Are hormonal contraceptive users more likely to misreport unprotected sex? Evidence from a biomarker validation study in Zimbabwe

AIDS Behav. 2014 Dec;18(12):2259-64. doi: 10.1007/s10461-014-0741-z.

Abstract

We analyzed biomarker validation data of unprotected sex from women in Zimbabwe to determine whether condom and sexual behavior misreporting differs between users of different contraceptive methods. Self-reported sexual behavior was compared with the presence of prostate-specific antigen (PSA) in vaginal fluid, a biomarker of semen exposure. Of the 195 women who were PSA positive, 94 (48 %) reported no sex or only condom-protected sex. Hormonal contraceptive users misreported sexual behavior less than women using non-hormonal methods (45 vs. 67 %, P = 0.03). This misclassification pattern could have implications on the elevated risk of HIV infection associated with hormonal contraception in some studies.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adult
  • Biomarkers / chemistry
  • Condoms / statistics & numerical data*
  • Contraceptive Agents, Female*
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Humans
  • Observational Studies as Topic
  • Predictive Value of Tests
  • Prostate-Specific Antigen / chemistry*
  • Reproducibility of Results
  • Self Report
  • Sexual Behavior*
  • Truth Disclosure
  • Unsafe Sex / psychology
  • Unsafe Sex / statistics & numerical data*
  • Vagina / chemistry*
  • Zimbabwe / epidemiology

Substances

  • Biomarkers
  • Contraceptive Agents, Female
  • Prostate-Specific Antigen