Biological Validation of Self-Reported Condom Use Among Sex Workers in Guinea
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Self-reported condom use may be prone to social desirability bias. Our aim was to assess the validity of self-reported condom use in a population of female sex workers using prostate specific antigen (PSA) as a gold standard biomarker of recent unprotected vaginal intercourse. We collected data on 223 sex-workers in Conakry, Guinea in order to assess the sensitivity and specificity of self-reported condom use as well as to examine the predictors of discordance between self-report and PSA presence. PSA was detected in 38.4% of samples. Sensitivity of self-reported condom use was 14.6% and its specificity was 94.7%. Self-perceived high risk of HIV infection was the only significant independent predictor of misreported condom use. PSA could be useful to validate self-reported condom use in surveys and to allow a better understanding of factors associated with social desirability in sexual behaviour reporting.
KeywordsSelf-reported condom use Validity PSA Female sex workers
We gratefully acknowledge funding support from the International Development Research Center (IDRC), Analyse et Évaluation des Interventions en Santé of University of Montreal (AnÉIS), and Canadian Institutes for Health Research (CIHR). We also wish to thank Maria Victoria Zunzunegui and Catherine Pirkle for their insights as well as our research partners in Conakry (SIDA3, INSPQ, FMG and Madina health centres) for contributing to this study.
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