Research questions and data collection methods.

Background
Domestic violence and abuse (DVA) is a violation of human rights that damages the health and well-being of—gay, bisexual and other men who have sex with men (gbMSM). Sexual health services provide a unique opportunity to assess for DVA and provide support. This study explores the feasibility and acceptability of Healthcare Responding to Men for Safety (HERMES), a pilot intervention aimed to improve the identification and referral of gbMSM experiencing DVA in a London NHS Trust.
Methods
The before and after mixed method evaluation of the intervention included semi-structured interviews with 21 sexual health practitioners, 20 matched pre-post questionnaires, and an audit of 533 patient records to assess identification and referral of gbMSM experiencing DVA.
Results
HERMES increased practitioners’ self-reported preparedness and confidence in enquiring, identifying and responding to gbMSM experiencing DVA. HERMES increased staff awareness of DVA among these patients, which led to higher identification practices in their work. There was a significant increase in the identification and reporting practices of trained staff (0% to 30%), with 6 (5%) DVA cases identified. However, as far as we could determine, none of these patients contacted the support agency.
Conclusions
HERMES proved successful in raising staff awareness, provided tools that increased identification and a referral pathway to an external specialist DVA service for the LGBT community. However, the poor uptake of the referral service indicates a need for further exploration of the help-seeking behaviour of gbMSM experiencing DVA and whether they would prefer to receive support within a sexual health service. Reinforcement training and clinical supervision is needed to sustain positive changes in practice over time and address potential challenges posed by staff turnover. Initial training should be conducted through face-to-face sessions with a combination of in-person and e-learning materials and followed by in-person and online reinforcement activities.

背景
家庭暴力与虐待（Domestic Violence and Abuse, DVA）是对人权的侵犯，会损害男同性恋、双性恋及其他男男性行为者（gay, bisexual and other men who have sex with men, gbMSM）的健康与福祉。性健康服务为筛查家庭暴力与虐待并提供支持创造了独特契机。本研究旨在评估「针对男性安全的医疗响应方案（Healthcare Responding to Men for Safety, HERMES）」的可行性与可接受性，该试点干预措施旨在改善伦敦某国民保健服务信托机构中遭受家庭暴力与虐待的男男性行为者的识别与转介工作。

方法
本研究采用干预前后混合方法评估方案，纳入21名性健康从业者的半结构化访谈、20组配对的前后调查问卷，以及对533份患者病历的审计，以评估遭受家庭暴力与虐待的男男性行为者的识别与转介情况。

结果
HERMES提升了从业者在询问、识别及回应遭受家庭暴力与虐待的男男性行为者时的自我报告准备度与自信心。该方案增强了医护人员对这类患者所受家庭暴力与虐待的认知，进而推动其在临床工作中提升识别实践水平。经过培训的医护人员的识别与报告实践占比从0%显著提升至30%，共识别出6例（占比5%）家庭暴力与虐待案例。但据我们所知，这些患者中无人联系过支持机构。

结论
HERMES在提升医护人员认知方面取得了成功，其提供的工具提升了识别率，并为女同性恋、男同性恋、双性恋与跨性别（Lesbian, Gay, Bisexual, Transgender, LGBT）群体搭建了通往外部家庭暴力与虐待专科服务的转介通道。然而，转介服务的使用率极低，这表明需要进一步探索遭受家庭暴力与虐待的男男性行为者的求助行为，以及他们是否更倾向于在性健康服务机构内获得支持。为维持临床实践中的积极改变、应对人员流动带来的潜在挑战，需开展强化培训与临床督导。初始培训应采用面对面授课结合线下与电子学习资料的形式，并辅以线下及线上的强化活动。