Limited benefit of repeating a sensitive question in a cross-sectional sexual health study
1 Division of Infectious Diseases, College of Medicine, Ohio State University, Columbus, OH, USA
2 Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA
BMC Medical Research Methodology 2013, 13:34 doi:10.1186/1471-2288-13-34Published: 9 March 2013
Sexual health research relies heavily on self-reported data. We explored whether repeating a key measure – number of lifetime sexual partners – improved the validity of this self-reported response.
Using data from a study of Tanzanian plantation residents, we examined which of 505 participants changed their responses when a question about sexual partners was repeated. We examined which variable (first, second, or maximum response) was more predictive of herpes simplex virus type 2 (HSV-2) seropositivity, a biomarker strongly associated with number of lifetime partners. HSV-2 status was assessed using the HerpeSelect 2 ELISA IgG test.
When asked a second time, 10.7% of participants increased and 3.6% decreased their reported number of partners. Participants using audio computer-assisted self-interviews were more likely to change than those interviewed in person (p = 0.006). The increased odds of HSV-2 seropositivity with each additional partner ranged from 10% to 13% in men, and 33% to 37% in women, depending on which partner variable was used. Estimates had considerable confidence interval overlap and no substantial differences in precision.
Some participants change their responses when asked a sensitive question a second time, but in this population, changes did not meaningfully affect associations between lifetime partners and HSV-2.