Table 1 ASIST-GBV screening instrument
GBV Screening Question Items: |
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1. In the past year, have you been threatened with physical or sexual violence by someone in your home or outside of your home? |
2. In the past year, have you been hit, punched, kicked, slapped, choked, hurt with a weapon, or otherwise physically hurt by someone in your home or outside of your house? |
3. In the past year, were you forced to have sex against your will? |
4. In the past year, were you forced to have sex to be able to eat, have shelter, or have sex for essential services (such as protection or school) because you or someone in your family would be in physical danger if you refused? |
5. In the past year, were you physically forced or made to feel that you had to become pregnant against your will? |
6. In the past year, were you coerced or forced into marriage? |
7. In the past year, were you coerced or forced to have an abortion? |
If yes to any of items 1 to 7, the woman has screened positive for gender-based violence. If positive screen, please ask: |
8. Would you like to talk to someone or learn more about services for women who have experienced gender-based violence? |