that work with survivors of domestic violence”(DPH, 2018). In my county specifically I know there is an organization called Community Welcome House, Inc. This organization helps domestic violence victims. It provides, “Emergency housing sanctuary in the time of crisis Residents receive assistance with medical care, child care, counseling, financial assistance, vocational training, employment and permanent housing”(Domesticshelters.org, 2019). Chamberlin, Linda & Levenson, Rebecca. (2011). Guidelines for Addressing Intimate Partner Violence Reproductive and Sexual Coercion For Obstetric, Gynecologic, Reproductive Health Care Settings. American College of Obstetrics and Gynecology. Retrieved on March 17, 2019 from https://www.acog.org/-/media/Departments/Violence-Against-Women/Guidelines-for-Addressing-Intimate-Partner-Violence.pdf?dmc=1&ts=20190317T1155502488 Joyful Heart Foundation. (2019). Effects of Sexual Assault and Rape. Retrieved on March 17, 2019 from http://www.joyfulheartfoundation.org/learn/sexual-assault-rape/effects-sexual-assault-and-rape Department of Public Health. (2018). Violence against Women Prevention. Retrieved on March 17, 2019 from https://dph.georgia.gov/violence-against-women-prevention Domestic Shelters, (2019). Retrieved on March 17, 2019 from https://www.domesticshelters.org/help/ga/newnan/30263/community-welcome-house Reply hollie Question 1—Domestic Violence Domestic violence can come in many shapes and forms. In some cases, physical injury can occur, while in other cases psychological abuse, deprivation, intimidation or other types of harm can occur (ACOG, 2012). The American College of Obstetricians and Gynecologists (ACOG) recognizes that routine visits and prenatal visits are an ideal time to assess for domestic violence (ACOG, 2012). Assessing for domestic violence can be done by using simple screening questions. These questions should not be asked in front of the abuser or other individuals. ACOG (2012) recommends using a framing statement and confidentiality statement before asking any questions. The framing statement lets the patient know that questions are being asked because relationships play a large role in health and the confidentiality statement lets the patient know that what she states today will not be told to anyone else unless reporting is required (ACOG, 2012). Risk Factors Two risk factors for domestic violence include: low education levels and drug and/or alcohol abuse (Huecker & Smock, 2018). Studies have shown that there is an inverse relationship between education levels and rates of domestic violence (Huecker & Smock, 2018). Men are more likely to perpetrate violence if they have low education and women are more likely to experience intimate partner violence (IPV) if they have a low education level (WHO, 2017). Alcohol and drug use are also risk factors for IPV. Alcohol and drug abuse is associated with an increase in the incidence of domestic violence, likely due to the inability of an impaired person to control violent impulses (Huecker & Smock, 2018). Clinical Signs Obtaining a history, screening for IPV, and performing a physical exam can help point to IPV. Huecker and Smock (2018) state the most common injuries involved in IPV are on the head, neck, and face. Defensive injuries may also be present on the forearms (Huecker & Smock, 2018). A full physical exam should also evaluate the skin in areas covered by clothing (Huecker & Smock, 2018). Sexual abuse may be harder to identify physically, depending on the nature of the abuse (Huecker & Smock, 2018). Psychological complaints may include: anxiety, depression, and fatigue (Huecker & Smock, 2018). The patient may also have vague complaints, such as chronic pain, headaches, or chest pain (Huecker & Smock, 2018). References ACOG. (2012). Intimate Partner Violence. The American College of Obstetricians and Gynecologists, 518 (1), 1-6. Retrieved from https://www.acog.org/-/media/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/co518.pdf?dmc=1&ts=20190318T0127216097 Huecker, M., & Smock, W. (2018). Domestic violence. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499891/ WHO. (2017). Violence against women. Retrieved from https://www.who.int/news-room/fact-sheets/detail/violence-against-women

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