Accounting for failures may improve precision: evidence supporting improved validity of self-reported condom use

Sex Transm Dis. 2005 Aug;32(8):513-5. doi: 10.1097/01.olq.0000170442.10150.28.

Abstract

Objectives: To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens.

Methods: Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted.

Results: The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms.

Conclusion: Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / etiology
  • Chlamydia Infections / prevention & control
  • Chlamydia trachomatis / isolation & purification
  • Condoms / statistics & numerical data*
  • Female
  • Georgia / epidemiology
  • Gonorrhea / epidemiology
  • Gonorrhea / etiology
  • Gonorrhea / prevention & control
  • Humans
  • Neisseria gonorrhoeae / isolation & purification
  • Prisoners
  • Reproducibility of Results
  • Self Disclosure
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / etiology
  • Sexually Transmitted Diseases / prevention & control*
  • Surveys and Questionnaires / standards*
  • Unsafe Sex*