Hostile Environments? Exploring gender and class in relation to sexual violence

This research project addresses the knowledge gap that exists regarding working class women’s experiences of sexual violence. The aim of the project is to explore how sexual violence is understood and experienced by victim-survivors at the intersection of gender and class. In doing so, we will develop a more nuanced picture of how social class intersects with, and is modified by, gender inequality in relation to sexual violence. To recognise violence as gendered is to enable a mobilisation of people to challenge violence against women; however, we must also retain a class focus as, for example, being considered as a ‘credible complainer’ is a deeply classed notion rooted in the notion of respectability (Phipps 2009). In this study, we will speak to women about their experiences, including if they have disclosed their experiences and the nature of responses, to better understand the nexus between gender, class and sexual violence.

The project is funded by British Academy/Leverhulme

The study website is

We are recruiting Feb – May 2023. Project runs until October 2023.

Towards an effective structure for the delivery of clinical supervision to sexual health nurses: a mixed methods project

Towards an effective structure for the delivery of clinical supervision to sexual health nurses: a mixed methods project

PI: Dr Jenny Dalrymple
CI: Karen Lorimer (GCU)
Funder: NHSGG&C mental/sexual health partnership

(Jan 2018 – March 2019)

Aim: The study aims to develop an effective format for undertaking clinical supervision with sexual health nurses.

Research questions:

  1. How does the length of each clinical supervision session impact on its effectiveness for sexual healthnurses?
  2. How does the frequency of clinical supervision impact on its effectiveness for sexual health nurses?
  3. How does one to one clinical supervision compared to group supervision impact on its effectiveness for sexual health nurses?
  4. How does the location of clinical supervision impact on its effectiveness for sexual health nurses?
  5. How does being able to choose a supervisor impact on the effectiveness of clinical supervision for sexual health nurses?
  6. How do sexual health nurses and junior doctors experience clinical supervision?

Rapid review of definitions and measures of sexual wellbeing

PI: Karen Lorimer
CI: Jenny Dalrymple (GCU)
Funding: Chief Scientist Office (CSO) Catalytic Grant

A WHO/UNFPA working group met in September 2007 to elaborate on sexual health indicators, at which the term ‘sexual wellbeing’ was discussed. In short, there was little agreement among participants about what sexual wellbeing was, nor how to measure it. Participants of that meeting concluded that ‘more research was needed to explore the various dimensions of ‘sexual well-being’ in order to draw up an appropriate set of indicators.’

Aim: To assess what is known from existing literature about how sexual wellbeing has been operationalised and measured.

Research questions:

  1. Do any measures of sexual wellbeing exist?
  2. If any measures of sexual wellbeing exist, what attributes of the concept were used and why?
  3. How has sexual wellbeing been defined and assessed across empirical studies?
  4. What factors are associated with sexual wellbeing?

This catalytic grant funding underpins a larger grant application to a research council, to de-risk the larger project.

World Health Organisation, Measuring sexual health: Conceptual and practical considerations and related indicators. 2010: Geneva, Switzerland.

Measuring patient experience and outcome in health care settings on receiving care after sexual violence: a systematic review

Measuring patient experience and outcome in health care settings on receiving care after sexual violence: a systematic review

PI: Dr Rachel Caswell (University Hospitals Birmingham NHS Foundation Trust)
CI: Dr Karen Lorimer, GCU; Prof Jonathan Ross (University Hospitals Birmingham NHS)
Funding: Sexually Transmitted Infections Research Foundation

The objectives of this review are

– to determine how patient reported outcomes measures (PROMS) and experiences (PREMS) have previously been defined and measured for men and women attending health care settings after experiencing sexual violence.
– to identify whether a “gold standard” measure of PROMS and PREMS exists for this group of patients, and if so how has it been defined in terms of reliability (are the results reproducible and consistent), validity (has an assessment been made of what patients consider to be important measures of quality and are they accurately evaluated), acceptability and feasibility;
– to identify key themes regarded by patients as priorities for delivering a high-quality service for individuals who have experienced sexual violence

