Comparisons of reported sexual behaviors from a retrospective survey versus a prospective diary in the Botswana Defence Force

Evaluating Recall Periods for Patient-Reported Outcome Measures: A Systematic Review of Quantitative Methods

OBJECTIVES

The current guidance for selection of recall periods recommends considering the design of the study, nature of the condition, patient's burden and ability to recall, and intent of the outcome measure. Empirical study of the accuracy of recall periods is recommended; however, there is not consensus on how to quantitatively evaluate the consistency of results from patient-reported outcome measures (PROMs) with different recall periods. We conducted a systematic review to describe quantitative methods for evaluating results obtained from PROMs with differing recall periods to lay the groundwork for establishing consensus.

METHODS

We searched MEDLINE, Embase, Scopus, and American Psychological Association PsycINFO for studies where participants are given the same health-related measure (eg, quality of life, well-being, functioning, and pain) with differing recall periods.

RESULTS

A total of 7174 abstracts were screened. The 30 included studies reflected a wide range of domains, including pain, fatigue, and sexual behavior and function. The recall periods ranged from momentary to 6 months. The analytic approaches varied, including different methods for assessing relative agreement, absolute agreement, and for assessing combined relative and absolute agreement.

CONCLUSIONS

We found variability in how PROM recall periods were evaluated, suggesting an opportunity for greater consensus on methodological approach. As a starting point, we provide recommendations for which methods are preferred for which contexts.

A qualitative exploration on accounts of condom-use negotiation with clients: challenges and predicaments related to sex work among street-based female sex workers in Ekurhuleni District, South Africa

INTRODUCTION

female sex workers (FSWs) are the key vulnerable populations since they carry the high burden of HIV and sexually transmitted infections (STIs). However, the vulnerability of street-based FSWs to HIV/STIs is much higher than that of the establishment-based FSWs. The study aimed to explore street-based FSWs' condom negotiation skills, barriers to condom use as well as the challenges and predicaments they face on a daily basis.

METHODS

an exploratory qualitative approach using focus group discussions was conducted among FSWs working in a major provincial road in a district of Gauteng Province. Thematic content analysis using NVivo version 10 software was conducted.

RESULTS

the age range of the FSWs was 19 to 44 years. The themes that emerged from the data on challenges to negotiation and condom use among FSWs revealed the ways condoms are used in early sex work and over time, ways of enforcing condom used, preferred types of condoms and the predicaments to working in the sex trade. FSWs gained experience of negotiating condom use over time in their work. Both female and male condoms were available and accurate insertion of condoms was reported. Male condom was preferred. Condom use strategies included direct request; using health-information messages; charging more for condomless sex; and refusing condomless sex. The FSW reported the risks of violent attacks of unregulated street-based environment.

CONCLUSION

condom negotiation strategies illustrated that peer-education and sharing experiences among themselves were beneficial for protective sexual behaviours. Peer-education benefits and peer-interactions yielded assertive attitudes and behaviours of demanding and/or enforcing condom use.

An intervention study examining the effects of condom wrapper graphics and scent on condom use in the Botswana Defence Force

Free condoms provided by the government are often not used by Botswana Defence Force (BDF) personnel due to a perceived unpleasant scent and unattractive wrapper. Formative work with the BDF found that scented condoms and military-inspired (camouflage) wrapper graphics were appealing to personnel. A non-randomized intervention study was implemented to determine whether condom wrapper graphics and scent improved condom use in the BDF. Four military sites were selected for participation. Two sites in the south received the intervention condom wrapped in a generic wrapper and two sites in the north received the intervention condom wrapped in a military-inspired wrapper; intervention condoms were either scented or unscented. Two hundred and eleven male soldiers who ever had sex, aged 18-30 years, and stationed at one of the selected sites consented to participate. Sexual activity and condom use were measured pre- and post-intervention using sexual behavior diaries. A condom use rate (CUR; frequency of protected sex divided by the total frequency of sex) was computed for each participant. Mean CURs significantly increased over time (85.7% baseline vs. 94.5% post-intervention). Adjusted odds of condom use over time were higher among participants who received the intervention condom packaged in the military wrapper compared with the generic wrapper. Adjusted odds of condom use were also higher for participants who reported using scented vs. unscented condoms. Providing scented condoms and condoms packaged in a military-inspired wrapper may help increase condom use and reduce HIV infection among military personnel.