Aggregate Versus Individual-Level Sexual Behavior Assessment: How Much Detail Is Needed to Accurately Estimate HIV/STI Risk?

Abstract

The sexual behaviors of HIV/sexually transmitted infection (STI) prevention intervention participants can be assessed on a partner-by-partner basis: in aggregate (i.e., total numbers of sex acts, collapsed across partners) or using a combination of these two methods (e.g., assessing five partners in detail and any remaining partners in aggregate). There is a natural trade-off between the level of sexual behavior detail and the precision of HIV/STI acquisition risk estimates. The results of this study indicate that relatively simple aggregate data collection techniques suffice to adequately estimate HIV risk. For highly infectious STIs, in contrast, accurate STI risk assessment requires more intensive partner-by-partner methods.

Keywords

HIV/STI prevention sexual behavior assessment risk

Get full access to this article

View all access options for this article.

References

Aral, S.O. 1993. Heterosexual transmission of HIV: The role of other sexually transmitted infections and behavior in its epidemiology prevention and control . Annual Review of Public Health 14:451-67.

Bell, D.C. , and R.A. Trevino. 1999. Modeling HIV risk. Journal of Acquired Immune Deficiency Syndromes 22:280-7.

Benotsch, E.G. , J.J. Mikytuck , K. Ragsdale , and S.D. Pinkerton. 2006. Sexual risk and HIV acquisition among men who have sex with men travelers to Key West, Florida: A mathematical modeling analysis. AIDS Patient Care and STDs 8:549-56.

Berry, M. , H.F. Raymond , and W. McFarland. 2007. Same race and older partner selection may explain higher HIV prevalence among black men who have sex with men (letter) . AIDS 21:2340-50.

Holtgrave, D.R. , L.C. Leviton , D.A. Wagstaff , and S.D. Pinkerton. 1997. Cumulative probability of HIV infection: A summary risk measure for HIV prevention intervention studies. AIDS and Behavior 1:169-72.

Holtgrave, D.R. , and S.D. Pinkerton. 2000. Consequences of HIV prevention interventions and programs: Spectrum, selection, and quality of outcome measures. AIDS 14:S27-33.

Kalichman, S.C. , D. Rompa , M. Cage , K. DiFonzo , D. Simpson , J. Austin , W. Luke , J. Buckles , F. Kyomugisha , E. Benotsch , S. Pinkerton , and J. Graham. 2001. Effectiveness of an intervention to reduce HIV transmission risks in HIVpositive people. American Journal of Preventive Medicine 21:84-92.

Katz, M.H. , and J.L. Gerberding . 1997. Postexposure treatment of people exposed to the human immunodeficiency virus through sexual contact or injection-drug use. New England Journal of Medicine 336:1097-100.

McAuliffe, T.L. , W. DiFranceisco , and B.R. Reed. 2007. Effects of question format and collection mode on the accuracy of retrospective surveys of health risk behavior: A comparison with daily sexual activity diaries. Health Psychology 26:60-7.

10.

National Institute of Mental Health Multisite HIV Prevention Trial Group. 1998. The NIMH multisite HIV prevention trial: Reducing HIV sexual risk behavior. Science 280:1889-94.

11.

Pinkerton, S.D. , and P.R. Abramson. 1993. Evaluating the risks: A Bernoulli process model of HIV infection and risk reduction. Evaluation Review 17:504-28.

12.

---. 1997. Effectiveness of condoms in preventing HIV transmission . Social Science and Medicine 9:1303-12.

13.

---, 1998. The Bernoulli-Process model of HIV transmission, applications and implications. In Handbook of economic evaluation of HIV prevention programs, ed., D. R. Holtgrave , 13-31. New York: Plenum Press.

14.

Pinkerton, S.D. , and Abramson, P.R. 1998. The Bernoulli-process model of HIV transmission: Applications and implications. In, Handbook of economic evaluation of HIV prevention programs, ed., D. R. Holtgrave , 13-32. New York: Plenum Press.

15.

Pinkerton, S.D. , H.W. Chesson , R.A. Crosby , and P.M. Layde. Forthcoming. Linearity and non-linearity in HIV/STI transmission dynamics: implications for the evaluation of sexual risk reduction interventions .

16.

Pinkerton, S.D. , H.W. Chesson , and P.M. Layde. NIMH Multisite HIV Prevention Trial Group. 2002. Utility of behavioral changes as markers of sexually transmitted disease risk reduction in sexually transmitted disease/HIV prevention trials. Journal of Acquired Immune Deficiency Syndromes 31:71-9.

17.

Pinkerton, S.D. , and D.R. Holtgrave. 1998. A method for evaluating the economic efficiency of HIV behavioral risk reduction interventions. AIDS and Behavior 2:189-201.

18.

Pinkerton, S.D. , D.R. Holtgrave , L.C. Leviton , D.A. Wagstaff , and P.R. Abramson. 1998. Model-based evaluation of HIV prevention interventions. Evaluation Review 22:155-74.

19.

Reiss, I.L. , and R.K. Leik. 1989. Evaluating strategies to avoid AIDS: Number of partners vs. use of condoms. Journal of Sex Research 26:411-33.

20.

Smith, K.W. , S.A. McGraw , S.L. Crawford , L.A. Costa , and J.B. McKinlay. 1993. HIV risk among Latino adolescents in two New England cities. American Journal of Public Health 83:1395-9.

21.

Stone, K.M. 1994. HIV, other STDs, and barriers. In Barrier contraceptives: Current status and future prospects, eds., C. K. Mauck , M. Cordero , H. L. Gabelnick , J. M. Spieler , and R. Rivera , 203-12. New York: John Wiley.

22.

Weinstein, M.C. , J.D. Graham , J.E. Siegel , and H.V. Fineberg. 1989. Cost-effectiveness analysis of AIDS prevention programs: concepts, complications, and illustrations. In AIDS: Sexual Behavior and Intravenous Drug Use, eds., C. F. Turner , H. G. Miller , and L. E. Moses , 471-99. Washington, DC : National Academy Press.