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Bias in Self-Reported Condom Use: Association Between Over-Reported Condom Use and Syphilis in a Three-Site Study in China

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Abstract

This study examined over-reporting bias in self-reported condom use and assessed its association with syphilis. A survey was conducted among 1245 female sex workers (FSWs) in three cities in China. Respondent’s over-reported condom use was defined as reporting no unprotected sex for the past 24 h but testing positive for prostate specific antigen. The proportion of prevalent syphilis and active syphilis was 23 and 10 % respectively among FSWs. The proportion of over-reported condom use with sex clients only was 27–45 % among the three study sites. The proportion of over-reported condom use with all sex partners (clients, husbands, or boyfriends) was 26–46 %. FSWs who had active or prevalent syphilis were more likely to over report condom use. Self-reported condom use may not be a valid tool to measure the efficacy of HIV/STI intervention because the bias is associated with the outcome measure, i.e., syphilis.

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Acknowledgments

This work was supported by a research Grant (R01HD068305) from National Institutes of Health, awarded to Hongjie Liu. We are grateful to the staff from Shandong University School of Public Health, Nanning Centre for Disease Control and Prevention, Hefei Centre for Diseases Control and Prevention, and Qingdao Centre for Disease Control and Prevention for their participation in the study, and to all the participants who willingly gave their time to provide the study data.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 2234 SPH Building, College Park, MD, 20742, USA

    Hongjie Liu

  2. Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Donald E. Morisky

  3. Department of AIDS Prevention, Nanning Centre for Disease Control and Prevention, Nanning, Guangxi, China

    Xinqin Lin

  4. Department of AIDS Prevention, Hefei Centre for Disease Control and Prevention, Hefei, Anhui, China

    Erjian Ma

  5. Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China

    Baofa Jiang

  6. National Reference Lab for STDs, China National Centre for STD Control, Nanjing, Jiangsu, China

    Yueping Yin

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  1. Hongjie Liu
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  2. Donald E. Morisky
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  3. Xinqin Lin
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  4. Erjian Ma
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Correspondence to Hongjie Liu.

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Liu, H., Morisky, D.E., Lin, X. et al. Bias in Self-Reported Condom Use: Association Between Over-Reported Condom Use and Syphilis in a Three-Site Study in China. AIDS Behav 20, 1343–1352 (2016). https://doi.org/10.1007/s10461-015-1269-6

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