1
|
Inbaraj LR, Heylen E, Srinivasan K, Ekstrand ML. Is self-reported adherence a valid measure of glycaemic control among people living with diabetes in rural India? A cross-sectional analysis. Prim Care Diabetes 2022; 16:849-852. [PMID: 36336604 PMCID: PMC9675721 DOI: 10.1016/j.pcd.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Visual analogue scale (VAS) is one of the simplest to measure medication adherence. It has neither been widely used for Non communicable diseases (NCD) nor validated for in the Indian setting. We examined the validity of self-reported medication adherence measures in relation to HbA1C in a rural population with diabetes mellitus (DM). METHODS Participants with DM was administered VAS, Diabetes Self-Management Questionnaire (DMSQ) and assessed for missed pills. Descriptive statistics and logistic regression analysis were done. RESULTS We recruited 1347 participants and 84% of them reported being 100% adherent as per VAS and 83.8% stated that they did not miss any pills. However, 58.2% of participants who reported having 100% adherence had poor glycaemic control, as did 58.1% of those who did not miss any pills. None of the diabetic self-care measures was significantly associated with glycaemic control. CONCLUSION We found a lack of association between self-reported adherence measures and glycaemic control in participants with DM suggesting that self-reported adherence scales may not be valid in this population.
Collapse
Affiliation(s)
- Leeberk Raja Inbaraj
- Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Bengaluru, India; Department of Clinical Research, ICMR- National Institute for Research in Tuberculosis, Chennai, India.
| | - Elsa Heylen
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA
| | - Krishnamachari Srinivasan
- Department of Psychiatry, St John's Medical College Hospital, Bengaluru, Karnataka, India; Division of Mental Health and Neurosciences, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Maria L Ekstrand
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA; Division of Mental Health and Neurosciences, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| |
Collapse
|
2
|
Phoo NNN, Lobo R, Vujcich D, Reid A. Comparison of audio computer-assisted self-interview (ACASI) to other survey modes in sexual behaviour surveys in Asia and Sub-Saharan Africa: A systematic literature review (Preprint). J Med Internet Res 2022; 24:e37356. [PMID: 35639465 PMCID: PMC9198818 DOI: 10.2196/37356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Reliable data about sexual behaviors is fundamental in the prevention and control of HIV, hepatitis, and other sexually transmitted infections. Generally, sexual behaviors are regarded as a sociocultural taboo in Africa and Asia, and this results in biased sexual behavior survey data due to social desirability. Various modes of survey delivery, including audio computer-assisted self-interviews (ACASIs), have been investigated to improve data quality. Objective This study aimed to review studies that compared the ACASI mode to other survey modes in sexual behavior surveys in Asia and sub-Saharan Africa to ascertain the impact of survey mode on responses to sexual behavior questions. Methods A systematic literature review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. The review protocol was registered at PROSPERO (International Prospective Register of Systematic Reviews). Six databases were searched. Results A total of 21 papers were included. The face-to-face interview (FTFI) mode was the survey mode most frequently compared to the ACASI mode. Among the most commonly reported outcome variable groups, ACASI participants were more likely to report sexual behaviors, such as “forced sex,” “multiple partners,” “transactional sex,” and “ever had sex,” as compared to FTFI participants. In addition to the survey mode effect, other factors were found to have had an impact on data quality, for example, participant characteristics, social norms, study design, and data collection setting. Conclusions Use of ACASIs for administering sexual behavior surveys among populations in Asia and sub-Saharan Africa demonstrated higher reports for some sexual behaviors than the use of FTFIs. More studies that compare the ACASI mode to other survey modes would improve our understanding of the usefulness of ACASIs in sexual behavior surveys in these regions.
Collapse
Affiliation(s)
| | - Roanna Lobo
- School of Population Health, Curtin University, Perth, Australia
| | - Daniel Vujcich
- School of Population Health, Curtin University, Perth, Australia
| | - Alison Reid
- School of Population Health, Curtin University, Perth, Australia
| |
Collapse
|
3
|
Firkey M, Sheinfil A, Ramos J, Woolf-King SE. Cannabis and Alcohol Co-Use and Condomless Anal Sex Among Men Who have Sex with Men Living with HIV: An Event-Level Analysis. AIDS Behav 2021; 25:3770-3781. [PMID: 33733310 DOI: 10.1007/s10461-021-03228-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
Men who have sex with men (MSM) account for more than two thirds of new HIV diagnoses annually. Sexual behavior that increases risk for onward transmission of HIV is associated with both alcohol and cannabis use. However, little is known about the influence of cannabis and alcohol co-use on engagement in condomless anal sex (CAS). The current study explored daily associations between substance use and CAS among HIV-positive MSM using a 42-day timeline followback interview (N = 101). Generalized estimating equation (GEE) logistic regression models were used to examine the association between cannabis and alcohol co-use and CAS at the sexual event while controlling for study site, condition, adherence to antiretroviral therapy, sex-related alcohol expectancies, and partner type. Participants provided data for 1052 sexual activity days, 60.7% of which involved CAS. Of 638 CAS days, 9.1% involved no substances, 72.0% involved either cannabis or alcohol use, and 18.9% involved cannabis and alcohol co-use. Results indicated that the odds of engaging in CAS were higher for sexual events in which cannabis and alcohol co-use occurred (aOR 2.98; 95% CI 1.27, 6.97) compared to events in which no substance use occurred (p = 0.012), but this relationship was no longer significant when cannabis and alcohol co-use was compared to single substance use (aOR 1.57; 95% CI 0.85, 2.90; p = 0.15). Future research should identify specific substance use (e.g., quantity) and partner characteristics (e.g., level of intoxication) that may uniquely influence the relationship between cannabis and alcohol co-use and condomless sex.
Collapse
|
4
|
Yakubu K, Bowen P, Govender R. Determinants of HIV testing behaviour among male South African construction workers. AIDS Care 2021; 34:847-855. [PMID: 34581654 DOI: 10.1080/09540121.2021.1981222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The global trend of poorer outcomes across the HIV treatment cascade for men has drawn attention to the importance of engaging men in prevention and treatment services. The South African construction industry is one of the economic sectors most adversely affected by HIV/AIDS. Previous research on HIV testing behaviour among workers in the industry has revealed that male workers are less likely to be tested than female workers. Given this gender differential, this study employed a field-administered survey to gather data from 450 site-based, male construction workers in Western Cape, South Africa. An integrated model comprising demographic, cognitive, and behavioural factors was then hypothesised to explain HIV testing behaviour. Bivariate analysis and structural equation modelling were then used to test the model. Findings indicate that HIV knowledge, having previously had an STI, and possessing a positive attitude towards HIV testing are terminal predictors of testing behaviour. As a strategy for positively influencing testing behaviour, employers should ensure that effective communication about HIV testing is established with workers across all levels of education and ethnic groups. Interventions relating to risky sexual behaviour need particular attention, and where possible HIV testing should be coupled with general STI screening.
Collapse
Affiliation(s)
- Kamal Yakubu
- Nelson Mandela School of Public Governance, University of Cape Town, Cape Town, South Africa
| | - Paul Bowen
- Department of Construction Economics and Management, University of Cape Town, Cape Town, South Africa
| | - Rajen Govender
- Nelson Mandela School of Public Governance, University of Cape Town, Cape Town, South Africa.,Institute for Social and Health Sciences, University of South Africa, Lenasia, South Africa.,Violence, Injury and Peace Research Unit, South African Medical Research Council, Tygerberg, South Africa
| |
Collapse
|
5
|
Abstract
Adolescent girls and young women (AGYW) ages (15-24 years old) in Southern and Eastern Africa account for nearly 30% of all new HIV infections. We conducted a systematic review of studies examining the effectiveness of behavioral, structural, and combined (behavioral + structural) interventions on HIV incidence and risky sexual behaviors among AGYW. Following PRISMA guidelines, we searched PubMed, CINAHL, Web of Science, and Global Health. Twenty-two studies met inclusion criteria conducted in Eastern and Southern Africa and comprised behavioral, structural, or combined (behavioral and structural) interventions. All findings are based on 22 studies. HIV incidence was significantly reduced by one structural intervention. All three types of interventions improved condom use among AGYW. Evidence suggests that structural interventions can reduce HIV incidence, while behavioral and combined interventions require further investigation.
Collapse
|
6
|
Wilson TE, Gousse Y, Joseph MA, Browne RC, Camilien B, McFarlane D, Mitchell S, Brown H, Urraca N, Romeo D, Johnson S, Salifu M, Stewart M, Vavagiakis P, Fraser M. HIV Prevention for Black Heterosexual Men: The Barbershop Talk with Brothers Cluster Randomized Trial. Am J Public Health 2019; 109:1131-1137. [PMID: 31219715 DOI: 10.2105/ajph.2019.305121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To identify the impact of a strengths-focused HIV prevention program among high-risk heterosexual Black men. Methods. Barbershops in Brooklyn, New York, neighborhoods with high rates of heterosexually transmitted HIV were randomized to the intervention or an attention control program. Men were recruited from barbershops between 2012 and 2016 and participated in a single small group, peer-led session focused on HIV risk reduction skills and motivation, community health empowerment, and identification of personal strengths and communication skills. The outcome was defined as 1 or more acts of condomless anal or vaginal sex in the preceding 90 days at a 6-month interview. Results. Fifty-three barbershops (24 intervention, 29 control) and 860 men (436 intervention, 424 control) were recruited; follow-up was completed by 657 participants (352 intervention, 305 control). Intervention exposure was associated with a greater likelihood of no condomless sex (64.4%) than control group participation (54.1%; adjusted odds ratio = 1.61; 95% confidence interval = 1.05, 2.47). Conclusions. Program exposure resulted in reduced sexual risk behaviors, and the program was acceptable for administration in partnership with barbershops. Public Health Implications. Dissemination of similar programs could improve public health in communities with high rates of HIV attributable to heterosexual transmission.
