Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
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Accounting for Failures May Improve Precision:Evidence Supporting Improved Validity of Self-Reported Condom Use

Crosby, Richard PhD*; Salazar, Laura F. PhD*; DiClemente, Ralph J. PhD†§∥; Yarber, William L. HSD‡¶#; Caliendo, Angela M. MD,PhD§; Staples-Horne, Michelle MD**

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Abstract

Objectives: To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens.

Methods: Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted.

Results: The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71–3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13–11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms.

Conclusion: Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

© Copyright 2005 American Sexually Transmitted Diseases Association

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