“It’s Always Good to Ask”: a mixed methods study on the perceived role of sexual health practitioners asking gay and bisexual men about experiences of domestic violence and abuse
Open accessAbstract
Development of joint displays is a valued approach to merging qualitative and quantitative findings in mixed methods research. This study aimed to illustrate a case series mixed methods display and the utility of using mixed methods for broadening our understanding of domestic violence and abuse. Using a convergent design, 532 gay and bisexual men participated in a Health and Relationship Survey in a U.K. sexual health service and 19 in an interview. Quantitative and qualitative data were analyzed separately and integrated at the level of interpretation and reporting. There were inconsistencies in perceptions and reports of abuse. Men were supportive of selective enquiry for domestic violence and abuse by practitioners (62.6%; 95% confidence interval = 58.1% to 66.7%) while being mindful of contextual factors.
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What appeared to be more important to men was the lack of visibility and targeting of services towards men, and thus a perception, or perhaps the reality, of a lack of access to such services.
“What appeared to be more important to men was the lack of visibility and targeting of services towards men, and thus a perception, or perhaps the reality of a lack of access to such services [16, 22, 26].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
The Discussion (page unavailable) reports that men wanted domestic-violence enquiries backed by available resources and recommends posters and leaflets to make support visible. The paper also says culturally appropriate services may be difficult to provide. It does not establish that lack of visibility or targeting was more important to men than other barriers, or that men perceived services to be inaccessible. (LLM, conf=0.78)
Experimental — accuracy not yet measuredPreference for receiving help from a female professional was consistent theme across studies and settings.
“A preference for receiving help from a female professional was a consistent theme across studies and settings.11 15 18 20”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
The “Gender of the Health Practitioner” section reports that some men felt more comfortable talking to female practitioners. It also describes mixed views, including that some might prefer male practitioners and that interpersonal skills mattered regardless of gender. This paper therefore supports the existence of a preference among some participants, but not its consistency across studies and settings. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe qualitative findings suggest a mixed response by men to referral from primary health care, with some men not perceiving it as a source of help and doubting the compassion and approach to confidentiality of general practitioners.
“The qualitative findings suggest a mixed response by men to referral from primary health care, with some men not perceiving it as a source of help as well as doubting the compassion and approach to confidentiality of general practitioners [16, 25].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
In “Asking Men About DVA in Other Health Care Settings” (page unavailable), interviewees question whether GPs have the time or skill to discuss abuse and express concerns about confidentiality. The paper does not describe a mixed response to referral from primary health care, and it does not clearly report doubts about GPs’ compassion. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThere is a consistent theme that female professional help in referral is acceptable, if not preferable for male victims of DVA, with no comparable discussion around male professional help in these settings.
“There is a consistent theme that female professional help in referral is acceptable, if not preferable for male victims of DVA with no comparable discussion around male professional help in these settings [16, 20, 23, 25].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
The “Gender of the Health Practitioner” section (page not provided) reports that some gay and bisexual men felt more comfortable disclosing abuse to female practitioners. It also discusses male practitioners, notes that some men might prefer them, and says interpersonal skills mattered regardless of gender. The paper does not establish a consistent preference for female help in referrals among male DVA victims generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOther men felt that general practice is a good place to disclose DVA and be referred, and that this process is facilitated by continuity of care and an individual approach by clinicians.
“Other men felt that general practice is a good place to disclose DVA and be referred, and that this process is facilitated by continuity of care and an individual approach by clinicans [16, 23, 25].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
The section “Views and Experiences of Routine Versus Selective Enquiry for DVA” (page unavailable) says that trust in an established patient–practitioner relationship can facilitate disclosure, and that men wanted referral support available. But “Asking Men About DVA in Other Health Care Settings” (page unavailable) reports concerns that GPs lacked time or skill and identifies sexual health clinics—not general practice—as favorable places to discuss DVA. The paper does not support the claim that these men regarded general practice as a good place to disclose and be referred. (LLM, conf=0.85)
Experimental — accuracy not yet measured
There was only one study which recruited men from sexual health clinics and these men appeared to have no problems with non-medically trained advisors supporting and referring them on.
“There was only one study which recruited men from sexual health clinics and these men appeared to have no problems with non-medically trained advisors supporting and referring them on [16].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
The Survey Participants section reports recruitment from sexual health clinics, and The Most Appropriate Sexual Health Practitioner to Ask About DVA says men regarded health advisors as well placed to discuss abuse. The Discussion proposes training advisors as an initial point of referral, but does not establish that men received support or referrals from them; some men also said enquiry should depend on available support and referral services. The paper does not establish that it was the only such study. (LLM, conf=0.85)
Experimental — accuracy not yet measuredNo specific routes of help were discussed by the men in the included studies, but there was a strong theme of the need for confidentiality and physical privacy in disclosing.