Collapse
Affiliation(s)
- Tracey E Wilson
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Yolene Gousse
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Michael A Joseph
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Ruth C Browne
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Brignel Camilien
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Davin McFarlane
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Shawn Mitchell
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Humberto Brown
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Nelson Urraca
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Desmond Romeo
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Steven Johnson
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Moro Salifu
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Mark Stewart
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Peter Vavagiakis
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| | - Marilyn Fraser
- Tracey E. Wilson, Yolene Gousse, Michael A. Joseph, Davin McFarlane, Moro Salifu, and Mark Stewart are with the State University of New York Downstate Medical Center, Brooklyn. Ruth C. Browne, Brignel Camilien, Shawn Mitchell, Humberto Brown, and Marilyn Fraser are with the Arthur Ashe Institute for Urban Health, Brooklyn. Nelson Urraca is with Nelson's Barbershop, Brooklyn. Desmond Romeo is with Cuts Barbershop, Brooklyn. Steven Johnson is with F & S Barbershop, Brooklyn. Peter Vavagiakis is with Panna Technologies, New York, NY. The authors collaborated through the Brooklyn Health Disparities Center, Brooklyn
| |
Collapse
|
7
|
Thapa R, Yang Y, Nget M. Perceptions of Sexual Infidelity in Rural Cambodia: A Qualitative Study of Adolescent Men. Am J Mens Health 2019; 13:1557988319848576. [PMID: 31055984 PMCID: PMC6505243 DOI: 10.1177/1557988319848576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/11/2019] [Accepted: 04/15/2019] [Indexed: 11/21/2022] Open
Abstract
Sexual infidelity plays a significant role in the high rate of spousal transmission of HIV in Cambodia. The sexual beliefs and attitudes of a person begin in childhood and are developed through multiple chains in early adolescence, affecting his or her future sexual behavior and future incidence of HIV. A deeper understanding of the perspectives of adolescents regarding infidelity is critical to effective HIV prevention efforts during adulthood. Using a descriptive qualitative approach, this study explored the perceptions of male adolescents regarding male infidelity. Through the thematic analysis method, themes and subcategories were developed from the responses of 48 male high school students from three provinces. Majority of the participants ( n = 33) were found to have liberal attitudes not only toward male infidelity but also toward the high possibility of their own future infidelity ( n = 14). Almost 45% ( n = 21) of the participants explained that men would fulfill their sexual desires outside, such as in karaoke, when their wives are unable to have sex with them. Participants believed it annoying for men to disclose their extramarital activities to their wives. The study concluded that the participants hold accepting perceptions about infidelity; they are part of the HIV problem and must be part of the solution. Educators and counselors need to deliver age-appropriate, scientifically correct, and culturally relevant messages about sexual health and HIV prevention to growing adolescents.
Collapse
Affiliation(s)
- Roshna Thapa
- School of Nursing, Research Institute of
Nursing Science, Chonbuk National University, Jeonju, Baekje-daero, Republic of
Korea
| | - Youngran Yang
- School of Nursing, Research Institute of
Nursing Science, Chonbuk National University, Jeonju, Baekje-daero, Republic of
Korea
| | - Manndy Nget
- School of Nursing, Thammasat University,
Bangkok, Thailand
| |
Collapse
|
8
|
Freeborn K, Portillo CJ. Does pre-exposure prophylaxis for HIV prevention in men who have sex with men change risk behaviour? A systematic review. J Clin Nurs 2018; 27:3254-3265. [PMID: 28771856 DOI: 10.1111/jocn.13990] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To review the literature regarding PrEP and sexual behaviour change in MSM. BACKGROUND Pre-exposure prophylaxis for HIV has been available since 2012. Even so, pre-exposure prophylaxis has not been widely accepted among healthcare providers and men who have sex with men some of whom are convinced that pre-exposure prophylaxis decreases condom use and increases sexually transmitted infections. DESIGN A systematic review of the state of the evidence regarding the association of pre-exposure prophylaxis with condom use, sexually transmitted infection incidence and change in sexual risk behaviours in men who have sex with men. A structured search of databases resulted in 142 potential citations, but only 10 publications met inclusion criteria and underwent data abstraction and critical appraisal. METHODS An adapted Cochrane Collaboration domain-based assessment tool was used to critically appraise the methodological components of each quantitative study, and the Mixed Methods Appraisal Tool was used to critically appraise qualitative and mixed-methods studies. RESULTS Condom use in men who have sex with men using pre-exposure prophylaxis is influenced by multiple factors. Studies indicate rates of sexually transmitted infections in treatment and placebo groups were high. Pre-exposure prophylaxis did not significantly change sexually transmitted infection rates between baseline and follow-up. Reporting of sexual risk improved when questionnaires were completed in private by clients. Our review found that pre-exposure prophylaxis may provide an opportunity for men who have sex with men to access sexual health care, testing, treatment and counselling services. We did not find any conclusive evidence that pre-exposure prophylaxis users increase sexual risk behaviours. CONCLUSION The perception among healthcare providers that pre-exposure prophylaxis leads to increased sexual risk behaviours has yet to be confirmed. In order to provide effective sexual health services, clinicians need to be knowledgeable about pre-exposure prophylaxis as an HIV prevention tool. RELEVANCE TO CLINICAL PRACTICE In an era where HIV prevention methods are rapidly improving, strategies for sexually transmitted infection testing, treatment, counselling and prevention remain vital to improve health. All healthcare providers are uniquely positioned to promote sexual health through the dissemination of accurate information.
Collapse
Affiliation(s)
- Kellie Freeborn
- Department of Community Health Systems, University of California, San Francisco, CA, USA
| | | |
Collapse
|
9
|
Lindberg L, Scott RH. Effect of ACASI on Reporting of Abortion and Other Pregnancy Outcomes in the US National Survey of Family Growth. Stud Fam Plann 2018; 49:259-278. [PMID: 30040126 PMCID: PMC6166437 DOI: 10.1111/sifp.12068] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abortion is a behavior that is stigmatized and difficult to measure. To improve reporting of abortion and other sensitive behaviors in the United States, the National Survey of Family Growth (NSFG) supplements the interviewer administered face-to-face (FTF) interview with audio computer-assisted self-interviewing (ACASI). This paper estimates differential reporting of abortion and other pregnancy outcomes (miscarriage, live birth) in the NSFG (2002, 2006-2010, 2011-2015) between women's ACASI and FTF interviews. Examining reporting of less stigmatized pregnancy outcomes can help understand the relative contributions of stigma and survey-level factors in reporting of abortions. More women reported abortions, miscarriages and births in the ACASI than the FTF interview. Differences in reporting were moderated by the length of recall. The ACASI elicited relatively more reporting of abortions and miscarriages among non-white and low-income women. Reporting ratios increased over time. ACASI is a tool that may work differently across time, for different measures, and with varying survey contexts.
Collapse
|
10
|
Mooney AC, Campbell CK, Ratlhagana MJ, Grignon JS, Mazibuko S, Agnew E, Gilmore H, Barnhart S, Puren A, Shade SB, Liegler T, Lippman SA. Beyond Social Desirability Bias: Investigating Inconsistencies in Self-Reported HIV Testing and Treatment Behaviors Among HIV-Positive Adults in North West Province, South Africa. AIDS Behav 2018; 22:2368-2379. [PMID: 29779162 DOI: 10.1007/s10461-018-2155-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This mixed-methods study used qualitative interviews to explore discrepancies between self-reported HIV care and treatment-related behaviors and the presence of antiretroviral medications (ARVs) in a population-based survey in South Africa. ARV analytes were identified among 18% of those reporting HIV-negative status and 18% of those reporting not being on ART. Among participants reporting diagnosis over a year prior, 19% reported multiple HIV tests in the past year. Qualitative results indicated that participant misunderstandings about their care and treatment played a substantial role in reporting inaccuracies. Participants conflated the term HIV test with CD4 and viral load testing, and confusion with terminology was compounded by recall difficulties. Data entry errors likely also played a role. Frequent discrepancies between biomarkers and self-reported data were more likely due to poor understanding of care and treatment and biomedical terminology than intentional misreporting. Results indicate a need for improving patient-provider communication, in addition to incorporating objective measures of treatment and care behaviors such as ARV analytes, to reduce inaccuracies.
