Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8545, Baltimore, MD 21205, USA.
Stud Fam Plann. 2012 Mar;43(1):33-42. doi: 10.1111/j.1728-4465.2012.00300.x.
This study uses couple-level data to measure couples' concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples' behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples.
本研究使用夫妇层面的数据,衡量了利比里亚(N=1673)、马达加斯加(N=4138)和纳米比亚(N=588)的一夫一妻制夫妇中,夫妇双方自我报告的上次性行为时间以及上次性行为中使用避孕套和其他避孕措施的一致性。本研究还考察了在报告一致的夫妇中,与报告前 28 天发生的性行为和避孕措施使用相关的特征。总体而言,我们的研究发现,报告的上次性行为时间的一致性不足 75%。使用避孕套和其他避孕措施在 Kappa 指数上的一致性为中等(0.27)到高度(0.67)。在至少两个国家中,预测一致性夫妇中上次性行为时间较短的因素包括财富、配偶年龄差异、教育程度以及双方都想要另一个孩子。最近性行为和避孕措施报告的不一致性表明,从一方配偶的报告中推断夫妇的行为时应谨慎,在可能的情况下应检查一致性报告,应寻求改进配偶报告有效性的方法学变化,计划生育和艾滋病毒预防项目应针对那些发现使用避孕套和其他避孕措施频率较低的群体,特别是较贫困的夫妇。