AIDS and Behavior

, Volume 17, Issue 2, pp 728–736 | Cite as

Exploring Discordance Between Biologic and Self-Reported Measures of Semen Exposure: A Qualitative Study Among Female Patients Attending an STI Clinic in Jamaica

  • Marion W. CarterEmail author
  • Althea Bailey
  • Margaret C. Snead
  • Elizabeth Costenbader
  • Malene Townsend
  • Maurizio Macaluso
  • Denise J. Jamieson
  • Tina Hylton-Kong
  • Lee Warner
  • Markus J. Steiner
Original Paper


We explored the use of qualitative interviews to discuss discrepancies between two sources of information on unprotected sex: biomarker results and self-reported survey data. The study context was a randomized trial in Kingston, Jamaica examining the effect of STI counseling messages on recent sexual behavior using prostate-specific antigen (PSA) as the primary study outcome. Twenty women were interviewed. Eleven participants were selected because they tested positive for PSA indicating recent semen exposure, yet reported no unprotected sex in a quantitative survey (“discordant”): 5 reported abstinence and 6 reported condom use. Nine participants who also tested positive for PSA but reported unprotected sex in the survey were interviewed for comparison (“concordant”). Qualitative interviews with 6 of the 11 discordant participants provided possible explanations for their PSA test results, and 5 of those were prompted by direct discussion of those results. Rapid PSA testing combined with qualitative interviews provides a novel tool for investigating and complementing self-reported sexual behavior.


Qualitative study Self-reported data Semen biomarker Prostate-specific antigen Jamaica 



The authors thank Maria Gallo, Shashauna Eastman, and Melrose Ellis for their support of this project. The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2012

Authors and Affiliations

  • Marion W. Carter
    • 1
    Email author
  • Althea Bailey
    • 2
  • Margaret C. Snead
    • 1
  • Elizabeth Costenbader
    • 3
  • Malene Townsend
    • 4
  • Maurizio Macaluso
    • 5
  • Denise J. Jamieson
    • 1
  • Tina Hylton-Kong
    • 4
  • Lee Warner
    • 1
  • Markus J. Steiner
    • 6
  1. 1.Division of Reproductive HealthCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Department of Community Health and PsychiatryUniversity of the West IndiesKingstonJamaica
  3. 3.Behavioral and Social Science DepartmentFHI 360DurhamUSA
  4. 4.Comprehensive Health Centre (CHC)/Epidemiology Research and Training Unit (ERTU)Jamaica Ministry of HealthKingstonJamaica
  5. 5.Division of Biostatistics and EpidemiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  6. 6.Clinical Sciences DepartmentFHI 360DurhamUSA

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