'He said, she said': assessing dyadic agreement of reported sexual behaviour and decision-making among an HIV sero-discordant couples cohort in Uganda. Issue 2 (30th March 2016)

• Record Type: Journal Article
• Authors: Muldoon, Katherine A; Kanters, Steve; Birungi, Josephine; King, Rachel L; Nyonyintono, Maureen; Khanakwa, Sarah; Moore, David M
• Is Part Of: Journal of family planning and reproductive health care. Volume 43:Issue 2(2017)
• Page Start: 142
• Page End: 146
• Publication Date: 2016-03-30
• Subjects: human immunodeficiency virus -- decision-making -- sexual behaviour -- condom -- statistics -- family planning service provision; Birth control -- Periodicals; Contraception -- Periodicals; Reproductive health -- Periodicals; 613.905
• DOI: 10.1136/jfprhc-2015-101323
• Languages: English
• ISSNs: 1471-1893

Abstract

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.