National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
AIDS Behav. 2010 Dec;14(6):1279-86. doi: 10.1007/s10461-010-9742-8.
Research on the determinants of condom use and condom non-use generally has relied on self-reported data with questionable validity. We identified predictors of recent, unprotected sex among 331 female sex workers in Madagascar using two outcome measures: self-reports of unprotected sex within the past 48 h and detection of prostate-specific antigen (PSA), a biological marker of recent semen exposure. Multivariable logistic regression revealed that self-reported unprotected sex was associated with three factors: younger age, having a sipa (emotional partner) in the prior seven days, and no current use of hormonal contraception. The sole factor related to having PSA detected was prevalent chlamydial infection (adjusted odds ratio, 4.5; 95% confidence interval, 2.0-10.1). Differences in predictors identified suggest that determinants of unprotected sex, based on self-reported behaviors, might not correlate well with risk of semen exposure. Caution must be taken when interpreting self-reported sexual behavior measures or when adjusting for them in analyses evaluating interventions for the prevention of HIV/STIs.
研究避孕套使用和不使用的决定因素通常依赖于自我报告的数据，其有效性值得怀疑。我们使用两种结果衡量标准，在马达加斯加的 331 名女性性工作者中确定了近期无保护性行为的预测因素：过去 48 小时内的自我报告无保护性行为和前列腺特异性抗原（PSA）的检测，这是最近精液暴露的生物标志物。多变量逻辑回归显示，自我报告的无保护性行为与三个因素相关：年龄较小、过去七天内有 sipa（情感伴侣），以及目前不使用激素避孕药。唯一与 PSA 检测呈阳性相关的因素是普遍存在的衣原体感染（调整后的优势比，4.5；95%置信区间，2.0-10.1）。确定的预测因素存在差异，这表明基于自我报告的性行为的无保护性行为决定因素可能与精液暴露风险相关性不好。在解释自我报告的性行为措施或在评估预防 HIV/性传播感染的干预措施时进行调整时，必须谨慎。