Collapse
Affiliation(s)
- Alyssa C Mooney
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
- Department of Epidemiology & Biostatistics, University of California San Francisco, Mission Hall, 2nd Floor, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Chadwick K Campbell
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| | - Mary-Jane Ratlhagana
- International Training and Education Center for Health (I-TECH) South Africa, Pretoria, Republic of South Africa
| | - Jessica S Grignon
- International Training and Education Center for Health (I-TECH) South Africa, Pretoria, Republic of South Africa
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Sipho Mazibuko
- International Training and Education Center for Health (I-TECH) South Africa, Pretoria, Republic of South Africa
| | - Emily Agnew
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| | - Hailey Gilmore
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| | - Scott Barnhart
- International Training and Education Center for Health (I-TECH) South Africa, Pretoria, Republic of South Africa
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Adrian Puren
- National Institute for Communicable Diseases/NHLS, Johannesburg, Republic of South Africa
- Division of Virology, School of Pathology, University of the Witwatersrand, Johannesburg, Republic of South Africa
| | - Starley B Shade
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| | - Teri Liegler
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Sheri A Lippman
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| |
Collapse
|
11
|
Implementation of Audio-Computer Assisted Self-Interview (ACASI) among adolescent girls in humanitarian settings: feasibility, acceptability, and lessons learned. Confl Health 2017; 10:32. [PMID: 28053657 PMCID: PMC5209867 DOI: 10.1186/s13031-016-0098-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Audio-Computer Assisted Self- Interview (ACASI) is a method of data collection in which participants listen to pre-recorded questions through headphones and respond to questions by selecting their answers on a touch screen or keypad, and is seen as advantageous for gathering data on sensitive topics such as experiences of violence. This paper seeks to explore the feasibility and acceptability of using ACASI with adolescent girls and to document the implementation of such an approach in two humanitarian settings: conflict-affected communities in eastern Democratic Republic of Congo (DRC) and refugee camps along the Sudan-Ethiopia border. METHODS This paper evaluates the feasibility and acceptability of implementing ACASI, based on the experiences of using this tool in baseline data collections for COMPASS (Creating Opportunities through Mentorship, Parental involvement, and Safe Spaces) impact evaluations in DRC (N = 868) and Ethiopia (N = 919) among adolescent girls. Descriptive statistics and logistic regression models were generated to examine associations between understanding of the survey and selected demographics in both countries. RESULTS Overall, nearly 90 % of girls in the DRC felt that the questions were easy to understand as compared to approximately 75 % in Ethiopia. Level of education, but not age, was associated with understanding of the survey in both countries. CONCLUSIONS Financial and time investment to ready ACASI was substantial in order to properly contextualize the approach to these specific humanitarian settings, including piloting of images, language assessments, and checking both written translations and corresponding verbal recordings. Despite challenges, we conclude that ACASI proved feasible and acceptable to participants and to data collection teams in two diverse humanitarian settings.
Collapse
|
12
|
Duby Z, Hartmann M, Mahaka I, Munaiwa O, Nabukeera J, Vilakazi N, Mthembu F, Colvin CJ, Mensch B, van der Straten A. Lost in Translation: Language, Terminology, and Understanding of Penile-Anal Intercourse in an HIV Prevention Trial in South Africa, Uganda, and Zimbabwe. JOURNAL OF SEX RESEARCH 2016; 53:1096-1106. [PMID: 26566583 PMCID: PMC4961617 DOI: 10.1080/00224499.2015.1069784] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Despite efforts to use culturally appropriate, understandable terms for sexual behavior in HIV prevention trials, the way in which participants interpret questions is underinvestigated and not well understood. We present findings from qualitative interviews with 88 women in South Africa, Uganda, and Zimbabwe who had previously participated in an HIV prevention trial. Findings suggested that participants may have misinterpreted questions pertaining to penile-anal intercourse (PAI) to refer to vaginal sex from behind and subsequently misreported the behavior. Three key issues emerge from these findings: first, the underreporting of socially stigmatized sexual behaviors due to social desirability bias; second, the inaccurate reporting of sexual behaviors due to miscomprehension of research terms; and third, the ambiguity in vernacular terms for sexual behavior and lack of acceptable terms for PAI in some languages. These findings highlight methodological challenges around developing clear and unambiguous definitions for sexual behaviors, with implications not only for clinical trials but also for clinical practice and sexual risk assessment. We discuss the challenges in collecting accurate and reliable data on heterosexual PAI in Africa and make recommendations for improved data collection on sensitive behaviors.
Collapse
Affiliation(s)
- Zoe Duby
- a School of Public Health and Family Medicine and Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine , University of Cape Town
| | | | - Imelda Mahaka
- c University of Zimbabwe-University of California San Francisco Collaborative Research Programme
| | - Otillia Munaiwa
- c University of Zimbabwe-University of California San Francisco Collaborative Research Programme
| | | | | | | | | | | | - Ariane van der Straten
- h RTI International , Women's Global Health Imperative, and University of California , San Francisco
| |
Collapse
|
13
|
Kalamar AM, Bayer AM, Hindin MJ. Interventions to Prevent Sexually Transmitted Infections, Including HIV, Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature. J Adolesc Health 2016; 59:S22-31. [PMID: 27562450 DOI: 10.1016/j.jadohealth.2016.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/26/2016] [Accepted: 05/26/2016] [Indexed: 11/17/2022]
Abstract
Sexually transmitted infections (STIs), including HIV, are prevalent among adolescents and can have lasting adverse health consequences. The objective of this review is to identify high-quality interventions and evaluations to decrease STI transmission and related risky behaviors among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched without language limitations for articles published through November 2015. Gray literature was searched by hand. Reference tracing was utilized, as well as the unpacking of systematic reviews. Retained articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Twenty-one high-quality interventions and evaluations were abstracted. Three reported declines in STI diagnoses, three reported declines in STI symptoms, six showed declines in risky sexual behavior, seven reported increases in abstinence, 11 found increases in condom use, and five reported increases in health care utilization. There is a wide range of rigorously evaluated high-quality interventions included in this review that can inform researchers, donors, and policy makers about where to make strategic investments to decrease the spread of STIs, including HIV. With the recent advent of biomarkers, researchers can use a gold standard measure to assess intervention impact. The diversity of interventions can allow decision makers to tailor interventions to the context, age range, and gender of the target population.
Collapse
Affiliation(s)
- Amanda M Kalamar
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Angela M Bayer
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Michelle J Hindin
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
| |
Collapse
|
14
|
The Incidence of Human Papillomavirus in Tanzanian Adolescent Girls Before Reported Sexual Debut. J Adolesc Health 2016; 58:295-301. [PMID: 26725717 PMCID: PMC4762460 DOI: 10.1016/j.jadohealth.2015.10.248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Acquisition of human papillomavirus (HPV) in women occurs predominantly through vaginal sex. However, HPV has been detected in girls reporting no previous sex. We aimed to determine incidence and risk factors for HPV acquisition in girls who report no previous sex in Tanzania, a country with high HPV prevalence and cervical cancer incidence. METHODS We followed 503 adolescent girls aged 15-16 years in Mwanza, Tanzania, with face-to-face interviews and self-administered vaginal swabs every 3 months for 18 months; 397 girls reported no sex before enrollment or during follow-up; of whom, 120 were randomly selected. Samples from enrollment, 6-, 12-, and 18-month visits were tested for 37 HPV genotypes. Incidence, clearance, point prevalence, and duration of any HPV and genotype-specific infections were calculated and associated factors were evaluated. RESULTS Of 120 girls who reported no previous sex, 119 were included, contributing 438 samples. HPV was detected in 51 (11.6%) samples. The overall incidence of new HPV infections was 29.4/100 person-years (95% confidence interval: 15.9-54.2). The point prevalence of vaccine types HPV-6,-11,-16, and -18 was .9%, .9%, 2.0%, and 0%, respectively. Spending a night away from home and using the Internet were associated with incident HPV, and reporting having seen a pornographic movie was inversely associated with HPV incidence. CONCLUSIONS Incident HPV infections were detected frequently in adolescent girls who reported no previous sex over 18 months. This is likely to reflect under-reporting of sex. A low-point prevalence of HPV genotypes in licensed vaccines was seen, indicating that vaccination of these girls might still be effective.
Collapse
|
15
|
Sanchez TH, Sineath RC, Kahle EM, Tregear SJ, Sullivan PS. The Annual American Men's Internet Survey of Behaviors of Men Who Have Sex With Men in the United States: Protocol and Key Indicators Report 2013. JMIR Public Health Surveill 2015; 1:e3. [PMID: 27227126 PMCID: PMC4869242 DOI: 10.2196/publichealth.4314] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 02/06/2023] Open
Abstract
Background Men who have sex with men (MSM) are disproportionately affected by human immunodeficiency virus (HIV) and there is evidence that this population is participating in increasingly risky sexual behavior. These changes are occurring in the context of new modes of online social interaction—many MSM now report first meeting their sex partners on the Internet. Better monitoring of key behavioral indicators among MSM requires the use of surveillance strategies that capitalize on these new modes of interaction. Therefore, we developed an annual cross-sectional behavioral survey of MSM in the United States, the American Men's Internet Survey (AMIS). Objective The purpose of this paper was to provide a description of AMIS methods. In addition we report on the first cycle of data collection (December 2013 through May 2014; AMIS-2013) on the same key indicators used for national HIV behavioral surveillance. Methods AMIS-2013 recruited MSM from a variety of websites using banner advertisements or email blasts. Adult men currently residing in the United States were eligible to participate if they had ever had sex with a man. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants' self-reported HIV status. Results In the AMIS-2013 round, 79,635 persons landed on the study page and 14,899 were eligible, resulting in 10,377 completed surveys from MSM representing every US state. Participants were mainly white, 40 years or older, living in the US South, living in urban areas, and recruited from a general social networking website. Self-reported HIV prevalence was 10.73% (n=1113). Compared to HIV-negative/unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with any male partner in the past 12 months (72.24% versus 61.24%, respectively; P<.001) and more likely to have had anal sex without a condom with their last male sex partner who was discordant/unknown HIV status (42.95% versus 13.62%, respectively; P<.001). Illicit substance use in the past 12 months was more likely to be reported by HIV-positive participants than HIV-negative/unknown status participants (39.17% versus 26.85%, respectively; P<.001). The vast majority of HIV-negative/unknown status participants (84.05%) had been previously HIV tested, but less than half (44.20%) had been tested in the past 12 months. Participants 18-24 years of age were more likely than those 40 years or older to have had anal sex without a condom with a discordant/unknown HIV status partner, were more likely to report substance use, and were less likely to have been HIV tested. Compared to general social networking, those from a geospatial social networking website were more likely to have reported all risk behaviors but were more likely to have been HIV tested. Conclusions The first round of AMIS generated useful behavioral measures from more than 10,000 MSM Internet users. Preliminary findings identified some subgroups of MSM Internet users that are at potentially higher risk of HIV acquisition/transmission. AMIS will provide an ongoing data source for examining trends in sexual risk behavior of MSM. This will help to plan and monitor the impact of programs to improve this population's health.
