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Telling truth from Ys: an evaluation of whether the accuracy of self-reported semen exposure assessed by a semen Y-chromosome biomarker predicts pregnancy in a longitudinal cohort study of pregnancy.
MedLine Citation:
PMID:  24627289     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Adolescents may use condoms inconsistently or incorrectly, or may over-report condom use. This study used a semen exposure biomarker to evaluate the accuracy of female adolescents' reports of condom use and predict subsequent pregnancy.
METHODS: The sample comprised 715 sexually active African-American female adolescents, ages 15-21 years. At baseline, 6 months and 12 months, participants completed a 40-min interview and were tested for semen Y-chromosome with PCR from a self-administered vaginal swab. We predicted pregnancy from semen exposure under-report using multivariate regression controlling for oral contraception, reported condom use and coital frequency.
RESULTS: At the 3 surveys, 30%, 20% and 15% of adolescents who reported always using condoms tested positive for semen exposure. At 6 month follow-up, 20.4% and 16.2% of the adolescents who under-reported semen exposure reported pregnancy, a higher pregnancy rate than accurate reporters of semen exposure, even accurate reporters who reported never using condoms (14.2% and 11.8%). Under-reporters of semen exposure were 3.23 (95% CI (1.61, 6.45)) times as likely to become pregnant at 6-month follow-up and 2.21 (0.94, 5.20) times as likely to become pregnant at 12-month follow-up as accurate reporters who reported not using contraception, adjusting for self-reported coital frequency.
CONCLUSIONS: Adolescents who under-report semen exposure may be at uniquely high risk for unplanned pregnancy and STIs, and may also under-report coital frequency. Condom efficacy trials that rely on self-report may yield inaccurate results. Adapted to a clinical setting, the Y-chromosome PCR could alert women to incorrect or inconsistent condom use.
Authors:
Janet E Rosenbaum; Jonathan Zenilman; Johan Melendez; Eve Rose; Gina Wingood; Ralph Diclemente
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-13
Journal Detail:
Title:  Sexually transmitted infections     Volume:  -     ISSN:  1472-3263     ISO Abbreviation:  Sex Transm Infect     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9805554     Medline TA:  Sex Transm Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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