Jennifer Guida1, Ami Fukunaga2, Hongjie Liu2. 1. School of Public Health, University of Maryland, College Park. Electronic address: jlguida@umd.edu. 2. School of Public Health, University of Maryland, College Park.
Abstract
PURPOSE: The objective of this study was to examine information bias arising from self-reported sexual activity and its association with syphilitic infections among female sex workers (FSWs) aged 35 years and older in China. METHODS: A questionnaire was administered to 1245 middle-aged FSWs. Respondents self-reported sexual intercourse in the past 48 hours. The prostate-specific antigen test was used to verify self-reported sexual activity. FSWs were considered discordant if they indicated no sexual intercourse in the past 48 hours on the questionnaire and had a positive prostate-specific antigen test. Logistic regression was used to assess the associations between discordance and syphilis. RESULTS: Three hundred twenty FSWs self-reported no engagement in sexual intercourse in the past 48 hours. One-fourth of respondents (25%) were discordant. Twenty-two percent and 35.8% of discordant FSWs tested positive for active and prevalent syphilis, respectively. After adjusting for confounders, discordant FSWs had 3.8 times the odds of active syphilis (95% confidence interval: 1.52-9.30) and 2.6 times the odds of prevalent syphilis (95% confidence interval: 1.37-5.02), compared with concordant FSWs. CONCLUSIONS: FSWs who had active or prevalent syphilis were more likely to be discordant. Data collected via self-reported questionnaire may not be a valid tool to assess sexual behavior.
PURPOSE: The objective of this study was to examine information bias arising from self-reported sexual activity and its association with syphilitic infections among female sex workers (FSWs) aged 35 years and older in China. METHODS: A questionnaire was administered to 1245 middle-aged FSWs. Respondents self-reported sexual intercourse in the past 48 hours. The prostate-specific antigen test was used to verify self-reported sexual activity. FSWs were considered discordant if they indicated no sexual intercourse in the past 48 hours on the questionnaire and had a positive prostate-specific antigen test. Logistic regression was used to assess the associations between discordance and syphilis. RESULTS: Three hundred twenty FSWs self-reported no engagement in sexual intercourse in the past 48 hours. One-fourth of respondents (25%) were discordant. Twenty-two percent and 35.8% of discordant FSWs tested positive for active and prevalent syphilis, respectively. After adjusting for confounders, discordant FSWs had 3.8 times the odds of active syphilis (95% confidence interval: 1.52-9.30) and 2.6 times the odds of prevalent syphilis (95% confidence interval: 1.37-5.02), compared with concordant FSWs. CONCLUSIONS: FSWs who had active or prevalent syphilis were more likely to be discordant. Data collected via self-reported questionnaire may not be a valid tool to assess sexual behavior.
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