“No specific routes of help were discussed by the men in the included studies but there was a strong theme of the need for confidentiality and physical privacy in disclosing [16, 20, 23, 25].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
In “Asking Men About DVA in Other Health Care Settings” (page unavailable), men describe sexual health clinics as offering greater confidentiality, supporting that part of the claim. But men also discuss help through clinic staff, counsellors and referrals in “Views and Experiences of Routine Versus Selective Enquiry for DVA” (page unavailable), contrary to the claim that no routes of help were discussed. The passages do not establish a strong theme of physical privacy during disclosure. (LLM, conf=0.85)
Experimental — accuracy not yet measuredProviding practical advice is likely to be less daunting than a specific therapeutic intervention for male victims of DVA.
“The qualitative studies also report that men can minimise or downplay their experiences, so providing practical advice is likely to be less daunting than a specific therapeutic intervention [16, 18, 26].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
The Discussion (page unavailable) describes men normalizing or concealing abuse, and the paper discusses offering advice, referrals, and other practical support. It does not say that practical advice is less daunting for male victims than a specific therapeutic intervention. (LLM, conf=0.82)
Experimental — accuracy not yet measuredProfessional interaction and continuity of contact (as in general practice) gives time for men to feel they can trust the professional and be comfortable in discussing their situation in more detail.
“The primary-level qualitative studies also report that professional interaction and continuity of contact (as in general practice), gives time for men to feel they can trust the professional and be comfortable in discussing their situation in more detail [16, 23].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
The Discussion and “Views and Experiences of Routine Versus Selective Enquiry for DVA” sections say that time to develop trust can help men disclose abuse to sexual health practitioners. But “Asking Men About DVA in Other Health Care Settings” reports that participants viewed GPs as lacking time and, in some cases, as difficult to speak to openly; it does not support general practice as the example. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMen seemed to appreciate continuity of care from services, and to prefer disclosing to female professionals.
“Men seemed to appreciate continuity of care from services, and to prefer disclosing to female professionals [16, 18, 23].”
From Help seeking by male victims of domestic violence and abuse: an example of an integrated mixed methods synthesis of systematic review evidence defining methodological terms (2020) · cites this paper as [16]
In “Views and Experiences of Routine Versus Selective Enquiry for DVA” (page unavailable), the paper says an established, trusting patient–practitioner relationship could facilitate disclosure, but it does not specifically report a preference for continuity of care from services. “Gender of the Health Practitioner” (page unavailable) says some men felt more comfortable with female practitioners, while views were mixed and interpersonal skills mattered regardless of gender. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe previous systematic review identified twelve relevant primary-level qualitative interview and survey studies of the experiences of male victims of domestic violence and abuse.
“The systematic review also identified twelve relevant primary-level qualitative interview and survey studies of the experiences of male victims of DVA [16–27] (Table 4).”
Men can minimise or downplay their experiences.
“The qualitative studies also report that men can minimise or downplay their experiences, so providing practical advice is likely to be less daunting than a specific therapeutic intervention [16, 18, 26].”
The searches identified 12 relevant qualitative studies.
“The searches identified 12 relevant qualitative studies (figure 1).11–22”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
Only three included studies considered the relationship between the researcher and participant.
“only three studies considered the relationship between the researcher and participant11 13 15”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
Studies in healthcare settings suggested continuity of contact (care) was favoured by men.
“Studies in the healthcare settings suggested that continuity of contact (care) was favoured by men.11 18 20”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
Five included studies explored professional approach; one focused on MSM.
“Five studies explored the professional approach, one of studies focused on MSM.11 15 16 18 20”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
Three included studies, two focused on MSM, explored invisibility of male victims within services.
“Three studies, two were focused on MSM, explored invisibility of male victims within services.11 13 17”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
Five included studies emphasised importance of confidentiality for men seeking help; two focused on MSM.
“Five studies emphasised the importance of confidentiality for men seeking help, two of the five studies focused on MSM.11 15 17 18 20”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
Need for DVA gender-aware culture in services was discussed in practical and policy terms.
“The need for a DVA gender-aware culture in services was discussed in both practical and policy terms.11”
From Help-seeking by male victims of domestic violence and abuse (DVA): a systematic review and qualitative evidence synthesis (2019) · cites this paper as [11]
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References 50 · Cited by 24
- Authors
- Bacchus, L. J., Buller, A. M., Ferrari, G., Brzank, P., & Feder, G.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- University of Bristol (GB)
- Technische Universität Berlin (DE)
- Corresponding author
- Bacchus, Loraine J.
- Venue
- Journal of Mixed Methods Research
- Publisher
- SAGE Publications
- Published
- 2016-06-08
- Volume
- 12
- Issue
- 2
- Pages
- 221-243
- ISSN
- 1558-6898 (ISSN-L)
- 1558-6901
- OpenAlex
- W2411415629
- Cited by
- 24
- References
- 50
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 1 · 2016: 2
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Mixed Methods Research (publishedVersion)
- Explore Bristol Research (publishedVersion, other-oa)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion, other-oa)
- Bristol Research (University of Bristol) (submittedVersion, other-oa)
- Funders
- National Institute for Health Research (RP-PG-0108-10084)
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- domestic violence, intimate partner violence, gay and bisexual men, joint displays, convergent design, sexual health services
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