Abstract
Coupled gay, bisexual, and other men who have sex with men (GBMSM) are at particularly high risk for HIV, and a clear understanding of behavioral risk is key to effective interventions. Accurate behavioral self-reports are a crucial component of valid sexual health research, yet reliability of these data remains understudied. This study aimed to quantify and identify predictors of dyadic discordance in reported 3-month anal intercourse (AI) occurrence and frequency. Using cross-sectional data from 407 male couples in the U.S. (2016–2017), we calculated proportional dyadic concordance and used dyad-level logistic and linear regression to identify demographic, behavioral, and relationship traits associated with the odds of discordant frequency reports and the relative difference between discordant partner reports. Couples had high levels of concordant reports of 3-month anal AI occurrence (97%) but low interpartner agreement in reported frequency (37%). After adjustment, the odds of discordance were significantly associated with dyadic employment and differences on the Communal Coping to Reduce HIV Threat Scale (CCS) (p < .05). Among frequency-discordant couples, the mean relative difference between partner reports was 52.80% ± 35.91% (M ± SD). After adjustment, relative differences between partners’ reported AI frequencies were positively associated with interpartner differences in CCS (p < .05). These results indicate that among GBMSM couples in committed partnerships, self-reported sexual behavior data may be impacted by granularity, recall, and relationship characteristics. Further research in this area is warranted to better understand measurement error in self-reported sexual activity data.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brewer, D. D., Rothenberg, R. B., Muth, S. Q., Roberts, J. M., & Potterat, J. J. (2006). Agreement in reported sexual partnership dates and implications for measuring concurrency. Sexually Transmitted Diseases, 33(5), 277–283. https://doi.org/10.1097/01.olq.0000204746.58160.c1.
Brody, S. (1995). Patients misrepresenting their risk factors for AIDS. International Journal of STD and AIDS, 6(6), 392–398. https://doi.org/10.1177/095646249500600603.
Caceres, C., & Van Griensen, G. (1994). Male homosexual transmission of HIV-1. AIDS, 8, 1051–1061.
Carballo-Diéguez, A., Remien, R. H., Dolezal, C., & Wagner, G. (1999). Reliability of sexual behavior self-reports in male couples of discordant HIV status. Journal of Sex Research, 36(2), 152–158. https://doi.org/10.1080/00224499909551980.
Catania, J. A., Gibson, D. R., Chitwood, D. D., & Coates, T. J. (1990). Methodological problems in AIDS behavioral research: Influences on measurement error and participation bias in studies of sexual behavior. Psychological Bulletin, 108(3), 339–362. https://doi.org/10.1037/0033-2909.108.3.339.
Centers for Disease Control and Prevention. (2020). HIV Surveillance Report, 2018 (Updated) (Vol. 31). Retrieved January 4, 2020, from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.
Coates, R. A., Calzavara, L., Soskolne, C., Read, S., Fanning, M., Shepherd, F., … Johnson, J. (1988). Validity of sexual histories in a prospective study of male sexual contacts of men with AIDS or an AIDS-related condition. American Journal of Epidemiology, 128(4), 719–728. https://doi.org/10.1093/oxfordjournals.aje.a115025.
Coates, R. A., Soskolne, C. L., Calzavara, L., Read, S. E., Fanning, M. M., Shepherd, F. A., … Johnson, J. K. (1986). The reliability of sexual histories in AIDS-related research: Evaluation of an interview-administered questionnaire. Canadian Journal of Public Health, 77(5), 343–348.
Downey, L., Ryan, R., Roffman, R., & Kulich, M. (1995). How could I forget? Inaccurate memories of sexually intimate moments. Journal of Sex Research, 32(3), 177–191. https://doi.org/10.1080/00224499509551789.
Futris, T. G., Campbell, K., Nielsen, R. B., & Burwell, S. R. (2010). The Communication Patterns Questionnaire-Short Form: A review and assessment. The Family Journal, 18(3), 275–287. https://doi.org/10.1177/1066480710370758.
