Discordance of HIV and HSV-2 biomarkers and self-reported sexual behaviour among orphan adolescents in Western Kenya.
BACKGROUND
This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya.


METHODS
In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey.


RESULTS
Comparing biological data with self-reported responses indicated that 70% of HIV-positive (7 out of 10) and 64% of HSV-2-positive (18 out of 28 positive) participants reported never having had sex. Among ever-married adolescents, 65% (57 out of 88) reported never having had sex. Overall, 10% of study participants appeared to have inconsistently reported their sexual behaviour. Logistic regression analyses indicated that lower educational level and exam scores were significant predictors of inconsistent reporting.


CONCLUSIONS
Our study demonstrates the discordance between infections measured by biomarkers and self-reports of having had sex among orphan adolescents in Kenya. In order to detect programme effects accurately in prevention research, it is necessary to collect both baseline and endline biological data. Furthermore, it is recommended to triangulate multiple data sources about adolescent participants' self-reported information about marriage and pregnancies from school records and parent/guardians to verify the information. Researchers should recognise potential threats to validity in data and design surveys to consider cognitive factors and/or cultural context to obtain more accurate and reliable information from adolescents regarding HIV/sexually transmitted infection risk behaviours.
NCT01501864.
The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina, USA.
Hyunsan
H
Cho
The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina, USA.
Winnie
W
Luseno
Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Carolyn
C
Halpern
The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina, USA.
Lei
L
Zhang
School of Nursing, Moi University, Eldoret, Kenya.
Isabella
I
Mbai
School of Nursing, Moi University, Eldoret, Kenya.
Benson
B
Milimo
The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina, USA.
Denise Dion
DD
Hallfors
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D054540:Child, Orphaned / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006561:Herpes Simplex / Q000517:prevention & control*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D012574:Schools; D057566:Self Report; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
D015415:Biomarkers
ADOLESCENT; AFRICA; HIV; HSV; SEXUAL BEHAVIOUR