Biomarker validation of recent unprotected sexual intercourse in a prospective study of young women engaged in sex work in Phnom Penh, Cambodia
| Autor: | Jennifer L. Evans, Kimberly Page, Marie-Claude Couture, Lisa Maher, Neth Sansothy, Ellen Stein |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Unprotected Sexual Intercourse Adolescent Population Amphetamine-Related Disorders HIV Infections Dermatology Article law.invention Condoms Young Adult Condom Acquired immunodeficiency syndrome (AIDS) Unsafe Sex law Semen Medicine Humans Prospective Studies education Central element Sex work Gynecology education.field_of_study Sex Workers business.industry Public Health Environmental and Occupational Health Prostate-Specific Antigen medicine.disease Sex Work Sexual intercourse Infectious Diseases Sexual Partners Female Self Report business Cambodia Biomarkers Demography |
| Popis: | Background: Accurate measurement of unprotected sex is essential in HIV prevention research. Since 2001, the 100% Condom Use Program targeting female sex workers (FSWs) has been a central element of the Cambodian National HIV/AIDS Strategy. We sought to assess the validity of self-reported condom use using the rapid prostate-specific antigen (PSA) test among Cambodian FSWs. Methods: From 2009 to 2010, we enrolled 183 FSWs in Phnom Penh in a prospective study of HIV risk behavior. Prostate-specific antigen test results from the OneStep ABAcard were compared with selfreported condom use in the past 48 hours at quarterly follow-up visits. Results: Among women positive for seminal fluid at the first followup visit, 42% reported only protected sex or no sex in the detection period. Discordant results were more likely among brothel and streetbased FSW versus entertainment (56% vs. 17%), recent (last 3 months) amphetamine-type stimulant (ATS) users (53% vs. 20%), and those with 5 or more partners in the past month (58% vs. 13%). In multivariable regression models, positive PSA results were associated with recent ATS use (adjusted risk ratio [ARR], 1.5; 95% confidence interval [CI], 1.1Y2.2), having a nonpaying last sex partner (ARR, 1.7; CI, 1.2Y2.5), and sex work venue (ARR, 3.0; CI, 1.4Y6.5). Correspondingly, women with a nonpaying last sex partner were more likely to report unprotected sex (ARR, 1.5; CI, 1.1Y2.2), but no associations were found with sex work venue or ATS use. Conclusions: Results confirm the questionable validity of self-reported condom use among FSW. The PSA biomarker assay is an important monitoring tool in HIV/sexually transmitted infection research including prevention trials. |
| Databáze: | OpenAIRE |
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