title: Bias in Self-Reported Condom Use: Association Between Over-Reported Condom Use and Syphilis in a Three-Site Study in China.
abstract: This study examined over-reporting bias in self-reported condom use and assessed its association with syphilis. A survey was conducted among 1245 female sex workers (FSWs) in three cities in China. Respondent's over-reported condom use was defined as reporting no unprotected sex for the past 24 h but testing positive for prostate specific antigen. The proportion of prevalent syphilis and active syphilis was 23 and 10 % respectively among FSWs. The proportion of over-reported condom use with sex clients only was 27-45 % among the three study sites. The proportion of over-reported condom use with all sex partners (clients, husbands, or boyfriends) was 26-46 %. FSWs who had active or prevalent syphilis were more likely to over report condom use. Self-reported condom use may not be a valid tool to measure the efficacy of HIV/STI intervention because the bias is associated with the outcome measure, i.e., syphilis.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 2234 SPH Building, College Park, MD, 20742, USA. hliu1210@umd.edu.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Morisky
authors.affiliation: Department of AIDS Prevention, Nanning Centre for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Xinqin
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of AIDS Prevention, Hefei Centre for Disease Control and Prevention, Hefei, Anhui, China.
authors.forename: Erjian
authors.initials: E
authors.lastname: Ma
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China.
authors.forename: Baofa
authors.initials: B
authors.lastname: Jiang
authors.affiliation: National Reference Lab for STDs, China National Centre for STD Control, Nanjing, Jiangsu, China.
authors.forename: Yueping
authors.initials: Y
authors.lastname: Yin
mesh_terms: D000328:Adult; D015982:Bias; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015995:Prevalence; D021841:Safe Sex / Q000706:statistics & numerical data*; D057566:Self Report; D060386:Sex Workers / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology*; D047568:Unsafe Sex; D055815:Young Adult
keywords: Condom use; Female sex workers; Misclassification; Over-reporting bias; Syphilis