Collapse
|
16
|
Abstract
Little is known about the influences of peers on the sexual activity of adolescents in sub-Saharan Africa. Better understanding of these issues could lead to more effective sexual and reproductive health interventions. Using two waves of survey data from 1,275 adolescents in two southeastern Ghanaian towns, we examine age, sex, and community differences in peer group characteristics. We also examine prospective associations between peer group characteristics and self-reported sexual initiation and multiple partnerships during a 20-month follow-up period. Sex differences in peer-context variables were small. Affiliation with antisocial peers and perceived peer norms favoring sex increased the odds of transition to first sex. Having more friends increased the odds among younger respondents of acquiring multiple new sexual partners. Among males, perceived peer norms favoring sex increased the odds of acquiring multiple partners. We discuss the implications of these findings for adolescent sexual and reproductive health intervention strategies in sub-Saharan Africa, and conclude that peer-based interventions may be best suited to the needs of at-risk adolescent boys.
Collapse
Affiliation(s)
- Jeffrey B Bingenheimer
- Assistant Professor, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Suite 300, Washington, DC 20052.
| | | | | |
Collapse
|
17
|
Disclosure of sensitive behaviors across self-administered survey modes: a meta-analysis. Behav Res Methods 2014; 47:1237-1259. [DOI: 10.3758/s13428-014-0533-4] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
18
|
Challenges in measuring the sequencing of life events among adolescents in Malawi: a cautionary note. Demography 2014; 51:277-85. [PMID: 24399140 DOI: 10.1007/s13524-013-0269-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Using data from two rounds of the Malawi Schooling and Adolescent Survey, this research note examines consistency of retrospective reporting on the timing and sequencing of sexual initiation, school leaving, and marriage. The analysis, which compares reporting of events both within and between rounds, indicates substantial inconsistency in reporting of event sequences and highlights difficulties in measuring transitions to adulthood in sub-Saharan Africa with survey data.
Collapse
|
19
|
Improving the quality of adult mortality data collected in demographic surveys: validation study of a new siblings' survival questionnaire in Niakhar, Senegal. PLoS Med 2014; 11:e1001652. [PMID: 24866715 PMCID: PMC4035258 DOI: 10.1371/journal.pmed.1001652] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 04/17/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In countries with limited vital registration, adult mortality is frequently estimated using siblings' survival histories (SSHs) collected during Demographic and Health Surveys (DHS). These data are affected by reporting errors. We developed a new SSH questionnaire, the siblings' survival calendar (SSC). It incorporates supplementary interviewing techniques to limit omissions of siblings and uses an event history calendar to improve reports of dates and ages. We hypothesized that the SSC would improve the quality of adult mortality data. METHODS AND FINDINGS We conducted a retrospective validation study among the population of the Niakhar Health and Demographic Surveillance System in Senegal. We randomly assigned men and women aged 15-59 y to an interview with either the DHS questionnaire or the SSC. We compared SSHs collected in each group to prospective data on adult mortality collected in Niakhar. The SSC reduced respondents' tendency to round reports of dates and ages to the nearest multiple of five or ten ("heaping"). The SSC also had higher sensitivity in recording adult female deaths: among respondents whose sister(s) had died at an adult age in the past 15 y, 89.6% reported an adult female death during SSC interviews versus 75.6% in DHS interviews (p = 0.027). The specificity of the SSC was similar to that of the DHS questionnaire, i.e., it did not increase the number of false reports of deaths. However, the SSC did not improve the reporting of adult deaths among the brothers of respondents. Study limitations include sample selectivity, limited external validity, and multiple testing. CONCLUSIONS The SSC has the potential to collect more accurate SSHs than the questionnaire used in DHS. Further research is needed to assess the effects of the SSC on estimates of adult mortality rates. Additional validation studies should be conducted in different social and epidemiological settings. TRIAL REGISTRATION Controlled-Trials.com ISRCTN06849961
Collapse
|
20
|
Abstract
OBJECTIVES To describe, at patient-level detail, the determining events and factors involved in the development of a country's HIV-1 epidemic. DESIGN Clinical information for all recorded Greenlandic HIV-1 patients was analysed and correlated with both novel and previously analysed pol sequences, representing more than half of the entire Greenlandic HIV-1 epidemic. Archival blood samples were sequenced to link early infection chain descriptions to the subsequent epidemic. METHODS In-depth phylogenetic analyses were used in synergy with clinical information to assess number of introductions of HIV-1 into Greenland, the source of geographic origin, time of epidemic introduction and its epidemiological characteristics such as initial transmission chain, geographic dispersal within Greenland, method of infection, cluster size, sociological and behavioural factors. RESULTS Despite its small population size and isolated geographic location, data support at least 25 introductions of HIV-1 into Greenland. Only a single of these led to an epidemic. This introduction occurred between 1985 and 1986, and the epidemic cluster is still active. Facilitating factors for the emergence and spread of the epidemic cluster include a rapid transition from MSM to heterosexual spread, high prevalence of other sexually transmitted diseases, rapid dispersal to larger cities and early emergence in a distinct subpopulation with high-risk behaviour including disregard for condomizing. CONCLUSIONS The synergistic use of disparate data categories yields such unique detail, that the Greenland epidemic now serves as a model example for the epidemic emergence of HIV-1 in a society. This renders it suitable for testing of present and future sequence-based epidemiological methodologies.
Collapse
|
21
|
Kelly CA, Hewett PC, Mensch BS, Rankin JC, Nsobya SL, Kalibala S, Kakande PN. Using biomarkers to assess the validity of sexual behavior reporting across interview modes among young women in Kampala, Uganda. Stud Fam Plann 2014; 45:43-58. [PMID: 24615574 PMCID: PMC4528964 DOI: 10.1111/j.1728-4465.2014.00375.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Understanding the transmission dynamics of HIV and other sexually transmitted infections is critically dependent on accurate behavioral data. This study investigates the effect of the mode of questionnaire delivery on the quality of sexual behavior reporting in a 2010 survey conducted in Kampala, Uganda, among 18-24-year-old women. We compare the reported prevalence of five sexual outcomes across three interview modes: traditional face-to-face interviewing (FTFI) in which question rewording was permitted, FTFI administered via computer-assisted personal interviewing (CAPI) in which questions were read as written, and audio computer-assisted self-interviewing (ACASI) in which participants listened to prerecorded questions and entered responses using a computer touchscreen. We then assess the validity of the data by evaluating the reporting of sexual experience against three biological markers. Results suggest that ACASI elicits higher reporting of some key indicators than FTFI does, but self-reports from all interview modes were subject to validity concerns when compared with biomarker data. The study highlights the important role that biomarkers can play in sexual behavior research.
Collapse
Affiliation(s)
- Christine A Kelly
- Staff Associate, Population Council, One Dag Hammarskjold Plaza, New York, NY 10017.
| | | | | | | | | | | | | |
Collapse
|
22
|
Ompad DC, Bell DL, Amesty S, Nyitray AG, Papenfuss M, Lazcano-Ponce E, Villa LL, Giuliano AR. Men who purchase sex, who are they? An interurban comparison. J Urban Health 2013; 90:1166-80. [PMID: 23719715 PMCID: PMC3853174 DOI: 10.1007/s11524-013-9809-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Most research concerning clients of commercial sex workers (CSWs) relies upon CSW reports of client characteristics and behavior. We describe correlates of ever purchasing sex among 3,829 men from three cities: São Paulo, Brazil; Cuernavaca, Mexico; and Tampa, USA. A computer-assisted self-interview collected data on demographics and sexual behavior. There were significant site differences-26.5 % paid for sex in São Paulo, 10.4 % in Cuernavaca, and 4.9 % in Tampa. In all cities, men who had sex with men and women (versus sex with women only) were more likely to have ever paid for sex. In São Paulo and Cuernavaca, CSW clients were older, had higher educational attainment, and were less likely to be married. In Tampa, older age was associated with being a CSW client but not education and marital status. In São Paulo and Cuernavaca, CSW clients had more partners than men who had never paid for sex. In São Paulo, CSW clients initiated vaginal sex at an earlier age, while in Cuernavaca they were more likely to self-report a sexually transmitted infection. CSW clients varied with respect to demographics across the three cities while the association between paying for sex and risky sexual behavior seems to be somewhat conserved. These findings suggest that interventions among CSW clients should focus on condom use with commercial and non-commercial partners as these men may be at increased risk for transmitting and acquiring sexually transmitted infections to and from their sex partners. Better understanding of client characteristics is needed for targeting interventions and creating culturally appropriate content.
Collapse
Affiliation(s)
- Danielle C Ompad
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS) and Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, 411 Lafayette Street, 5th floor, New York, NY, 10003, USA,
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Kelly CA, Soler-Hampejsek E, Mensch BS, Hewett PC. Social desirability bias in sexual behavior reporting: evidence from an interview mode experiment in rural Malawi. INTERNATIONAL PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2013; 39:14-21. [PMID: 23584464 DOI: 10.1363/3901413] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
CONTEXT Social desirability bias is problematic in studies that rely on self-reported sexual behavior data. Where gender norms create different expectations about socially acceptable behavior, males and females face distinct pressures in reporting certain outcomes, which can distort assessments of risk for HIV and STIs. METHODS In 2009, relationship and sexual behavior data were collected from 1,750 never-married males and females aged 16-18 via audio computer-assisted self-interviewing (audio-CASI) during the third round of the Malawi Schooling and Adolescent Study. A comparison group of 311 youth completed an identical questionnaire in face-to-face interviews. To assess whether interview mode may have influenced participants' reporting of sensitive behavior, reports of sexual experience in the two groups were compared. Multiple logistic regression analysis was used to identify associations between interview mode and reports of these behaviors, by gender. RESULTS In adjusted regression models, males were less likely to report ever having had a girlfriend in audio-CASI than in face-to-face interviews (odds ratio, 0.4), but they were more likely to report having had sex with a relative or teacher (3.5). For females, reports of ever having had a boyfriend or having had sex did not differ between modes. A small proportion of females reported ever having had sex with a relative or teacher in audio-CASI, while none did so in face-to-face interviews. CONCLUSIONS The method used for collecting relationship and sexual behavior data may influence the reported prevalence of some key behaviors, particularly among males. Further research is needed to improve methods of collecting sensitive data.
