ArticleBMJ open2025
Trauma has an echo: a mixed methods study exploring barriers to routine healthcare for survivors of sexual violence in a UK higher education setting.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo explore barriers to healthcare among survivors of sexual violence (SV) and the behavioural pathways behind avoidance, focusing on survivor-led solutions.
designA mixed methods study collated qualitative interviews/surveys to explore the lived experiences of survivors of SV. Data were analysed using both quantitative descriptors and qualitative thematic analysis to expand the mechanisms/solutions to reported rates.
settingHigher education setting in the UK.
participantsForty-two survivors of SV between the ages of 18 and 29 self-identified as female (36), male (4), genderfluid (1) and non-binary transmasculine (1), with 10 describing themselves as being from racially minoritised communities and 32 as White survivors.
resultsAnalysis found 86% of survivors completely or significantly avoided healthcare, particularly sexual and reproductive services. Three themes were identified: (1) wider societal blame/marginalisation of survivors hindered their ability to access care in what felt like 'a system of oppression'; (2) once past these barriers, direct experiences with professionals replicated trauma, exacerbating avoidance and health disparities through 'healthcare-induced re-traumatisation'; (3) survivors identified what they needed to re-engage in healthcare including trauma-informed professionals and compassionate services with 'survivor-centred care'.
conclusionsSV may deepen health inequalities as survivors avoid healthcare. Survivor-led reforms called for survivor-centred practices and encouraged systemic reflection on how healthcare systems may contribute to the broader marginalisation of survivors. Findings echo policy recommendations for co-produced services led by minoritised/marginalised patients and operationalise trauma-informed training for healthcare professionals. Additionally, access-focused psychological support could reduce the impact of sexual trauma on morbidity and mortality.
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