Biomarker validation of reports of recent sexual activity: results of a randomized controlled study in Zimbabwe.

Full Abstract

Challenges in the accurate measurement of sexual behavior in human immunodeficiency virus (HIV) prevention research are well documented and have prompted discussion about whether valid assessments are possible. Audio computer-assisted self-interviewing (ACASI) may increase the validity of self-reported behavioral data. In 2006-2007, Zimbabwean women participated in a randomized, cross-sectional study that compared self-reports of recent vaginal sex and condom use collected through ACASI or face-to-face interviewing (FTFI) with a validated objective biomarker of recent semen exposure (prostate-specific antigen (PSA) levels). Of 910 study participants, 196 (21.5%) tested positive for PSA, an indication of semen exposure during the previous 2 days. Of these 196 participants, 23 (11.7%) reported no sex in the previous 2 days, with no difference in reported sexual activity between interview modes (12.5% ACASI vs. 10.9% FTFI; Fisher's exact test: P = 0.72). In addition, 71 PSA-positive participants (36.2%) reported condom-protected vaginal sex only; their reports also indicated no difference between interview modes (33.7% ACASI vs. 39.1% FTFI; P = 0.26). Only 52% of PSA-positive participants reported unprotected sex during the previous 2 days. Self-report was a poor predictor of recent sexual activity and condom use in this study, regardless of interview mode, providing evidence that such data should be interpreted cautiously.

Author information

Author/s: Minnis, Alexandra M (AM); Steiner, Markus J (MJ); Gallo, Maria F (MF); Warner, Lee (L); Hobbs, Marcia M (MM); van der Straten, Ariane (A); Chipato, Tsungai (T); Macaluso, Maurizio (M); Padian, Nancy S (NS);

Affiliation: Women's Global Health Imperative, RTI International, San Francisco, CA 94104, USA. aminnis(-atsign-)rti.org

Journal and publication information

Publication Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.

Journal: American journal of epidemiology (Am J Epidemiol), published in United States. (Language: eng)

Reference: 2009-Oct; vol 170 (issue 7) : pp 918-24

Dates: Created 2009/09/23; Completed 2009/10/06;

PMID: 19741042, status: MEDLINE (last retrieval date: 10/6/2009, IMS Date: )

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