Evidence for use of a healthy relationships assessment tool in the CHARISMA pilot study

Introduction The CHARISMA intervention, nested within the MTN-025/HOPE vaginal ring trial in Johannesburg, South Africa, seeks to facilitate women’s use of HIV prevention products by promoting partner dialogue and mitigating intimate partner violence (IPV). We developed “HEART”, a lay counselor-administered relationship assessment tool, for the CHARISMA pilot. The five-scale tool assesses participants’ endorsement of Traditional Values (TV), her HIV Prevention Readiness (HPR) and levels of partner support (PS), abuse and control (PAC), and resistance to HIV prevention (PR), guiding decisions about which of three counselling modules to offer (partner communication/A; ring disclosure/B; and IPV prevention/C). Methods We correlated baseline scores on HEART subscales with a) independent measures of relationship stability, disclosure and IPV to assess construct validity, and b) with specific modules offered to determine how HEART was used in the pilot. We examined changes in HEART scores at three and six months. Finally, we ran separate growth models for each subscale to examine changes in scores, accounting for partnership changes and counseling module(s) received. Results Baseline HEART scores correlated as predicted among subscales and with other measures. Reliabilities for four subscales were 0.75 or higher. Women who disclosed study participation and ring use scored higher on PS and lower on PR. Women experiencing IPV scored lower on PS, and higher on PAC and PR. During the pilot, 82% of women received one and 17% received two or more modules; over half received the IPV module. Women with higher PAC and PR scores were more likely to receive the IPV than the communication or disclosure modules. Over time, the TV, PAC and PR scores decreased, and PS score increased. Receiving the IPV module was associated with a decreased PAC score. Conclusions These data offer preliminary evidence for HEART construct and predictive validity and support its further evaluation to guide implementation and monitor the impact of the CHARISMA intervention in a randomized controlled evaluation.

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Development and initial validation of a simple tool to screen for partner support or opposition to HIV prevention product use

PLoS ONE ◽

10.1371/journal.pone.0242881 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242881

Author(s):

Elizabeth E. Tolley ◽

Seth Zissette ◽

Andres Martinez ◽

Thesla Palanee-Phillips ◽

Florence Mathebula ◽

...

Keyword(s):

Hiv Prevention ◽

Partner Violence ◽

Qualitative Data ◽

Assessment Tool ◽

Multiple Scales ◽

Controlled Trial ◽

Qualitative Interviews ◽

Male Partner ◽

Partner Support ◽

Initial Validation

In HIV prevention trials, male partners have influenced women’s ability to adhere to investigational products, including antiretroviral (ARV) containing vaginal rings. Validated scales can be useful tools to systematically measure complex constructs, such as those related to male partner engagement. Although multiple scales exist to assess physical, psychological and sexual violence within intimate relationships, fewer scales focus on supportive behaviors within these relationships. Our intervention involved development of a Healthy Relationship Assessment Tool (HEART) that assessed both positive and negative aspects of male partner involvement in women’s HIV prevention. We identified and refined 127 potential items, representing intimate partner violence, agency and social support. A structured survey, including potential items and other sociodemographic and behavioral variables was administered to former microbicide trial and non-trial participants. We conducted an exploratory factor analysis (EFA) to identify a reduced set of constructs and items to screen women who might experience social harms or benefits from vaginal ring use. We examined associations between constructs and with other survey variables to assess content and construct validity. In a subset of 10 women who participated in the survey and qualitative interviews, we used qualitative data to predict survey scores. We retained five constructs with theoretical relevance and good-to-strong reliability for the tool, including: Traditional Values; Partner Support; Partner Abuse & Control; Partner Resistance to HIV Prevention; and HIV Prevention Readiness. Predicted associations between HEART constructs, and correspondence between participants’ qualitative data and HEART scores were generally correct, while those between constructs and other sociodemographic variables were more mixed. Initial validation of the HEART tool was promising. The tool will be used during the CHARISMA pilot study at the Johannesburg MTN 025/HOPE site and validated as part of a randomized controlled trial of CHARISMA within a PrEP demonstration project. Beyond clinical trial settings, HEART could assist PrEP or antiretroviral treatment (ART) providers with an easy-to-administer tool to identify risk and tailor risk reduction, empowerment and adherence counseling for microbicides, PrEP or ART related services.

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The Impact of Perpetrator Characteristics on the Completion of a Partner Abuse Intervention Program

Journal of Interpersonal Violence ◽

10.1177/0886260517719904 ◽

2017 ◽

Vol 35 (23-24) ◽

pp. 5228-5254 ◽

Cited By ~ 3

Author(s):

Jami L. Mach ◽

Arthur L. Cantos ◽

Emily N. Weber ◽

David S. Kosson

Keyword(s):

Partner Violence ◽

Intervention Program ◽

Readiness To Change ◽

Partner Abuse ◽

Stage Of Change ◽

Preliminary Evidence ◽

Program Completion ◽

Composite Score ◽

Self Report ◽

The Impact

This study examined how type of perpetrator (family only [FO] vs. generally violent [GV]), readiness to change, and stake in conformity function separately and together in predicting completion of a partner abuse intervention program (PAIP). Data were collected from 192 male perpetrators of intimate partner violence (IPV) who were court mandated to attend a PAIP. Participants were categorized as FO violent or GV based on a combination of their self-report and official records of violence. Stake in conformity has been defined as the degree to which an individual is invested in the values and institutions of a society. A composite stake in conformity score was computed for each participant based on his education level, and marital and employment status. Each participant was also assigned a stage of change score based on his responses on a validated measure of stage of change for domestic violence perpetrators. Analyses indicated that stage of change was not related to program completion or attendance. Type of perpetrator and stake in conformity composite score were significantly related to program completion. Perpetrators with higher stake in conformity scores and individuals categorized as FO attended more PAIP sessions and were more likely to complete the program. When both predictors were examined together, only stake in conformity composite score uniquely predicted program attendance and completion. These findings provide additional evidence that subtype of IPV perpetrator has implications for treatment responsiveness and provide preliminary evidence for the value of improved measurement of investment in societal institutions.