DeMaSH project

Deprivation, Masculinities and Sexual Health

PI: Dr Karen Lorimer
CIs: Prof Kate Hunt, Prof Lesley McMillan, Prof Lisa McDaid, Dona Milne, Rosie Ilett
Funder: Chief Scientist Office (CZH/4/925)

This ambitious qualitative study, funded by the CSO, recruited 116 men and women aged 18-40 years, from areas of high socio-economic deprivation across Scotland, to 18 focus groups and 35 individual interviews. The project explored an array of sexual health understandings and behaviours via a masculinities framework, to explore how we might better develop interventions to tackle poor sexual health outcomes. We embraced the WHO holistic definition of sexual health, which goes beyond ‘bugs and babies’ to include freedom from coercion and violence.  So, in this project we explored with men and women their understandings of various forms of gender-based violence.

here is the summary on the CSO website

Lorimer, K., L. McMillan, L. McDaid, D. Milne, S. Russell and K. Hunt (2018). “Exploring masculinities, sexual health and wellbeing across areas of high deprivation in Scotland: the depth of the challenge to improve understandings and practices.” Health and Place, Vol50. Open access

McDaid, L., K. Hunt, L. McMillan, S. Russell, D. Milne, R. Ilett and K. Lorimer (2019). “Absence of holistic sexual health understandings among men and women in deprived areas of Scotland: qualitative study.” BMC Public Health 19(1): 299.

Systematic review: intervening after a HIV- test

The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative HIV test in men who have sex with men (MSM): systematic review and intervention development

PI: Prof Paul Flowers, (GCU)
Funder: NIHR HTA

Background: MSM experience significant inequalities in health and wellbeing. They are the group at highest risk of acquiring HIV within the United Kingdom. Guidance relating to both HIV prevention in general and individual level behaviour change interventions in particular is very limited.

Objective(s): To conduct an evidence synthesis of the clinical effectiveness of behavioural change interventions to reduce risky sexual behaviour after a negative HIV test in MSM. To identify effective components within interventions in reducing HIV risky related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention.

Data sources: All major electronic databases were searched between January 2000 and December 2014.

Review methods: systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique taxonomy, theory coding assessment, mode of delivery and proximity to testing event. Data were summarised in narrative review and meta-analysis were carried out where appropriate. Supplemental analyses for the development of the candidate intervention focussed upon post hoc realist review methods, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of acceptability and optimisation.

Results: Overall, trials included in this review (n=10) reported positive findings and suggest individual level behavioural change interventions are effective in reducing key HIV risk related behaviours. However, there were considerable clinical and methodological heterogeneity among the trials. Exploratory meta-analysis showed a statistically significant reduction in behaviours associated with high risk of HIV transmission (risk ratio 0.75; 95% CI 0.62, 0.91). Additional stratified analyses suggested effectiveness may be enhanced through face-to-face, immediately post-test delivery, theory based content and behaviour change techniques drawn from ‘goals and planning’ and ‘identity’ groups. All evidence collated within the review was synthesised to develop a candidate intervention. Experts highlighted overall acceptability of the intervention and outlined key ways the candidate intervention could be optimised to enhance UK implementation.

Limitations: There was a limited number of primary studies, all from outside the UK, and within them considerable clinical, methodological and statistical heterogeneity. The findings of the meta-analysis must be treated with caution, and may only be used for hypotheses generating. In terms of assessing intervention content and delivery, findings are limited by uncertain intervention fidelity, an overreliance upon published papers rather than intervention manuals, and the use of innovative methodologies.

Conclusions: The limited evidence regarding the effectiveness of behaviour change interventions does suggest they are effective in changing behaviour associated with HIV transmission. However, there are uncertainties around the generalisability of these findings to the UK setting. UK experts found the intervention acceptable and provided ways of optimising the candidate intervention.

Future work There is a need for well-designed, UK-based trials of individual behaviour change interventions which clearly articulate intervention content and demonstrate intervention fidelity.

Study registration: The study was registered as PROSPERO no.CRD42014009500

Funding details: The National Institute for Health Research Health Technology Assessment programme.

Final report can be found HERE