How you ask really matters: randomised comparison of four sexual behaviour questionnaire delivery modes in Zimbabwean youth

Langhaug, Lisa; Cheung, Yin Bun; Pascoe, Sophie; Chirawu, Petronella; Woelk, Godfrey; Hayes, Richard; Cowan, Frances M

doi:10.1136/sti.2009.037374

Cited by 65 publications

(58 citation statements)

References 31 publications

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“…Limitations include that we did not sample HPV in girls who did not report sexual activity, so limiting our scope for analysis of the association of HPV infection with number of sexual partners. In addition, since under-reporting of sexual activity with face-to-face interviews has been well documented among young women in Africa,27 28 and HPV has been detected in 2% of vaginal samples from virgins in the USA,29 by not sampling all subjects we could have underestimated the prevalence of HPV infection. This study was not representative of all young women in our setting since HIV positive participants and participants with >6 lifetime sexual partners, who might be at higher risk of HPV infection, were excluded and so our observed prevalence and incidence of HPV is likely to be conservative.…”

Section: Discussionmentioning

confidence: 99%

High prevalence and incidence of human papillomavirus in a cohort of healthy young African female subjects

et al. 2013

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ObjectivesWe measured the prevalence and incidence of human papillomavirus (HPV) infection in young female subjects recruited for a safety and immunogenicity trial of the bivalent HPV-16/18 vaccine in Tanzania.MethodsHealthy HIV negative female subjects aged 10–25 years were enrolled and randomised (2:1) to receive HPV-16/18 vaccine or placebo (Al(OH)3 control). At enrolment, if sexually active, genital specimens were collected for HPV DNA, other reproductive tract infections and cervical cytology. Subjects were followed to 12 months when HPV testing was repeated.ResultsIn total 334 participants were enrolled; 221 and 113 in vaccine and control arms, respectively. At enrolment, 74% of 142 sexually active subjects had HPV infection of whom 69% had >1 genotype. Prevalent infections were HPV-45 (16%), HPV-53 (14%), HPV-16 (13%) and HPV-58 (13%). Only age was associated with prevalent HPV infection at enrolment. Among 23 girls who reported age at first sex as 1 year younger than their current age, 15 (65.2%) had HPV infection. Of 187 genotype-specific infections at enrolment, 51 (27%) were present at 12 months. Overall, 67% of 97 sexually active participants with results at enrolment and 12 months had a new HPV genotype at follow-up. Among HPV uninfected female subjects at enrolment, the incidence of any HPV infection was 76 per 100 person-years.ConclusionsAmong young women in Tanzania, HPV is highly prevalent and acquired soon after sexual debut. Early HPV vaccination is highly recommended in this population.

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Section: Discussionmentioning

confidence: 99%

High prevalence and incidence of human papillomavirus in a cohort of healthy young African female subjects

et al. 2013

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“…Some studies have tried to address social desirability bias by providing cultural and gender sensitivity training to clinic and research staff, but achieving adequate control over this bias can be difficult in settings in which sexuality is not openly discussed and/or specific sexual behaviors are stigmatized. Several studies have questioned the validity of using self-reported measures of sexual risk behavior among HIV-infected populations and have instead recommended utilizing audio computer-assisted selfinterview (ACASI) [111,112]. Although none of the studies assessing ART and sexual risk behaviors in the developing world used ACASI, some used STIs as epidemiological biomarkers of sexual risk behavior by correlating reports of unprotected sex with incident STI diagnoses [42,51].…”

Section: Measurement Of Sexual Risk Behaviorsmentioning

confidence: 99%

Is expanded HIV treatment preventing new infections? Impact of antiretroviral therapy on sexual risk behaviors in the developing world

Venkatesh

Flanigan

Mayer

2011

Aids

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There have been dramatic increases in access to antiretroviral therapy (ART) across the developing world, and growing public health attention has focused on the possibility of utilizing ART as a means of slowing the global HIV epidemic. The preventive impact of ART will likely depend on decreasing levels of sexual risk behaviors following treatment initiation. The current review study examines the impact of wider access to ART on sexual risk behaviors among HIV-infected individuals in the developing world. The observational studies to date demonstrate that ART is associated with a significant reduction in unprotected sex following treatment initiation. Although data on the impact of ART on possible risk compensation are rapidly expanding across the developing world, more evidence is still needed before we can safely conclude expanded treatment will result in durable decreases in sexual risk behaviors.

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“…Ideally information on AI should be collected using interviewing techniques to reduce social desirability bias 18 38. In our model, we have assumed random mixing between those who practice and do not practice AI.…”

Section: Discussionmentioning

confidence: 99%

“…18 35 38 39 42 43 The gender-specific HIV transmission probability estimates per vaginal and anal act and the relative increase in HIV acquisition risk during RAI (RR RAI =4 to 20) (online Appendix C) are based on meta-analyses of observational studies 11–14. The limited data on HIV risk per insertive anal intercourse (IAI) indicate a lower risk than for RAI 10 11 14.…”

Section: Methodsmentioning

confidence: 99%

The future role of rectal and vaginal microbicides to prevent HIV infection in heterosexual populations: implications for product development and prevention

et al. 2011

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Objectives To compare the potential impact of rectal(RMB), vaginal(VMB) and bi-compartment(RVMB) (applied vaginally and protective during vaginal and anal intercourse) microbicides to prevent HIV in various heterosexual populations. To understand when a RMB is as useful than a VMB for females practicing anal intercourse(AI). Methods Mathematical model was used to assess the population-level impact (cumulative fraction of new HIV infections prevented(CFP)) of the 3 different microbicides in various intervention scenarios and prevalence settings. We derived the break-even RMB efficacy required to reduce a female’s cumulative risk of HIV infection by the same amount than a VMB. Results Under optimistic coverage (fast roll-out, 100% uptake), a 50% efficacious VMB used in 75% of sex acts in population without AI may prevent ~33%[27,42%] new total (males and females combined) HIV infections over 25 years. The 25-year CFP reduces to ~25%[20,32%] and 17% [13,23%] if uptake decreases to 75% and 50%, respectively. Similar loss of impact (by 25–50%) is observed if the same VMB is introduced in populations with 5–10% AI and for RRRAI=4–20. A RMB is as useful as a VMB (i.e. break-even) in populations with 5% AI if RRRAI=20, and in populations with 15–20% AI if RRRAI=4, independently of adherence as long as it is the same with both products. The 10-year CFP with a RVMB is 2-fold larger than for a VMB or RMB when AI=10% and RRRAI=10. Conclusion Even low AI frequency can compromise the impact of VMB interventions. RMB and RVMB will be important prevention tools for heterosexual populations.

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How you ask really matters: randomised comparison of four sexual behaviour questionnaire delivery modes in Zimbabwean youth

Abstract: ACASI appears to reduce bias significantly, and is feasible and acceptable in resource-poor settings with low computer literacy. Its increased use would likely improve the quality of questionnaire data in general and sexual behaviour data specifically.

Cited by 65 publications

References 31 publications

High prevalence and incidence of human papillomavirus in a cohort of healthy young African female subjects

High prevalence and incidence of human papillomavirus in a cohort of healthy young African female subjects

Is expanded HIV treatment preventing new infections? Impact of antiretroviral therapy on sexual risk behaviors in the developing world

The future role of rectal and vaginal microbicides to prevent HIV infection in heterosexual populations: implications for product development and prevention

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