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. 2024 Jan;28(1):320-331.
doi: 10.1007/s10461-023-04177-y. Epub 2023 Sep 26.

A Comparison of Self-reported Condomless Sex and Yc-DNA Biomarker Data from Young Women Engaged in High Risk Sexual Activity in Kampala, Uganda

Pippa Boering  1 , Janet Seeley  2   3 , Joshua Buule  4 , Onesmus Kamacooko  5 , Rachel King  6   7
Affiliations

A Comparison of Self-reported Condomless Sex and Yc-DNA Biomarker Data from Young Women Engaged in High Risk Sexual Activity in Kampala, Uganda

Pippa Boering et al. AIDS Behav. 2024 Jan.

Abstract

Reporting of condom-use can limit researchers' understanding of high-risk sexual behaviours. We compared self-reported condom-use with the Yc-DNA biomarker data and investigated potential factors influencing participation in, and reporting of, sexual behaviours. Self-reported data were collected using Audio Computer Assisted Self Interviews (ACASI) and samples for Yc-DNA biomarker were collected using self-administered and health worker-collected vaginal swabs from 644 women (aged 15-24 years) who were not living with HIV. Yc-DNA results and interview data were compared using McNemar-Bowker Analysis and Cohen's Kappa. Test statistics for Yc-DNA biomarker were calculated. Log Binomial models for Yc-DNA and self-reported results were conducted to assess for association. We found strong evidence (p < 0.001) for a difference between Yc-DNA and self-reported results. 13.7% of participants reported consistent condom-use with all partners, regardless of HIV status. Self-reported condom-use was discordant in 50.0% (n = 206) of cases, when compared to Yc-DNA results. Positive Yc-DNA results were found to be associated with older age (RR 1.36; 95%CI 1.04, 1.76 p = 0.023). Self-reported condom-use with partners with unknown HIV status was associated with higher education (RR 0.76; 95%CI 0.58,0.99 p = 0.043). Sensitivity analysis did not determine difference between methods for controlling for missing data. We found significant under-reporting of condomless sex in the self-reported data when compared to Yc-DNA results.

Keywords: Biomarkers; Condomless Sex; HIV Prevention; Sex work; Social desirability bias.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Fenton KA, Johnson AM, McManus S, Erens B. Measuring sexual behaviour: methodological challenges in survey research. Sex Transm Infect. 2001;77(2):84–92. doi: 10.1136/sti.77.2.84. - DOI - PMC - PubMed
    1. Michaels S. Sexual Behavior and Practices: data and measurement. In: Baumle AK, editor. International Handbook on the demography of sexuality. Dordrecht: Springer Netherlands; 2013. pp. 11–20.
    1. Zenilman JM, Yuenger J, Galai N, Turner CF, Rogers SM. Polymerase chain reaction detection of Y chromosome sequences in Vaginal Fluid: preliminary studies of a potential biomarker for sexual behavior. Sex Transm Dis. 2005;32(2):90–4. doi: 10.1097/01.olq.0000149668.08740.91. - DOI - PubMed
    1. Montgomery ET, Mensch B, Musara P, Hartmann M, Woeber K, Etima J, et al. Misreporting of product adherence in the MTN-003/VOICE Trial for HIV Prevention in Africa: participants’ explanations for dishonesty. AIDS Behav. 2017;21(2):481–91. doi: 10.1007/s10461-016-1609-1. - DOI - PMC - PubMed
    1. Malagón T, Burchell A, El-Zein M, Guénoun J, Tellier PP, Coutlée F, et al. Y chromosome DNA in Women’s vaginal samples as a biomarker of recent vaginal sex and Condom Use with Male Partners in the HPV infection and transmission among couples through heterosexual activity Cohort Study. Sex Transm Dis. 2018;45(1):28–34. doi: 10.1097/OLQ.0000000000000688. - DOI - PMC - PubMed