title: Are hormonal contraceptive users more likely to misreport unprotected sex? Evidence from a biomarker validation study in Zimbabwe.
abstract: We analyzed biomarker validation data of unprotected sex from women in Zimbabwe to determine whether condom and sexual behavior misreporting differs between users of different contraceptive methods. Self-reported sexual behavior was compared with the presence of prostate-specific antigen (PSA) in vaginal fluid, a biomarker of semen exposure. Of the 195 women who were PSA positive, 94 (48 %) reported no sex or only condom-protected sex. Hormonal contraceptive users misreported sexual behavior less than women using non-hormonal methods (45 vs. 67 %, P = 0.03). This misclassification pattern could have implications on the elevated risk of HIV infection associated with hormonal contraception in some studies.
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, 1918 University Avenue, Suite 3C, Berkeley, CA, 94704, USA, smccoy@berkeley.edu.
authors.forename: Sandra I
authors.initials: SI
authors.lastname: McCoy
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Ralph
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Padian
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Minnis
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000737:chemistry; D017280:Condoms / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D064887:Observational Studies as Topic; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000737:chemistry*; D015203:Reproducibility of Results; D057566:Self Report; D012725:Sexual Behavior; D014342:Truth Disclosure; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D014621:Vagina / Q000737:chemistry*; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D003271:Contraceptive Agents, Female; D017430:Prostate-Specific Antigen