Collapse
|
24
|
Brawner BM, Volpe EM, Stewart JM, Gomes MM. Attitudes and beliefs toward biobehavioural research participation: voices and concerns of urban adolescent females receiving outpatient mental health treatment. Ann Hum Biol 2013; 40:485-95. [PMID: 23822716 PMCID: PMC4668940 DOI: 10.3109/03014460.2013.806590] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Biobehavioural research methodology can be invasive and burdensome for participants - particularly adolescents with mental illnesses. Human biological researchers should consider how methodological impositions may hinder adolescent research participation. However, literature on adolescent's voices and concerns toward biobehavioural research participation is virtually non-existent. AIM This study was designed to determine adolescents' perceptions of participation in research involving the collection of biomarkers via blood, saliva and/or urine samples. SUBJECTS AND METHODS Urban adolescent females (aged 12-19) receiving outpatient mental health treatment (n = 37) participated in focus groups with concurrent survey administration to explore attitudes, beliefs and willingness/intentions toward biobehavioural research participation. RESULTS Participants had favourable attitudes toward biobehavioural research and were amenable to provide each specimen type. Mistrust for research emerged, however, and concerns related to privacy and confidentiality were expressed. CONCLUSION Participant recruitment is a critical component in study design and implementation; this includes knowledge of population-specific recruitment barriers and facilitators. This innovative paper provides a context for the research participants' decision-making process, strategies to allay fears and concerns and concrete areas to target in research-related interventions. Although the findings are from a specific, US-based sample, the implications warrant replication of the research in other geosocial settings.
Collapse
Affiliation(s)
- Bridgette M. Brawner
- Center for Health Equity Research, Center for Global Women’s Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Ellen M. Volpe
- Center for Health Equity Research, Center for Global Women’s Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jennifer M. Stewart
- Center for Health Equity Research, Center for Global Women’s Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Melissa M. Gomes
- Department of Family and Community Health Nursing, Virginia Commonwealth University School of Nursing, Richmond, VA, USA
| |
Collapse
|
25
|
Soler-Hampejsek E, Grant MJ, Mensch BS, Hewett PC, Rankin J. The effect of school status and academic skills on the reporting of premarital sexual behavior: evidence from a longitudinal study in rural Malawi. J Adolesc Health 2013; 53:228-34. [PMID: 23688856 PMCID: PMC3752995 DOI: 10.1016/j.jadohealth.2013.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 03/04/2013] [Accepted: 03/05/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE Reliable data on sexual behavior are needed to identify adolescents at risk of acquiring human immunodeficiency virus or other sexually transmitted diseases, as well as unintended pregnancies. This study aimed to investigate whether schooling status and literacy and numeracy skills affect adolescents' reports of premarital sex, collected using audio computer-assisted self-interviews. METHODS We analyzed data on 2,320 participants in the first three rounds of the Malawi Schooling and Adolescent Study to estimate the level of inconsistency in reporting premarital sex among rural Malawian adolescents. We used multivariate logistic regressions to examine the relationships between school status and academic skills and premarital sexual behavior reports. RESULTS Males were more likely than females to report premarital sex at baseline, whereas females were more likely than males to report sex inconsistently within and across rounds. School-going females and males were more likely to report never having had sex at baseline and to retract reports of ever having sex across rounds than were their peers who had recently left school. School-going females were also more likely to report sex inconsistently at baseline. Literate and numerate respondents were less likely to report sex inconsistently at baseline; however, they were more likely to retract sex reports across rounds. CONCLUSIONS The level of inconsistency both within a survey round and across rounds reflects the difficulties in collecting reliable sexual behavior data from young people in settings such as rural Malawi, where education levels are low and sex among school-going females is not socially accepted.
Collapse
|
26
|
Color-coded audio computer-assisted self-interviews (C-ACASI) for poorly educated men and women in a semi-rural area of South India: "good, scary and thrilling". AIDS Behav 2013; 17:2260-8. [PMID: 23361948 DOI: 10.1007/s10461-013-0414-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It is challenging to collect accurate and complete data on sensitive issues such as sexual behaviors. Our objective was to explore experience and perceptions regarding the use of a locally programmed color-coded audio computer-assisted self interview (C-ACASI) system among men and women in a semi-rural setting in south India. We conducted a mixed-methods cross-sectional survey using semi-structured interviews among 89 truck drivers and 101 truck driver wives who had participated earlier in the C-ACASI survey across a predominantly rural district in Tamil Nadu. To assess the color-coded format used, descriptive quantitative analysis was coupled with thematic content analysis of qualitative data. Only 10% of participants had ever used a computer before. Nearly 75% did not report any problem in using C-ACASI. The length of the C-ACASI survey was acceptable to 98% of participants. Overall, 87% of wives and 73% of truck drivers stated that C-ACASI was user-friendly and felt comfortable in responding to the sensitive questions. Nearly all (97%) participants reported that using C-ACASI encouraged them to respond honestly compared to face-to-face personal interviews. Both the drivers and wives expressed that C-ACASI provided confidentiality, privacy, anonymity, and an easy mechanism for responding truthfully to potentially embarrassing questions about their personal sexual relationships. It is feasible and acceptable to use C-ACASI for collecting sensitive data from poorly computer-literate, non-English-speaking, predominantly rural populations of women and men. Our findings support the implementation of effective and culturally sensitive C-ACASI for data collection, albeit with additional validation.
Collapse
|
27
|
Yeganeh N, Dillavou C, Simon M, Gorbach P, Santos B, Fonseca R, Saraiva J, Melo M, Nielsen-Saines K. Audio computer-assisted survey instrument versus face-to-face interviews: optimal method for detecting high-risk behaviour in pregnant women and their sexual partners in the south of Brazil. Int J STD AIDS 2013; 24:279-85. [PMID: 23970659 DOI: 10.1177/0956462412472814] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Audio computer-assisted survey instrument (ACASI) has been shown to decrease under-reporting of socially undesirable behaviours, but has not been evaluated in pregnant women at risk of HIV acquisition in Brazil. We assigned HIV-negative pregnant women receiving routine antenatal care at in Porto Alegre, Brazil and their partners to receive a survey regarding high-risk sexual behaviours and drug use via ACASI (n = 372) or face-to-face (FTF) (n = 283) interviews. Logistic regression showed that compared with FTF, pregnant women interviewed via ACASI were significantly more likely to self-report themselves as single (14% versus 6%), having >5 sexual partners (35% versus 29%), having oral sex (42% versus 35%), using intravenous drugs (5% versus 0), smoking cigarettes (23% versus 16%), drinking alcohol (13% versus 8%) and using condoms during pregnancy (32% versus 17%). Therefore, ACASI may be a useful method in assessing risk behaviours in pregnant women, especially in relation to drug and alcohol use.
Collapse
Affiliation(s)
- N Yeganeh
- Division of Infectious Disease, Department of Pediatrics, David Geffen School of Medicine at UCLA, MDCC 22-442 10833 LeConte Avenue, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Mirzazadeh A, Haghdoost AA, Nedjat S, Navadeh S, McFarland W, Mohammad K. Accuracy of HIV-related risk behaviors reported by female sex workers, Iran: a method to quantify measurement bias in marginalized populations. AIDS Behav 2013; 17:623-31. [PMID: 22983500 DOI: 10.1007/s10461-012-0285-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We quantified discrepancies in reported behaviors of female sex workers (FSW) by comparing 63 face-to-face interviews (FTFI) to in-depth interviews (IDI), with corroboration of the directions and magnitudes of reporting by a panel of psychologists who work with FSW. Sensitivities, specificities, positive and negative predictive values (PPV and NPV) were assessed for FTFI responses using IDI as a "gold standard". Sensitivities were lowest in reporting symptoms of sexually transmitted infections (63.9 %), finding sex partners in venues (52.4 %) and not receiving HIV test results (66.7 %). Specificities (all >83 %) and PPVs (all >74.0 %) were higher than NPV. FSW significantly under-reported number of clients, sexual contacts and non-condom use sex acts with clients and number of days engaging in sex work in the preceding week. This study provides a quantified gauge of reporting biases in FSW behaviors. Such estimates and methods help better understand true HIV risk in marginalized populations and calibrate survey estimates accordingly.
Collapse
Affiliation(s)
- Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran.
| | | | | | | | | | | |
Collapse
|
29
|
Anglewicz P, Gourvenec D, Halldorsdottir I, O'Kane C, Koketso O, Gorgens M, Kasper T. The effect of interview method on self-reported sexual behavior and perceptions of community norms in Botswana. AIDS Behav 2013; 17:674-87. [PMID: 22696139 DOI: 10.1007/s10461-012-0224-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Since self-reports of sensitive behaviors play an important role in HIV/AIDS research, the accuracy of these measures has often been examined. In this paper we (1) examine the effect of three survey interview methods on self-reported sexual behavior and perceptions of community sexual norms in Botswana, and (2) introduce an interview method to research on self-reported sexual behavior in sub-Saharan Africa. Comparing across these three survey methods (face-to-face, ballot box, and randomized response), we find that ballot box and randomized response surveys both provide higher reports of sensitive behaviors; the results for randomized response are particularly strong. Within these overall patterns, however, there is variation by question type; additionally the effect of interview method differs by sex. We also examine interviewer effects to gain insight into the effectiveness of these interview methods, and our results suggest that caution be used when interpreting the differences between survey methods.