Gabbay, N., Lafontaine, M.-F., & Bourque, L. (2012). Factor structure and reliability assessment of the Dyadic Trust Scale with individuals in same-sex romantic relationships. Journal of GLBT Family Studies, 8(3), 258–269. https://doi.org/10.1080/1550428X.2012.677237.
Gallo, M. F., Behets, F. M., Steiner, M. J., Thomsen, S. C., Ombidi, W., Luchters, S., … Hobbs, M. M. (2007). Validity of self-reported “safe sex” among female sex workers in Mombasa, Kenya-PSA analysis. International Journal of STD and AIDS, 18(1), 33–38. https://doi.org/10.1258/095646207779949899.
Gallo, M. F., Steiner, M. J., Hobbs, M. M., Warner, L., Jamieson, D. J., & Macaluso, M. (2013). Biological markers of sexual activity: tools for improving measurement in HIV/sexually transmitted infection prevention research. Sexually Transmitted Diseases, 40(6), 447–452. https://doi.org/10.1097/OLQ.0b013e31828b2f77.
Gillmore, M. R., Leigh, B. C., Hoppe, M. J., & Morrison, D. M. (2010). Comparison of daily and retrospective reports of vaginal sex in heterosexual men and women. Journal of Sex Research, 47(4), 279–284. https://doi.org/10.1080/00224490903050584.
Goldberg, S. K., Haydon, A. A., Herring, A. H., & Halpern, C. T. (2014). Longitudinal consistency in self-reported age of first vaginal intercourse among young adults. Journal of Sex Research, 51(1), 97–106. https://doi.org/10.1080/00224499.2012.719169.
Greene, G. J., Andrews, R., Kuper, L., & Mustanski, B. (2014). Intimacy, monogamy, and condom problems drive unprotected sex among young men in serious relationships with other men: A mixed methods dyadic study. Archives of Sexual Behavior, 43(1), 73–87. https://doi.org/10.1007/s10508-013-0210-1.
Harvey, S. M., Bird, S. T., Henderson, J. T., Beckman, L. J., & Huszti, H. C. (2004). He said she said. Sexually Transmitted Diseases, 31(3), 185–191. https://doi.org/10.1097/01.OLQ.0000114943.03419.C4.
Helleringer, S., Kohler, H. P., Kalilani-Phiri, L., Mkandawire, J., & Armbruster, B. (2011). The reliability of sexual partnership histories: Implications for the measurement of partnership concurrency during surveys. AIDS, 25(4), 503–511. https://doi.org/10.1097/QAD.0b013e3283434485.
Hernández-Romieu, A. C., Sullivan, P. S., Rothenberg, R., Grey, J., Luisi, N., Sanchez, T., … Rosenberg, E. S. (2016). Concordance of demographic characteristics, sexual behaviors, and relationship attributes among sex dyads of black and white men who have sex with men. Archives of Sexual Behavior, 45(6), 1463–1470. https://doi.org/10.1007/s10508-015-0668-0.
Jaccard, J., McDonald, R., Wan, C. K., Dittus, P. J., & Quinlan, S. (2002). The accuracy of self-reports of condom use and sexual behavior. Journal of Applied Social Psychology, 32(9), 1863–1905. https://doi.org/10.1111/j.1559-1816.2002.tb00263.x.
James, N. J., Bignell, C. J., & Gillies, P. A. (1991). The reliability of self-reported sexual behaviour. AIDS, 5(3), 333–336. https://doi.org/10.1097/00002030-199103000-00016.
Kauth, M. R., St Lawrence, J. S., & Kelly, J. A. (1991). Reliability of retrospective assessments of sexual HIV risk behavior: A comparison of biweekly, three-month, and twelve-month self-reports. AIDS Education and Prevention, 3(3), 207–214.
Maguire, M. C. (1999). Treating the dyad as the unit of analysis: A primer on three analytic approaches. Journal of Marriage and the Family, 61(1), 213. https://doi.org/10.2307/353895.
Mark, K. P., Smith, R. V., Young, A. M., & Crosby, R. (2017). Comparing 3-month recall to daily reporting of sexual behaviours. Sexually Transmitted Infections, 93, 196–201. https://doi.org/10.1136/sextrans-2016-052556.
