‘Measuring Sexual Behavior in the Era of HIV/AIDS: The Experience of Demographic and Health Surveys and Similar Enquiries’

Department of Maternal and Child Health and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA. .
Sexually Transmitted Infections (Impact Factor: 3.4). 01/2005; 80 Suppl 2(suppl_2):ii22-7. DOI: 10.1136/sti.2004.011650
Source: PubMed


To review the sexual behaviour data collected in the Demographic and Health Surveys (DHS) and other similar national surveys from the perspective of data quality.
Two indicators of premarital and higher risk sexual behaviour were analysed for 31 surveys in 10 countries in sub-Saharan Africa and Latin America and the Caribbean. The analysis focused on the internal consistency of trends and gender differences in the reported indicators.
The authors found fluctuating trends in premarital sex in sub-Saharan Africa but consistent increases in Latin America and the Caribbean. Changes in questionnaire design do not seem to contribute to these trends and there is evidence that the increase in premarital sex is genuine in Latin America. Trends in sex with non-spousal, non-cohabiting partners show large fluctuations and inconsistencies between surveys in some countries but not others. Men are consistently more likely to report non-marital sexual partners than women and unmarried women are less likely than unmarried men to report casual partners.
Surveys are potentially a valuable source of information on sexual behaviour but there are sufficient grounds for concern to warrant considerable caution in the use of survey data to monitor trends in sexual behaviour. Survey findings must be evaluated carefully and interpreted in the context of other available information. These results caution against placing heavy emphasis on short term changes in sexual behaviour between individual surveys and highlight the need for attention to quality in data collection.

Download full-text


Available from: Siân L Curtis
  • Source
    • "Although not entirely related, a multi-country study that examined sexual behaviour using DHS data found high levels of validity of the measures of sexual behaviour. These observations point to minimal problems associated with the validity of responses generated from the DHS [35]. A recent analysis of some popular questions that are used to measure misconceptions about HIV, which have been adopted for TB, also found positive indications about validity [36]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Myths and misconceptions about TB can serve as a barrier to efforts at reducing stigmatisation of people infected and affected by the disease. Understanding such drivers of myths and misconceptions is important for improving information, education and communication (IEC) efforts of national control and preventive interventions. This study therefore assesses the influence of interaction of spatial, socioeconomic and demographic characteristics on myths and misconceptions. Data was drawn from male (N = 4,546) and female (N = 4,916) files of the 2008 Ghana Demographic and Health Survey. A myth and misconception variable was created from five-related constructs with internal consistency score of r = 0. 8802 for males (inter-item correlation: 0.5951) and for females, r = 0. 0.9312 (inter-item correlation: 0.7303). The Pearson Chi-square was used to test the bivariate relationship between the independent variables and the dependent variable. Logistic regression was subsequently used to explore the factors determining myths and misconceptions of TB transmission. Majority of Ghanaians (males: 66.75%; females: 66.13%) did not hold myths and misconceptions about TB transmission. Females resident in the Upper East (aOR = 0.31, CI = 0.17-0.55) and Upper West (aOR = 0.41, CI = 0.24-0.69) and males resident in the Northern (aOR = 0.23, CI = 0.13-0.39) and the Greater Accra (aOR = 0.25, CI = 0.16-0.39) regions were independently associated with no misconceptions about TB transmission. Significant differences were also found in education, ethnicity and age. That spatial and other socioeconomic difference exists in myths and misconceptions suggest the need for spatial, socioeconomic and demographic segmentations in IEC on TB. This holds potentials for reaching out to those who are in critical need of information and education on the transmission processes of TB.
    Full-text · Article · Sep 2013 · BMC International Health and Human Rights
  • Source
    • "For instance, individual covariate information is likely to be unreliable or sparse when dealing with sensitive topics, such as risky sexual behavior, fidelity, or drug use [23]. Sensitive issues such as partaking in risky sexual behavior are of course associated with hiv status, and studies suggest that there are inconsistencies in reporting of sexual behavior in Demographic Health Surveys (dhs) [24,25]. Further, using dhs data from Zambia, one recent study concluded that models based on observed covariates (i.e. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Many HIV prevalence surveys are plagued by the problem that a sizeable number of surveyed individuals do not consent to contribute blood samples for testing. One can ignore this problem, as is often done, but the resultant bias can be of sufficient magnitude to invalidate the results of the survey, especially if the number of non-responders is high and the reason for refusing to participate is related to the individual's HIV status. One reason for refusing to participate may be for reasons of privacy. For those individuals, we suggest offering the option of being tested in a pool. This form of testing is less certain than individual testing, but, if it convinces more people to submit to testing, it should reduce the potential for bias and give a cleaner answer to the question of prevalence. This paper explores the logistics of implementing a combined individual and pooled testing approach and evaluates the analytical advantages to such a combined testing strategy. We quantify improvements in a prevalence estimator based on this combined testing strategy, relative to an individual testing only approach and a pooled testing only approach. Minimizing non-response is key for reducing bias, and, if pooled testing assuages privacy concerns, offering a pooled testing strategy has the potential to substantially improve HIV prevalence estimates.
    Full-text · Article · Feb 2013 · Emerging Themes in Epidemiology
  • Source
    • "The authors recommend using likelihood techniques; however, they caution that the 'numerics can be delicate'. factors is likely to exhibit large measurement errors, and therefore including these factors as explanatory variables in regressions can produce biased estimates and unreliable results (Curtis and Sutherland, 2004). Obtaining accurate results is critical because the results have a potential impact on policy formulation. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Using data from the Demographic and Health Survey, this article analyses the relationship between HIV status and the socio‐economic and demographic characteristics of adults in Lesotho, Malawi, Swaziland and Zimbabwe. It constructs the risk profile of the average adult, computes the values of age, education and wealth where the estimated probability of infection assumes its highest value, and determines the percentage of adults for whom these three factors are positively correlated with that probability. It finds that in all four countries: (i) the probability of being HIV‐positive is higher for women than for men; (ii) the likelihood of infection is higher for urban than for rural residents; and (iii) there is an inverted‐U relationship between age and HIV status. Also that, unlike gender, rural/urban residence and age, the relationship between the probability of infection and wealth, education and marital status varies by country. The results provide support for country‐specific and more targeted HIV policies and programmes.
    Full-text · Article · May 2012 · Development Policy Review
Show more