Collapse
Affiliation(s)
- Philip Anglewicz
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
| | | | | | | | | | | | | |
Collapse
|
30
|
Gorbach PM, Mensch BS, Husnik M, Coly A, Mâsse B, Makanani B, Nkhoma C, Chinula L, Tembo T, Mierzwa S, Reynolds K, Hurst S, Coletti A, Forsyth A. Effect of computer-assisted interviewing on self-reported sexual behavior data in a microbicide clinical trial. AIDS Behav 2013; 17:790-800. [PMID: 23054034 DOI: 10.1007/s10461-012-0302-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In a microbicide safety and effectiveness trial (HPTN 035) in Malawi, 585 women completed the same questionnaire through a face-to-face interview (FTFI) and an audio computer-assisted self-interview (ACASI). Concordance between FTFI and ACASI responses ranged from 72.0 % for frequency of sex in the past week to 95.2 % for anal intercourse (AI) in the past 3 months. Reported gel and condom use at last sex act were marginally lower with ACASI than FTFI (73.5 % vs. 77.2 %, p = 0.11 and 60.9 % vs. 65.5 %, p = 0.05, respectively). More women reported AI with ACASI than FTFI (5.0 % vs. 0.2 %, p < 0.001). Analyses of consistency of responses within ACASI revealed that 15.0 % of participants in the condom-only arm and 28.7 % in the gel arm provided at least one discrepant answer regarding total sex acts and sex acts where condom and gel were used (19.2 % reported one inconsistent answer, 8.1 % reported two inconsistent answers, and 1.4 % reported three inconsistent answers). While ACASI may provide more accurate assessments of sensitive behaviors in HIV prevention trials, it also results in a high level of internally inconsistent responses.
Collapse
Affiliation(s)
- Pamina M Gorbach
- Department of Epidemiology, University of California, Los Angeles, 90095-1772, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Young men's preferences for sexually transmitted disease and reproductive health services in San Francisco, California. Sex Transm Dis 2012; 39:421-3. [PMID: 22592826 DOI: 10.1097/olq.0b013e318249d651] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We explored STD (sexually transmitted disease) service preferences among 108 African-American adolescent males recruited from a high-morbidity neighborhood. Participants largely preferred to seek care at traditional STD testing venues (86.5%) rather than nontraditional venues. Additionally, most males preferred receiving STD test results from a clinician (61.1%) rather than online (11.1%) or through email or text message (12.0%). These results highlight the need for continued strengthening of traditional public health clinics to ensure capacity to meet young men's health needs and to improve outreach and access to traditional STD services for young men.
Collapse
|
32
|
Montealegre JR, Risser JM, Selwyn BJ, McCurdy SA, Sabin K. Prevalence of HIV risk behaviors among undocumented Central American immigrant women in Houston, Texas. AIDS Behav 2012; 16:1641-8. [PMID: 22249955 DOI: 10.1007/s10461-011-0130-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Undocumented Central American immigrants in the United States are disproportionately affected by HIV infection. However, epidemiological data on sexual behaviors among undocumented women are sparse and the extent to which behaviors vary by duration of residence in the U.S.is largely unknown. In 2010, we used respondent driven sampling to conduct an HIV behavioral survey among Central American immigrant women residing in Houston, Texas without a valid U.S. visa or residency papers. Here we describe the prevalence of sexual risk behaviors and compare recent (5 years or less in the U.S.) and established immigrants (over 5 years in the U.S.) to elucidate changes in sexual risk behaviors over time. Our data suggest that recent immigrants have less stable sexual partnerships than established immigrants, as they are more likely to have multiple and concurrent sexual partnerships, as well as partnerships of shorter duration.
Collapse
Affiliation(s)
- Jane R Montealegre
- Division of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, USA.
| | | | | | | | | |
Collapse
|
33
|
Caltabiano M, Dalla-Zuanna G. A comparison of survey techniques on sensitive sexual behavior in Italy. JOURNAL OF SEX RESEARCH 2012; 50:537-547. [PMID: 22816489 DOI: 10.1080/00224499.2012.674573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This article compares two national surveys carried out through the most commonly used procedures in Italy: CATI (computer-assisted telephone interviews) and SAQ-FI (self-answered questionnaires following interviews). Both surveys ask two identical questions concerning sensitive sexual behavior: early age at first intercourse and same-sex attraction. The SAQ-FI survey had both unit non-response and item non-response rates much lower than the CATI survey. Moreover, in the CATI survey, the groups with highest item non-response rates were also the groups with the lowest proportions of early intercourse and homosexual attraction. In addition, a differential analysis of the respondents produced diverse results for the two surveys. This is especially true of results by gender for same-sex attraction: Such behavior is more common among men (3.1%) than women (2.9%), according to the CATI survey, whereas the opposite is true of the SAQ-FI survey (6.1% of men vs. 7.7% women). In Italy at the beginning of the 21st century, CATI surveys reveal a lower level of early intercourse and same-sex attraction than SAQ-FI surveys. This article argues that the CATI survey underestimates the true level of these sensitive sexual behaviors in the Italian population.
Collapse
Affiliation(s)
- Marcantonio Caltabiano
- Department of Economics, Statistics, Mathematics, and Sociology, University of Messina, Messina 98122, Italy.
| | | |
Collapse
|
34
|
Hewett PC, Haberland N, Apicella L, Mensch BS. The (mis)reporting of male circumcision status among men and women in Zambia and Swaziland: a randomized evaluation of interview methods. PLoS One 2012; 7:e36251. [PMID: 22629312 PMCID: PMC3358314 DOI: 10.1371/journal.pone.0036251] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 04/03/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To date, male circumcision prevalence has been estimated using surveys of men self-reporting their circumcision status. HIV prevention trials and observational studies involving female participants also collect data on partners' circumcision status as a risk factor for HIV/STIs. A number of studies indicate that reports of circumcision status may be inaccurate. This study assessed different methods for improving self- and partner reporting of circumcision status. METHODS/FINDINGS The study was conducted in urban and rural Zambia and urban Swaziland. Men (N = 1264) aged 18-50 and their female partners (N = 1264), and boys (N = 840) aged 13-17 were enrolled. Participants were recruited from HIV counseling and testing sites, health centers, and surrounding communities. The study experimentally assessed methods for improving the reporting of circumcision status, including: a) a simple description of circumcision, b) a detailed description of circumcision, c) an illustration of a circumcised and uncircumcised penis, and d) computerized self-interviewing. Self-reports were compared to visual examination. For men, the error in reporting was largely unidirectional: uncircumcised men more often reported they were circumcised (2-7%), depending on setting. Fewer circumcised men misrepresented their status (0.05-5%). Misreporting by women was significantly higher (11-15%), with the error in both directions. A sizable number of women reported that they did not know their partner's circumcision status (3-8%). Computerized interviewing did not improve accuracy. Providing an illustration, particularly for illiterate participants, significantly improved reporting of circumcision status, decreasing misreporting among illiterate participants from 13% to 10%, although misreporting was not eliminated. CONCLUSIONS Study results suggest that the prevalence of circumcision may be overestimated in Zambia and Swaziland; the error in reporting is higher among women than among men. Improved reporting when a description or illustration is provided suggests that the source of the error is a lack of understanding of male circumcision.
Collapse
Affiliation(s)
- Paul C Hewett
- HIV-AIDS Program, Population Council, Lusaka, Zambia.
| | | | | | | |
Collapse
|
35
|
Kagan S, Deardorff J, McCright J, Lightfoot M, Lahiff M, Lippman SA. Hopelessness and sexual risk behavior among adolescent African American males in a low-income urban community. Am J Mens Health 2012; 6:395-9. [PMID: 22406766 DOI: 10.1177/1557988312439407] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
African American youth bear a disproportionate burden of sexually transmitted infections. Environmental stressors may lead to increased hopelessness, which in turn can lead to increases in risk-taking behavior. This study explored the hypothesis that as hopelessness increases, sexual risk behavior will increase-specifically, inconsistent condom use and increased number of sex partners. In 2010, 108 African American men 15 to 24 years old responded to sexual behavior questions and Beck's Hopelessness Scale. The associations between hopelessness and sexual risk behaviors were evaluated with multivariate logistic regression. Increased hopelessness was associated with increased inconsistent condom use with non-main sexual partners (adjusted odds ratio = 2.3, 95% confidence interval = 1.3-4.0). There was no association between hopelessness and condom use with a main partner or sex with more than one partner in the past 3 months. These findings imply that hopelessness may encourage sexual risk-taking behavior in young males.
