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Exploring Discordance Between Biologic and Self-Reported Measures of Semen Exposure: A Qualitative Study Among Female Patients Attending an STI Clinic in Jamaica

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Abstract

We explored the use of qualitative interviews to discuss discrepancies between two sources of information on unprotected sex: biomarker results and self-reported survey data. The study context was a randomized trial in Kingston, Jamaica examining the effect of STI counseling messages on recent sexual behavior using prostate-specific antigen (PSA) as the primary study outcome. Twenty women were interviewed. Eleven participants were selected because they tested positive for PSA indicating recent semen exposure, yet reported no unprotected sex in a quantitative survey (“discordant”): 5 reported abstinence and 6 reported condom use. Nine participants who also tested positive for PSA but reported unprotected sex in the survey were interviewed for comparison (“concordant”). Qualitative interviews with 6 of the 11 discordant participants provided possible explanations for their PSA test results, and 5 of those were prompted by direct discussion of those results. Rapid PSA testing combined with qualitative interviews provides a novel tool for investigating and complementing self-reported sexual behavior.

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Notes

  1. This rapid test performed favorably compared to a more extensive, quantitative laboratory test for PSA, with 99 % sensitivity and 96 % specificity [27]. Quality control measures conducted during the ACME trial also found excellent agreement between the rapid test results and quantitative laboratory tests.

  2. Visiting partner is a relationship term commonly used in Jamaica and the Caribbean, to denote fairly serious or stable relationships in which one partner, usually the man, lives separately and visits regularly (see, for example, [28]).

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Acknowledgments

The authors thank Maria Gallo, Shashauna Eastman, and Melrose Ellis for their support of this project. The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Correspondence to Marion W. Carter.

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Carter, M.W., Bailey, A., Snead, M.C. et al. Exploring Discordance Between Biologic and Self-Reported Measures of Semen Exposure: A Qualitative Study Among Female Patients Attending an STI Clinic in Jamaica. AIDS Behav 17, 728–736 (2013). https://doi.org/10.1007/s10461-012-0286-y

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