Recent heterosexual partnerships and patterns of condom use: a weighted analysis.
BACKGROUND
In epidemiologic studies of sexual partnerships, characteristics are often collected in part through detailed questions concerning recent partnerships. These data present challenges for analysis. First, although research interest generally lies in all partnerships in a certain time period, participants may be asked to provide detailed information only concerning their most recent, up to a fixed number. As more recent partnerships may differ from others, a simple analysis of these data may lead to bias. Second, the total number of partnerships for a study participant may be informative, so the analyst must choose between inference for the population of partnerships or for a typical partnership from the population of individuals. Third, data may be more fully recorded for study participants than their partners, and not all partners may be eligible to participate.


METHODS
We propose weighting to deal with these challenges. Weighting provides a sensitivity analysis for the possible selection bias due to incomplete reporting. We analyze heterosexual condom use in Britain, using data from the National Survey of Sexual Attitudes and Lifestyles 2000.


RESULTS
The sensitivity of estimates to possible selection bias is low. We find that the choice of population for inference is important for prevalence estimates, but has relatively little impact on measures of association. By defining within-participant partnership predictors we demonstrate how participants vary their condom use. We establish that, at least for male participants, shorter partnership duration is linked to a higher probability of condom use at last sex but lower probability at first sex.


CONCLUSIONS
We recommend a weighted analysis approach to recent partnership data, which can be simply implemented in standard survey analysis software. In other surveys the sensitivity of estimates to possible selection bias may be substantial and this will need to be assessed in each case.
Copas
Andrew J
AJ
Research Department of Infection and Population Health, Centre for Sexual Health and HIV Research, University College London, UK. acopas@gum.ucl.ac.uk
Mercer
Catherine H
CH
Farewell
Vern T
VT
Nanchahal
Kiran
K
Johnson
Anne M
AM
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D017280:Condoms / Q000706:statistics & numerical data*; D003627:Data Interpretation, Statistical; D004739:England; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012725:Sexual Behavior; D055815:Young Adult