Collapse
Affiliation(s)
- Sarah Kagan
- University of California, San Francisco, CA 94105, USA.
| | | | | | | | | | | |
Collapse
|
36
|
Napierala Mavedzenge SM, Doyle AM, Ross DA. HIV prevention in young people in sub-Saharan Africa: a systematic review. J Adolesc Health 2011; 49:568-86. [PMID: 22098767 DOI: 10.1016/j.jadohealth.2011.02.007] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 02/06/2011] [Accepted: 02/08/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To systematically review and update evidence on the effectiveness of youth HIV/AIDS prevention interventions in sub-Saharan Africa (SSA) and to make evidence-based policy recommendations to guide efforts toward meeting the United Nations General Assembly Special Session HIV/AIDS goals. METHODS Recent evidence (January 2005-December 2008) on the effectiveness of interventions to improve reported sexual behavior and biological outcomes among youth in SSA was assessed using the Steady, Ready, Go! (SRG) approach and synthesized with an earlier SRG review (January 1990-June 2005). RESULTS A total of 23 studies were included following screening of approximately 1,200 citations. School-based, adult-led, curriculum-based interventions showed clear evidence of reducing reported risky sexual behavior. Interventions in health facilities increased the use of services when made accessible and more youth-friendly. In geographically defined communities, both interventions specifically targeting youth and community-wide interventions reduced reports of risky sexual behavior. CONCLUSIONS HIV prevention among youth is a top priority in SSA. The most promising interventions should be scaled-up now, with careful evaluation, while exploring supplementary interventions to impact HIV incidence.
Collapse
Affiliation(s)
- Sue M Napierala Mavedzenge
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
| | | | | |
Collapse
|
37
|
Macia M, Maharaj P, Gresh A. Masculinity and male sexual behaviour in Mozambique. CULTURE, HEALTH & SEXUALITY 2011; 13:1181-1192. [PMID: 21972786 DOI: 10.1080/13691058.2011.611537] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Like many countries in sub-Saharan Africa, Mozambique is facing a severe HIV epidemic. Evidence suggests that male sexual behaviour is one of the driving forces behind the epidemic. Yet, there is limited understanding of how notions of masculinity influence such behaviour in the context of HIV. Using data collected through focus group discussions and in-depth interviews with sexually active men and women, this paper investigates how notions of masculinity influence the risk of HIV infection among men. The study findings suggest that traditional norms of masculinity, the man as the main provider and figure of authority, continue to exert a strong influence on male attitudes and behaviour. Alternative approaches are urgently needed in HIV programming that take into consideration notions of masculinity in order to reduce risky sexual behaviour.
Collapse
Affiliation(s)
- Manuel Macia
- School of Development Studies, University of KwaZulu-Natal, Durban, South Africa.
| | | | | |
Collapse
|
38
|
Luppi CG, Oliveira RLSD, Veras MA, Lippman SA, Jones H, Jesus CHD, Pinho AA, Ribeiro MC, Caiaffa-Filho H. Diagnóstico precoce e os fatores associados às infecções sexualmente transmissíveis em mulheres atendidas na atenção primária. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2011; 14:467-77. [DOI: 10.1590/s1415-790x2011000300011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Accepted: 04/11/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Infecções Sexualmente Transmissíveis (IST) em mulheres permanecem um desafio para a Saúde Pública: elevada prevalência, dificuldade para implantação de estratégias de diagnóstico precoce e elevada ocorrência de sequelas. OBJETIVO: Identificar a prevalência de IST em usuárias de um serviço de atenção primária à saúde em São Paulo. MÉTODOS: Mulheres de 18 a 40 anos foram convidadas para realizar autocoleta de secreção vaginal para a detecção de Chlamydia trachomatis, Neisseria gonorrhoeae e Trichomonas vaginalis por meio de Reacão em Cadeia da Polimerase (PCR). As mulheres também responderam a um questionário com questões demográficas e relativas à história sexual face a face ou autoaplicado por meio de um computador. RESULTADOS: Das 781 mulheres incluídas no estudo, as prevalências obtidas foram: Chlamydia trachomatis (8,4%), Neisseria gonorrhoeae (1,9%) e Trichomonas vaginalis (3,2%). A positividade para pelo menos uma das três IST foi de 13%. As variáveis associadas independentemente com maior risco de IST foram: idade menor que 20 anos, mais de dois parceiros sexuais na vida e percepção de risco para IST; o uso de preservativo como método contraceptivo foi um fator protetor. CONCLUSÃO: A prevalência encontrada em usuárias indica a necessidade da implantação de estratégias de rastreamento de IST em serviços de atenção primária.
Collapse
|
39
|
Rathod SD, Minnis AM, Subbiah K, Krishnan S. ACASI and face-to-face interviews yield inconsistent estimates of domestic violence among women in India: The Samata Health Study 2005-2009. JOURNAL OF INTERPERSONAL VIOLENCE 2011; 26:2437-2456. [PMID: 21282116 PMCID: PMC3126890 DOI: 10.1177/0886260510385125] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Audio computer-assisted self-interviews (ACASI) are increasingly used in health research to improve the accuracy of data on sensitive behaviors. However, evidence is limited on its use among low-income populations in countries like India and for measurement of sensitive issues such as domestic violence. METHOD We compared reports of domestic violence and three less sensitive behaviors related to household decision making and spousal communication in ACASI and face-to-face interviews (FTFI) among 464 young married women enrolled in a longitudinal study of gender-based power and adverse health outcomes in low-income communities in Bangalore, India. We used a test-retest design. At the 12-month study visit, we elicited responses from each participant through FTFI first, followed by ACASI. At the 24-month visit, we reversed the order, implementing ACASI first, followed by FTFI. Univariable log-linear regression models and kappa statistics were used to examine ACASI's effects on self-reports. RESULTS Regression results showed significantly lower reporting in ACASI relative to FTFI at both visits, including for domestic violence (12-month risk ratio [RR] = 0.61, 95% CI = 0.52, 0.73; 24-month RR = 0.74, 95% CI = 0.62, 0.89). Response agreement between interview modes, calculated by kappa scores, was universally low, though highest for domestic violence (12-month κ = 0.45; 24-month κ = 0.48). Older age and greater educational attainment appeared associated with higher response agreement. CONCLUSIONS Greater reporting in FTFI may be due to social desirability bias for the less sensitive questions and perceptions of therapeutic benefit for domestic violence. These results cast doubt on the appropriateness of using ACASI for measurement of sensitive behaviors in India.
Collapse
Affiliation(s)
- Sujit D Rathod
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA 94720, USA.
| | | | | | | |
Collapse
|
40
|
Glynn JR, Kayuni N, Banda E, Parrott F, Floyd S, Francis-Chizororo M, Nkhata M, Tanton C, Hemmings J, Molesworth A, Crampin AC, French N. Assessing the validity of sexual behaviour reports in a whole population survey in rural Malawi. PLoS One 2011; 6:e22840. [PMID: 21818398 PMCID: PMC3144949 DOI: 10.1371/journal.pone.0022840] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 07/05/2011] [Indexed: 11/22/2022] Open
Abstract
Background Sexual behaviour surveys are widely used, but under-reporting of particular risk behaviours is common, especially by women. Surveys in whole populations provide an unusual opportunity to understand the extent and nature of such under-reporting. Methods All consenting individuals aged between 15 and 59 within a demographic surveillance site in northern Malawi were interviewed about their sexual behaviour. Validity of responses was assessed by analysis of probing questions; by comparison of results with in-depth interviews and with Herpes simplex type-2 (HSV-2) seropositivity; by comparing reports to same sex and opposite sex interviewers; and by quantifying the partnerships within the local community reported by men and by women, adjusted for response rates. Results 6,796 women and 5,253 men (83% and 72% of those eligible) consented and took part in sexual behaviour interviews. Probing questions and HSV-2 antibody tests in those who denied sexual activity identified under-reporting for both men and women. Reports varied little by sex or age of the interviewer. The number of marital partnerships reported was comparable for men and women, but men reported about 4 times as many non-marital partnerships. The discrepancy in reporting of non-marital partnerships was most marked for married women (men reported about 7 times as many non-marital partnerships with married women as were reported by married women themselves), but was only apparent in younger married women. Conclusions We have shown that the under-reporting of non-marital partnerships by women was strongly age-dependent. The extent of under-reporting of sexual activity by young men was surprisingly high. The results emphasise the importance of triangulation, including biomarkers, and the advantages of considering a whole population.
Collapse
Affiliation(s)
- Judith R Glynn
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Yeatman S, Trinitapoli J. Best-friend reports: a tool for measuring the prevalence of sensitive behaviors. Am J Public Health 2011; 101:1666-7. [PMID: 21778489 DOI: 10.2105/ajph.2011.300194] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We introduce the best-friend methodology for using surveys to measure the population prevalence of sensitive behaviors. We demonstrate the effectiveness of this tool by comparing self-reports to best-friend reports of sexual behavior and abortion history among young women in Malawi (n = 1493). Best-friend reports reveal higher and more believable estimates of abortion and multiple sexual partners. In contexts in which best friends commonly discuss such behaviors, best-friend reports are an inexpensive and easily implemented tool.
Collapse
Affiliation(s)
- Sara Yeatman
- Department of Health and Behavioral Sciences, University of Colorado Denver, 80217, USA.
| | | |
Collapse
|
42
|
Marra G, Radice R. Estimation of a semiparametric recursive bivariate probit model in the presence of endogeneity. CAN J STAT 2011. [DOI: 10.1002/cjs.10100] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
43
|
Mensch BS, Hewett PC, Abbott S, Rankin J, Littlefield S, Ahmed K, Cassim N, Patel S, Ramjee G, Palanee T, Mierzwa S, Skoler-Karpoff S. Assessing the reporting of adherence and sexual activity in a simulated microbicide trial in South Africa: an interview mode experiment using a placebo gel. AIDS Behav 2011; 15:407-21. [PMID: 20886278 DOI: 10.1007/s10461-010-9791-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Misreporting of adherence undermines detection of an association between product use and HIV infection in microbicide trials. This study investigates whether, in a placebo trial, audio computer-assisted self-interviewing (ACASI) produces more accurate reporting of adherence and sexual behavior than a face-to-face interview (FTFI). At three South African clinics, 849 women were enrolled and instructed to use applicators filled with placebo gel; participants were randomly assigned to FTFI or ACASI. Behavioral reports were validated through two biomarkers that detect product usage and unprotected sex. For most behaviors, ACASI generated significantly higher reporting, although differences by interview mode appeared to diminish over time. ACASI participants were more likely to report having had sex without gel, but reported and tested applicators did not indicate greater honesty about gel insertion with ACASI. While comparisons of reported unprotected sex with the validated biomarker revealed more agreement with ACASI than with FTFI, differences were small.
