P153 Female genital mutilation (FGM)—providing a holistic approach and challenging taboos in a sexual health setting

Abstract

Background In England and Wales nearly 66-000 women are living with FGM and a potential 22-000 girls are at risk each year. Due to increasing demand, a dedicated FGM service within the sexual health setting was initiated in partnership with a dynamic Somali facilitator and a voluntary community organisation. Aims To analyse the attendances of women with FGM to our dedicated clinic. Methods Retrospective analysis of all attendees to the FGM clinic between 1 December 2010 and 31 December 2011. Results Of 197 attendees, 96% were from Somalia (190); mean age was 38 (14-72 years) with 52% living locally. Of those in whom we had documented information, FGM was mainly undertaken for cultural reasons (83/105, 79%), the majority (50/68, 73%) being cut in groups at their home (66/113, 58%). Mothers were the main instigators (58/81, 71%). Nearly half (84/173, 49%) had female children and seven women reported having their daughters cut abroad. The majority were against the practice (112/114, 98%). Reasons for attendance included chronic pelvic pain (57%), dyspareunia (44%) and sub fertility (24%). There was a high uptake of sexual health screening, with almost all patients (191, 97%) having serology for HIV and syphilis. Interestingly, no HIV was detected but 7% (13/185) were hepatitis B surface antigen positive and 31% (58/185) had cleared hepatitis B. There were six diagnoses of late latent syphilis and two of chlamydia. Conclusions Our Somali facilitator has played a key role in challenging the taboo of sexual health issues within FGM-practising communities, providing a service that is culturally and linguistically appropriate. The rate of blood-borne viruses in this vulnerable group proves the importance of engaging them with sexual health services. Fast track referrals to on-site gynaecology and hepatitis clinic have facilitated re-engagement of some patients with medical care.