title: Correlates of and couples' concordance in reports of recent sexual behavior and contraceptive use.
abstract: This study uses couple-level data to measure couples' concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples' behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8545, Baltimore, MD 21205, USA. alkoffi@jhsph.edu
authors.forename: Alain K
authors.initials: AK
authors.lastname: Koffi
authors.forename: Visseho D
authors.initials: VD
authors.lastname: Adjiwanou
authors.forename: Stan
authors.initials: S
authors.lastname: Becker
authors.forename: Funmilola
authors.initials: F
authors.lastname: Olaolorun
authors.forename: Amy O
authors.initials: AO
authors.lastname: Tsui
mesh_terms: D000328:Adult; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior; D005260:Female; D006801:Humans; D007988:Liberia; D008270:Madagascar; D008297:Male; D009276:Namibia; D012494:Sampling Studies; D012747:Sexual Partners / Q000523:psychology*; D013997:Time Factors