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Agreement Between Gay, Bisexual, and other Men Who Have Sex with Men (MSM)'s Period Prevalence and Event-Level Recall of Sexual Behavior: Implications for Research & Evidence
Methods: Participants were sexually active men aged ≥16 years recruited using Respondent-Driving Sampling (RDS). Participants completed a self-administered computer-based survey, which included questions regarding sexual practices in the past six months as both individual-level period prevalence recall (ever) and sexual event-level recall (last sex with each of the five most recent partners). All analyses used RDS-generated weights. We calculated weighted kappa statistics, stratified by HIV status, between data sources across three outcomes: “any anal intercourse” (anyAI), “any condomless anal intercourse” (anyCAI), “any condomless anal intercourse with a serodiscordant or unknown status partner” (anyCAI-discordant/unknown).
Results: Of 719 participants, 23.4% were HIV-positive, 68.0% were White, and median age was 33 years (IQR 26-47). For HIV-negative and status unknown MSM, there were substantial agreements between individual-level and event-level data for anyAI (86.6% versus 83.7%, Kappa=0.64[95%CI:0.55-0.73]) and anyCAI (58.6% versus 50.5%, Kappa=0.66[95%CI:0.60-0.73]), but only moderate agreement regarding anyCAI-discordant/unknown (30.8% versus 19.1%, Kappa=0.53[95%CI:0.45-0.61). Of the disagreements in anyCAI-discordant/unknown (n=93/501), the majority (81.7%) reported the outcome in the individual-level period-prevalence data, but not the event-level data. For HIV-positive men, there was substantial agreement between individual-level and event-level data sources for anyAI, (84.3% versus 89.8%, Kappa=0.70[95%CIL0.53-0.86]), anyCAI (74.1% versus 70.7%, Kappa=0.79[95%CI:0.68-0.89]), and anyCAI-discordant/unknown (47.1% versus 44.6%, Kappa=0.70[95%CI:0.59-0.82]).
Conclusion: We observed substantial agreement between sexual behavior reported through event-level questions and individual-level period prevalence, with no clear overall advantage between either method.
Learning Areas:
Assessment of individual and community needs for health educationConduct evaluation related to programs, research, and other areas of practice
Epidemiology
Public health or related research
Social and behavioral sciences
Learning Objectives:
Evaluate the level of agreement between different data sources for HIV risk behaviors amongst MSM
Keyword(s): HIV Risk Behavior, Research
Qualified on the content I am responsible for because: I have a PhD and years of experience conducting research in the realm of HIV.I have been the co-principal or co-investigator of multiple funded grants focusing on the epidemiology and prevention of HIV among gay, bisexual, and other men who have sex with men in Canada and New Zealand. Among my scientific interests has been the development of strategies for preventing HIV and STDs with consideration of proximal behavioural factors and more up-stream determinants.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.