title: Accuracy of HIV-related risk behaviors reported by female sex workers, Iran: a method to quantify measurement bias in marginalized populations.
abstract: We quantified discrepancies in reported behaviors of female sex workers (FSW) by comparing 63 face-to-face interviews (FTFI) to in-depth interviews (IDI), with corroboration of the directions and magnitudes of reporting by a panel of psychologists who work with FSW. Sensitivities, specificities, positive and negative predictive values (PPV and NPV) were assessed for FTFI responses using IDI as a "gold standard". Sensitivities were lowest in reporting symptoms of sexually transmitted infections (63.9 %), finding sex partners in venues (52.4 %) and not receiving HIV test results (66.7 %). Specificities (all >83 %) and PPVs (all >74.0 %) were higher than NPV. FSW significantly under-reported number of clients, sexual contacts and non-condom use sex acts with clients and number of days engaging in sex work in the preceding week. This study provides a quantified gauge of reporting biases in FSW behaviors. Such estimates and methods help better understand true HIV risk in marginalized populations and calibrate survey estimates accordingly.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran. ali.mirzazadeh@hivhub.ir
authors.forename: Ali
authors.initials: A
authors.lastname: Mirzazadeh
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Haghdoost
authors.forename: Saharnaz
authors.initials: S
authors.lastname: Nedjat
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Navadeh
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.forename: Kazem
authors.initials: K
authors.lastname: Mohammad
mesh_terms: D000293:Adolescent; D000328:Adult; D015982:Bias; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D007492:Iran / Q000453:epidemiology; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D062487:Social Marginalization / Q000523:psychology; D057545:Social Stigma; D011795:Surveys and Questionnaires