Association between participant self-report and biological outcomes used to measure sexual risk behavior in HIV-1- seropositive female sex workers in Mombasa, Kenya
Date
2012Author
McClelland, R. Scott
Richardson, Barbra A.
Wanje, George H.
Graham, Susan M.
Mutunga, Esther
Peshu, Norbert
Kiarie, James N.
Kurth, Ann E.
Jaoko Walter G.
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Few studies have examined the association between self-reported sexual risk behaviors and biologic outcomes in human immunodeficiency virus (HIV)-1-seropositive African adults.
METHODS:
We conducted a prospective cohort study in 898 HIV-1-seropositive women who reported engaging in transactional sex in Mombasa, Kenya. Primary outcome measures included detection of sperm in genital secretions, pregnancy, and sexually transmitted infections. Because 3 outcomes were evaluated, data are presented with odds ratios [OR] and 96.7% confidence intervals [CI] to reflect that we would reject a null hypothesis if a P-value was ≤0.033 (Simes' methodology).
RESULTS:
During 2404 person-years of follow-up, self-reported unprotected intercourse was associated with significantly higher likelihood of detecting sperm in genital secretions (OR: 2.32, 96.7% CI: 1.93, 2.81), and pregnancy (OR: 2.78, 96.7% CI: 1.57, 4.92), but not with detection of sexually transmitted infections (OR: 1.20, 96.7% CI: 0.98, 1.48). At visits where women reported being sexually active, having >1 sex partner in the past week was associated with lower likelihood of detecting sperm in genital secretions (OR: 0.74, 96.7% CI: 0.56, 0.98). This association became nonsignificant after adjustment for reported condom use (adjusted OR: 0.81, 96.7% CI: 0.60, 1.08).
CONCLUSIONS:
Combining behavioral and biologic outcomes, which provide complementary information, is advantageous for understanding sexual risk behavior in populations at risk for transmitting HIV-1. The paradoxical relationship between higher numbers of sex partners and less frequent identification of sperm in genital secretions highlights the potential importance of context-specific behavior, such as condom use dependent on partner type, when evaluating sexual risk behavior.
URI
http://www.ncbi.nlm.nih.gov/pubmed/21217420http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/10086
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155001/
Citation
NIH Public AccessCollections
- Faculty of Health Sciences (FHS) [10387]