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Female Victimization and Intimate Partner Violence After the May 12, 2008, Sichuan Earthquake

Violence and Victims ◽

10.1891/0886-6708.26.3.364 ◽

2011 ◽

Vol 26 (3) ◽

pp. 364-376 ◽

Cited By ~ 25

Author(s):

Ko Ling Chan ◽

Yulian Zhang

Keyword(s):

Intimate Partner Violence ◽

Violence Prevention ◽

Partner Violence ◽

Physical Violence ◽

Well Being ◽

Preliminary Evidence ◽

Intimate Partner ◽

Psychological Aggression ◽

Study Results ◽

The Impact

This study investigates the impact of the earthquake that occurred on May 12, 2008 in Sichuan, China on stressed families already experiencing domestic violence. We hypothesized that cumulative postdisaster stress would increase marital aggression and that the well-being of victims would deteriorate following the quake. A total of 186 women were recruited for this study. Results show that all types of family violence, including psychological aggression and physical violence between partners, increased after the earthquake. We provided preliminary evidence that psychological aggression was significantly associated with the detrimental effects on victims’ mental and physical functioning. The findings support the need for violence assessment among victims of earthquakes, and we recommend that violence prevention be considered as part of the intervention during such natural disasters.

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Assessing Polyvictimization in a Family Justice Center: Lessons Learned From a Demonstration Project

Journal of Interpersonal Violence ◽

10.1177/08862605211027998 ◽

2021 ◽

pp. 088626052110279

Author(s):

Danielle M. Romain Dagenhardt ◽

Joshua Mersky ◽

James “Dimitri” Topitzes ◽

Erin Schubert ◽

Amber E. Krushas

Keyword(s):

Partner Violence ◽

Assessment Tool ◽

Qualitative Interviews ◽

Lessons Learned ◽

Assessment Tools ◽

Measurement Development ◽

Social Service Agencies ◽

Promising Line ◽

Assessment Procedures ◽

The Impact

There is a growing interest in developing comprehensive assessments that measure intimate partner violence (IPV) alongside other adverse events that correlate with IPV and compound its effects. One promising line of research in this area has focused on the impact of exposure to multiple types of victimization, i.e., polyvictimization. The purpose of this study is to examine the experience of administration of a polyvictimization tool from staff and client perspectives in order to inform future tool developments and assessment procedures. Qualitative interviews and focus groups with clients and staff from a family justice center who had experience with the assessment tool were used to identify strengths and challenges of the assessment too and inform future tool development. Findings demonstrate that an assessment tool provides the space for clients to talk about trauma and facilitate empowerment, while providing the opportunity for psychoeducation and service referrals. Concerns about the assessment tool included adverse reactions without proper framing and language, as well as shifting the emphasis from screening for adversities toward strengths, coping skills, and resilience. Implications for future measurement development and establishing best practices in polyvictimization assessment are discussed, with an emphasis on the benefits of social service agencies utilizing assessment tools.

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Phylodynamics Helps to Evaluate the Impact of an HIV Prevention Intervention

Viruses ◽

10.3390/v12040469 ◽

2020 ◽

Vol 12 (4) ◽

pp. 469 ◽

Cited By ~ 3

Author(s):

Tetyana I. Vasylyeva ◽

Alexander Zarebski ◽

Pavlo Smyrnov ◽

Leslie D. Williams ◽

Ania Korobchuk ◽

...

Keyword(s):

Hiv Prevention ◽

Hiv Transmission ◽

Assessment Tool ◽

Population Level ◽

Reproductive Number ◽

Post Intervention ◽

Hiv Prevention Intervention ◽

Transmission Parameters ◽

Transmission Reduction ◽

The Impact

Assessment of the long-term population-level effects of HIV interventions is an ongoing public health challenge. Following the implementation of a Transmission Reduction Intervention Project (TRIP) in Odessa, Ukraine, in 2013–2016, we obtained HIV pol gene sequences and used phylogenetics to identify HIV transmission clusters. We further applied the birth-death skyline model to the sequences from Odessa (n = 275) and Kyiv (n = 92) in order to estimate changes in the epidemic’s effective reproductive number (Re) and rate of becoming uninfectious (δ). We identified 12 transmission clusters in Odessa; phylogenetic clustering was correlated with younger age and higher average viral load at the time of sampling. Estimated Re were similar in Odessa and Kyiv before the initiation of TRIP; Re started to decline in 2013 and is now below Re = 1 in Odessa (Re = 0.4, 95%HPD 0.06–0.75), but not in Kyiv (Re = 2.3, 95%HPD 0.2–5.4). Similarly, estimates of δ increased in Odessa after the initiation of TRIP. Given that both cities shared the same HIV prevention programs in 2013–2019, apart from TRIP, the observed changes in transmission parameters are likely attributable to the TRIP intervention. We propose that molecular epidemiology analysis can be used as a post-intervention effectiveness assessment tool.

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