Validation of women abuse screening tool (WAST-S) in the Mozambique National Health Service (significance for HIV prevention and ART treatment Adherence): A quasi-experimental crossover study

Abstract

Intimate partner violence (IPV), includes a wide range of abusive behaviors perpetrated by someone involved or who was involved in an intimate relationship with the victim. It is a serious and preventable public health problem globally. This article reports on the validation of an adaptation of the Women Abuse Screening Tool (WAST-S) in Mozambique and recommends its application for more effective prevention and ART treatment. The study utilized a quantitative approach in a prospective quasi-experimental crossover design, in which clusters, 4 health care units, were allocated to two intervention approaches in reverse order. IPV was measured using a translated, culturally-adapted version of WAST-S. This was compared to a standard clinical interview that included questions on IPV. There was a good agreement between the scales of WAST-Short and the standard clinical interview: 0.235 (95% CI: 0.219 - 0.250). The WAST-Short was found to be more effective than the standard clinical interview as an IPV screening tool. It provides information about intimate relationships and can measure the presence of violence. The standard clinical interview is less effective at obtaining this information. WAST-S proved to be a more reliable instrument than a clinically adapted interview, and can be applied in the screening of IPV in high patient volume settings and efficiently implemented in primary health care units which can then refer patients for specialized care. The two questions of the WAST-S provide insight into the intimate relationship measuring the presence of violence, information not easily accessible by the standard clinical interview. This information when provided to clinicians has the potential for assuring more effective prevention and treatment adherence.