He said, she said’: assessing dyadic agreement of reported sexual behaviour and decision-making among an HIV sero-discordant couples cohort in Uganda
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ
Abstract
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 (κ) 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
(κ=0.635, 95% CI 0.551–0.718) and frequency
of condom use (κ=0.625, 95% CI 0.551–0.698).
Questions with low or fair couple agreement
included decision-making regarding condom use
(κ=0.385, 95% CI 0.319–0.451), wanting more
biological children (κ=0.375, 95% CI 0.301–
0.449) and deciding when to have sex (κ=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.
Description
Keywords
Sexual behaviour, Sero-discordant couples, HIV
Citation
Moore, D. M., Birungi, J., khanikwa, S., Kanters, S., King, S., Maldoon, C., & Nyonyinton, M. (2015). He said, she said’: assessing dyadic agreement of reported sexual behaviour and decision-making among an HIV sero-discordant couples cohort in Uganda. Fam Plann Reprod Health Care, 43:142–146. doi:10.1136/jfprhc-2015-101323