AIDS and Behavior

, Volume 17, Issue 2, pp 623–631 | Cite as

Accuracy of HIV-Related Risk Behaviors Reported by Female Sex Workers, Iran: A Method to Quantify Measurement Bias in Marginalized Populations

  • Ali Mirzazadeh
  • Ali Akbar Haghdoost
  • Saharnaz Nedjat
  • Soodabeh Navadeh
  • Willi McFarland
  • Kazem Mohammad
Original Paper

Abstract

We quantified discrepancies in reported behaviors of female sex workers (FSW) by comparing 63 face-to-face interviews (FTFI) to in-depth interviews (IDI), with corroboration of the directions and magnitudes of reporting by a panel of psychologists who work with FSW. Sensitivities, specificities, positive and negative predictive values (PPV and NPV) were assessed for FTFI responses using IDI as a “gold standard”. Sensitivities were lowest in reporting symptoms of sexually transmitted infections (63.9 %), finding sex partners in venues (52.4 %) and not receiving HIV test results (66.7 %). Specificities (all >83 %) and PPVs (all >74.0 %) were higher than NPV. FSW significantly under-reported number of clients, sexual contacts and non-condom use sex acts with clients and number of days engaging in sex work in the preceding week. This study provides a quantified gauge of reporting biases in FSW behaviors. Such estimates and methods help better understand true HIV risk in marginalized populations and calibrate survey estimates accordingly.

Keywords

Female sex workers Validity HIV Risk behaviors Bias Iran 

Precisión de las conductas de riesgo relacionadas con el VIH reportadas por trabajadoras del sexo en Irán: un método para cuantificar el sesgo de medición en las poblaciones marginadas

Resumen

Se cuantificaron discrepancias en la notificación de conductas de trabajadoras sexuales (TS) mediante comparación de 63 entrevistas cara a cara (ECC) con entrevistas en profundidad (EEP), con la corroboración de las direcciones y magnitudes de informes de especialistas. Se evaluaron la sensibilidad, especificidad, valores predictivos positivo y negativo (VPP y VPN) de las ECC usando la EEP como “estándar de oro”. La sensibilidad fue más baja en la notificación de síntomas de infecciones de transmisión sexual (63.9 %), de búsqueda de parejas sexuales (52.4 %) y no recibir los resultados de la prueba del VIH (66.7 %). La especificidad (>83 %) y VPP (>74.0 %) fueron más altos que el VPN. Las TS infrareportaron significativamente el número de clientes, contactos sexuales, actos sexuales sin preservativos y el número de días trabajados sexualmente la semana anterior. Este estudio proporciona un indicador cuantitativo de sesgos en la información sobre los comportamientos de las TS. Estas estimaciones y métodos ayudan a entender mejor el riesgo al VIH de las poblaciones marginadas y calibrar las estimaciones correspondientes.

Palabras clave

Trabajadoras sexuales Validación VIH Conductas de riesgo Sesgo Irán 

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ali Mirzazadeh
    • 1
  • Ali Akbar Haghdoost
    • 2
  • Saharnaz Nedjat
    • 3
  • Soodabeh Navadeh
    • 1
  • Willi McFarland
    • 4
  • Kazem Mohammad
    • 1
  1. 1.Department of Epidemiology and BiostatisticsSchool of Public Health, Tehran University of Medical SciencesTehranIran
  2. 2.Regional Knowledge Hub for HIV/AIDS SurveillanceKerman University of Medical SciencesKermanIran
  3. 3.Department of Epidemiology and BiostatisticsSchool of Public Health, Knowledge Utilization Research Center, Tehran University of Medical SciencesTehranIran
  4. 4.San Francisco Department of Public HealthSan FranciscoUSA

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