How Do HEART Scale Scores Change Over Time After Receiving a Counseling Session?
ABUSE
In addition to understanding whether the HEART could be used to sort participants and recommend counseling modules at enrollment, we sought to understand whether and how the HEART scale scores would change after receiving the modules. The Healthy Relationship Assessment Tool Scale Score Over Time, by Module Received at Enrollment in the CHARISMA PrEP Adherence Counseling Intervention, Johannesburg, South AfricaAbbreviations: CHARISMA, Community Health clinic model for Agency in Relationships and Safer Microbicide Adherence; IPV, intimate partner violence; PrEP, pre-exposure prophylaxis.For participants who were recommended the responding to IPV module, there were substantial changes across all 5 scales, particularly in the Partner Support, the Partner Abuse and Control, and the Partner Resistance scales. Mean scores on the Partner Support scale increased from 3.09 at enrollment to 3.27 at month 3 and 5.00 at month 6; the Partner Abuse and Control scale mean scores decreased from 3.49 at enrollment to 3.29 at month 3 and 1.71 at month 6; and the Partner Resistance scale mean scores also changed from 3.44 at enrollment to 4.60 at month 3 and 1.00 at month 6. Conceptually, these changes reflect participants' perceptions that their partners had become more supportive in their relationships (from the Partner Support scale), were exhibiting less abusive and controlling behavior in their relationships (from the Partner Abuse and Control scale), and had become less resistant to the use of HIV prevention products in their relationships (from the Partner Resistance scale). Changes in the Traditional Values and in the HIV Prevention Readiness scales were smaller but also in the expected direction (i.e., decreases in gendered traditional values and increases in readiness to use HIV prevention products). In turn, mean scores in the Traditional Values scale decreased from 1.83 at enrollment to 1.19 at month 3 and 1.00 at month 6, and mean scores in the HIV Prevention Readiness scale changed from 4.69 at enrollment to 4.67 at month 3 and 5.80 at month 6.For participants who received the partner communication or the PrEP disclosure modules, the changes across all 5 scales were largely in the expected direction but of much smaller magnitude, seemingly because for these 2 groups the scores at enrollment were already close to the lower and upper bounds of each respective scale range.