Collapse
Affiliation(s)
- Barbara S Mensch
- Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Lindstrom DP, Belachew T, Hadley C, Hattori MK, Hogan D, Tessema F. Nonmarital Sex and Condom Knowledge among Ethiopian Young People: Improved Estimates Using a Nonverbal Response Card. Stud Fam Plann 2010; 41:251-62. [DOI: 10.1111/j.1728-4465.2010.00251.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Parnell BA, Dunivan GC, Connolly A, Jannelli ML, Wells EC, Geller EJ. Validation of web-based administration of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12). Int Urogynecol J 2010; 22:357-61. [PMID: 20972537 DOI: 10.1007/s00192-010-1297-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 09/26/2010] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We studied a web-based version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12). METHODS A randomized crossover study in which subjects completed both a web-based and paper-based version of the PISQ-12, with a 2-week separation between the completion of the two versions. Demographic data and questionnaire preferences were also assessed. Group 1 completed the web version first, and group 2 completed the paper version first. RESULTS We recruited 52 women and 50 (96.2%) completed the study. Demographic data were similar for the two groups. There was no difference in total PISQ-12 score (P = 0.41) and a high degree of correlation between versions (r = 0.88). Women preferred the web-based PISQ-12 (77.6%) over the paper-based version. CONCLUSION The web-based version of the PISQ-12 is a reliable alternative to the standard paper-based version and was preferred by women in this study regardless of age, race, and education.
Collapse
Affiliation(s)
- Brent A Parnell
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Campus Box 7570, Chapel Hill, NC 27599-7570, USA
| | | | | | | | | | | |
Collapse
|
46
|
Phillips AE, Gomez GB, Boily MC, Garnett GP. A systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI associated behaviours in low- and middle-income countries. Int J Epidemiol 2010; 39:1541-55. [PMID: 20630991 DOI: 10.1093/ije/dyq114] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Studies identifying risks and evaluating interventions for human immunodeficiency virus (HIV) and other sexually transmitted infections often rely on self-reported measures of sensitive behaviours. Such self-reports can be subject to social desirability bias. Concerns over the accuracy of these measures have prompted efforts to improve the level of privacy and anonymity of the interview setting. This study aims to determine whether such novel tools minimize misreporting of sensitive information. METHODS Systematic review and meta-analysis of studies in low- and middle-income countries comparing traditional face-to-face interview (FTFI) with innovative tools for reporting HIV risk behaviour. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Cochran's chi-squared test of heterogeneity was performed to explore differences between estimates. Pooled estimates were determined by gender, region, education, setting and question time frame using a random effects model. RESULTS We found and included 15 data sets in the meta-analysis. Most studies compared audio computer-assisted self interview (ACASI) with FTFI. There was significant heterogeneity across studies for three outcomes of interest: 'ever had sex' (I(2) = 93.4%, P < 0.001), non-condom use (I(2) = 89.3%, P < 0.001), and number of partners (I(2) = 75.3%, P < 0.001). For the fourth outcome, 'forced sex', there was homogenous increased reporting by non-FTFI methods (OR 1.47; 95% CI 1.11-1.94). Overall, non-FTFI methods were not consistently associated with a significant increase in the reporting of all outcomes. However, there was increased reporting associated with non-FTFI with region (Asia), setting (urban), education (>60% had secondary education) and a shorter question time frame. CONCLUSION Contrary to expectation, differences between FTFI and non-interviewer-administered interview methods for the reported sensitive behaviour investigated were not uniform. However, we observed trends and variations in the level of reporting according to the outcome, study and population characteristics. FTFI may not always be inferior to innovative interview tools depending on the sensitivity of the question as well as the population assessed.
Collapse
Affiliation(s)
- Anna E Phillips
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
| | | | | | | |
Collapse
|
47
|
Langhaug LF, Sherr L, Cowan FM. How to improve the validity of sexual behaviour reporting: systematic review of questionnaire delivery modes in developing countries. Trop Med Int Health 2010; 15:362-81. [PMID: 20409291 DOI: 10.1111/j.1365-3156.2009.02464.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To systematically review comparative research from developing countries on the effects of questionnaire delivery mode. METHODS We searched Medline, EMbase and PsychINFO and ISSTDR conference proceedings. Randomized control trials and quasi-experimental studies were included if they compared two or more questionnaire delivery modes, were conducted in a developing country, reported on sexual behaviours and occurred after 1980. RESULTS A total of 28 articles reporting on 26 studies met the inclusion criteria. Heterogeneity of reported trial outcomes between studies made it inappropriate to combine trial outcomes. Eighteen studies compared audio computer-assisted survey instruments (ACASI) or its derivatives [personal digital assistant (PDA) or computer-assisted personal interview (CAPI)] against another self-administered questionnaires, face-to-face interviews or random response technique. Despite wide variation in geography and populations sampled, there was strong evidence that computer-assisted interviews lowered item-response rates and raised rates of reporting sensitive behaviours. ACASI also improved data entry quality. A wide range of sexual behaviours were reported including vaginal, oral, anal and/or forced sex, age of sexual debut, condom use at first and/or last sex. Validation of self-reports using biomarkers was rare. CONCLUSIONS These data reaffirm that questionnaire delivery modes do affect self-reported sexual behaviours and that use of ACASI can significantly reduce reporting bias. Its acceptability and feasibility in developing country settings should encourage researchers to consider its use when conducting sexual health research. Triangulation of self-reported data using biomarkers is recommended. Standardizing sexual behaviour measures would allow for meta-analysis.
Collapse
Affiliation(s)
- Lisa F Langhaug
- Centre for Sexual Health & HIV Research, University College London, UK.
| | | | | |
Collapse
|
48
|
Nyitray AG, Smith D, Villa L, Lazcano-Ponce E, Abrahamsen M, Papenfuss M, Giuliano AR. Prevalence of and risk factors for anal human papillomavirus infection in men who have sex with women: a cross-national study. J Infect Dis 2010; 201:1498-508. [PMID: 20367457 DOI: 10.1086/652187] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although the primary cause of anal cancer is human papillomavirus (HPV) infection in the anal canal, little attention has been paid to the epidemiology of anal HPV infection in men who have sex with women (MSW). METHODS Exfoliated cells from the anal canal of 902 MSW in Brazil (São Paulo), Mexico (Cuernavaca), and the United States (Tampa) were tested for HPV DNA. RESULTS The prevalence of HPV infection in the anal canal (12.0%) was similar among MSW in each city (P=.77), whereas 7.0% had infection with oncogenic types. Men in Tampa had a 4-fold higher prevalence of infection with HPV type 16 (HPV-16) than that among men in São Paulo or Cuernavaca (P<.001). Duration of relationship with a primary sex partner and ever having oral or anal sex with a man was associated with infection with any HPV type and with any oncogenic type, whereas lifetime number of female sex partners was associated with infection with any HPV type. CONCLUSIONS Anal canal HPV infection is commonly found among MSW, and the prevalence of infection with HPV-16 may differ substantially by geography. Men who have a larger lifetime number of female sex partners, who are in a sexual relationship of <1 year in duration, and who have a history of oral or anal sex with men were most likely to have an anal HPV infection.
Collapse
Affiliation(s)
- Alan G Nyitray
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
| | | | | | | | | | | | | |
Collapse
|
49
|
Reporting on first sexual experience: The importance of interviewer-respondent interaction. DEMOGRAPHIC RESEARCH 2010; 22:237-288. [PMID: 20357897 DOI: 10.4054/demres.2010.22.11] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Survey methodologists typically seek to improve data on sensitive topics by standardizing surveys and avoiding the use of human interviewers. This study uses data collected from 90 never-married young adults in rural Malawi to compare reports on first sexual encounters between a standard survey and an in-depth interview. A significant fraction of young women who claimed in the survey to have never been sexually active affirmed sexual experience during the in-depth interview, fielded shortly thereafter. Two elements of the in-depth interview, flexibility and reciprocal exchange, foster trust and more truthful reporting. The findings contradict the long-standing presumption that face-to-face interviews are inherently threatening when the topic is sex.
Collapse
|
50
|
Nyitray AG, Kim J, Hsu CH, Papenfuss M, Villa L, Lazcano-Ponce E, Giuliano AR. Test-retest reliability of a sexual behavior interview for men residing in Brazil, Mexico, and the United States: the HPV in Men (HIM) Study. Am J Epidemiol 2009; 170:965-74. [PMID: 19741044 DOI: 10.1093/aje/kwp225] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Understanding the natural history of sexually transmitted infections requires the collection of data on sexual behavior. However, there is concern that self-reported information on sexual behavior may not be valid, especially if study participants are culturally and linguistically distinct. The authors completed a test-retest reliability study of 1,069 men recruited in Brazil, Mexico, and the United States in 2005 and 2006. All of the men completed the same computer-assisted self-interview approximately 3 weeks apart. Refusal rates, kappa coefficients, and intraclass correlation coefficients were calculated for the full sample and by country, age, and lifetime number of female sex partners. Reliability coefficients for each study site and the combined population were high for almost all questions. With few exceptions, the authors found high test-retest reliability with a computer-assisted self-interview on sexual behavior used in 3 culturally and linguistically distinct countries.
Collapse
Affiliation(s)
- Alan G Nyitray
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
| | | | | | | | | | | | | |
Collapse
|