title: Limited benefit of repeating a sensitive question in a cross-sectional sexual health study.
abstract: BACKGROUND
  Sexual health research relies heavily on self-reported data. We explored whether repeating a key measure - number of lifetime sexual partners - improved the validity of this self-reported response.
  
  
  METHODS
  Using data from a study of Tanzanian plantation residents, we examined which of 505 participants changed their responses when a question about sexual partners was repeated. We examined which variable (first, second, or maximum response) was more predictive of herpes simplex virus type 2 (HSV-2) seropositivity, a biomarker strongly associated with number of lifetime partners. HSV-2 status was assessed using the HerpeSelect 2 ELISA IgG test.
  
  
  RESULTS
  When asked a second time, 10.7% of participants increased and 3.6% decreased their reported number of partners. Participants using audio computer-assisted self-interviews were more likely to change than those interviewed in person (p = 0.006). The increased odds of HSV-2 seropositivity with each additional partner ranged from 10% to 13% in men, and 33% to 37% in women, depending on which partner variable was used. Estimates had considerable confidence interval overlap and no substantial differences in precision.
  
  
  CONCLUSIONS
  Some participants change their responses when asked a sensitive question a second time, but in this population, changes did not meaningfully affect associations between lifetime partners and HSV-2.
authors.affiliation: Division of Infectious Diseases, College of Medicine, Ohio State University, Columbus, OH, USA. ant@osumc.edu
authors.forename: Abigail
authors.initials: A
authors.lastname: Norris Turner
authors.forename: Prabasaj
authors.initials: P
authors.lastname: Paul
authors.forename: Alison H
authors.initials: AH
authors.lastname: Norris
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D008297:Male; D060728:Reproductive Health; D057566:Self Report; D012725:Sexual Behavior; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology; D014342:Truth Disclosure
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers