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Abstract
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Survivors of sexual violence, abuse, and exploitation--including people who have experienced human trafficking, intimate partner violence, and sexual assault--may avoid health care due to fear of stigmatization and potential re-traumatization in health care settings.1,2 The PurpLE (Purpose: Listen and Engage) Clinic was a family medicine practice piloted to address these barriers to primary care access for this population.
The clinic was founded and led by a family medicine physician (A.R.) and piloted within a New York City Federally Qualified Health Center (FQHC) from July 2015 to January 2019. During its 3.5 years, the program received nearly 700 referrals from 75 community partners, with 287 patients ultimately connecting for care (62% had repeat visits, ranging from 2 to 43 visits) (Supplemental Table). Survivors (and their children) received routine primary care, including reproductive, HIV, LGBTQ+, and preventative health care, regardless of age, documentation, or insurance status. Patients were referred within the FQHC for social work and mental health services.
Stakeholder feedback, including from incarcerated sex trafficking survivors on Rikers Island,3,4 was utilized to design PurpLE Clinic's trauma-informed clinical operations and care delivery. Examples included pre- and post-care coordination with referring organizations (Supplemental Appendix) and extended appointments (30- to 120-minute visits) to facilitate language interpretation and shared visits with patient advocates from community organizations.
Patients' histories ranged from being in the midst of a trafficking situation or abusive relationship, to being years removed from the experience. Many also had socioeconomic circumstances that further complicated their care, such as unstable housing, intermittent incarceration, financial insecurity, and undocumented status...
Language: en |