'He said, she said': assessing dyadic agreement of reported sexual behaviour and decision-making among an HIV sero-discordant couples cohort in Uganda

作者:Muldoon Katherine A; Kanters Steve; Birungi Josephine; King Rachel L; Nyonyintono Maureen; Khanakwa Sarah; Moore David M*
来源:Journal of Family Planning and Reproductive Health Care, 2017, 43(2): 142-146.
DOI:10.1136/jfprhc-2015-101323

摘要

Background The intimate nature of sexuality makes it challenging to accurately measure sexual behaviour. To assess response reliability, we examined agreement between couples in heterosexual HIV sero-discordant partnership on survey questions regarding condom use and sexual decision-making. Methods Data for this analysis come from baseline data from a cohort study of HIV sero-discordant couples in Jinja, Uganda. We examined the degree of agreement between male and female partners on standard measures of sexual behaviour using the kappa (.) statistic and 95% confidence intervals (95% CIs). Results Among 409 couples, the median age for the male partner was 41 [interquartile range (IQR) 35-48] years and the female partner was 35 (IQR 30-40) years. Among 58.2% of the couples, the male was the HIV-positive partner. Questions with high or substantial couple agreement included condom use at last sex (kappa=0.635, 95% CI 0.551-0.718) and frequency of condom use (kappa=0.625, 95% CI 0.551-0.698). Questions with low or fair couple agreement included decision-making regarding condom use (kappa=0.385, 95% CI 0.319-0.451), wanting more biological children (kappa=0.375, 95% CI 0.301-0.449) and deciding when to have sex (kappa=0.236, 95% CI 0.167-0.306). Conclusions Survey questions assessing condom use had the highest level of couple agreement and questions regarding sexual decision-making and fertility desire had low couple agreement. Questions with high agreement have increased reliability and reduced measurement bias; however, questions with low agreement between couples identify important areas for further investigation, particularly perceived relationship control and gender differences.

  • 出版日期2017-4