McCallum, E. B., & Peterson, Z. D. (2012). Investigating the impact of inquiry mode on self-reported sexual behavior: Theoretical considerations and review of the literature. Journal of Sex Research, 49, 212–226. https://doi.org/10.1080/00224499.2012.658923.
McLaws, M. L., Cooper, D. A., Oldenburg, B., & Ross, M. W. (1990). Sexual behaviour in AIDS-related research: Reliability and validity of recall and diary measures. Journal of Sex Research, 27(2), 265–281. https://doi.org/10.1080/00224499009551556.
Mustanski, B., Newcomb, M. E., & Clerkin, E. M. (2011). Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychology, 30(5), 597–605. https://doi.org/10.1037/a0023858.
Mustanski, B., Starks, T., & Newcomb, M. E. (2014). Methods for the design and analysis of relationship and partner effects on sexual health. Archives of Sexual Behavior, 43(1), 21–33. https://doi.org/10.1007/s10508-013-0215-9.
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2016). Drinking levels defined. Retrieved February 13, 2017, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking.
Neal, S. E., & Hosegood, V. (2015). How reliable are reports of early adolescent reproductive and sexual health events in demographic and health surveys? International Perspectives on Sexual and Reproductive Health, 41(4), 210–217. https://doi.org/10.1363/intsexrephea.41.4.0210.
Nyitray, A. G., Harris, R. B., Abalos, A. T., Nielson, C. M., Papenfuss, M., & Giuliano, A. R. (2010). Test-retest reliability and predictors of unreliable reporting for a sexual behavior questionnaire for U.S. men. Archives of Sexual Behavior, 39(6), 1343–1352. https://doi.org/10.1007/s10508-009-9522-6.
Nyitray, A. G., Kim, J., Hsu, C. H., Papenfuss, M., Villa, L., Lazcano-Ponce, E., & Giuliano, A. R. (2009). Test-retest reliability of a sexual behavior interview for men residing in Brazil, Mexico, and the United States. American Journal of Epidemiology, 170(8), 965–974. https://doi.org/10.1093/aje/kwp225.
Ochs, E. P., & Binik, Y. M. (1999). The use of couple data to determine the reliability of self-reported sexual behavior. Journal of Sex Research, 36(4), 374–384. https://doi.org/10.1080/00224499909552010.
Palen, L.-A., Smith, E. A., Caldwell, L. L., Flisher, A. J., Wegner, L., & Vergnani, T. (2008). Inconsistent reports of sexual intercourse among South African high school students. Journal of Adolescent Health, 42(3), 221–227. https://doi.org/10.1016/j.jadohealth.2007.08.024.
Patel, P., Borkowf, C. B., Brooks, J. T., Lasry, A., Lansky, A., & Mermin, J. (2014). Estimating per-act HIV transmission risk: A systematic review. AIDS, 28(10), 1509–1519. https://doi.org/10.1097/QAD.0000000000000298.
Petry, N. M. (2001). Reliability of drug users’ self-reported HIV risk behaviors using a brief, 11-item scale. Substance Use and Misuse, 36(12), 1731–1747. https://doi.org/10.1081/JA-100107576.
Potterat, J. J., Phillips, L., & Muth, J. B. (1987). Lying to military physicians about risk factors for HIV infections. Journal of the American Medical Association, 257, 1727. https://doi.org/10.1001/jama.1987.03390130045010.
Ritchie, A. J., Kuldanek, K., Moodie, Z., Wang, Z. M., Fox, J., Nsubuga, R. N., … Fidler, S. (2012). Comparison of sexual behavior and HIV risk between two HIV-1 serodiscordant couple cohorts: The CHAVI 002 Study. PLoS ONE, 7. https://doi.org/10.1371/journal.pone.0037727.
Ross, M. W. (1984). Sexually transmitted diseases in homosexual men: A study of four societies. British Journal of Venereal Diseases, 60(1), 52–55. https://doi.org/10.1136/sti.60.1.52.
Salazar, L. F., Stephenson, R. B., Sullivan, P. S., & Tarver, R. (2013). Development and validation of HIV-related dyadic measures for men who have sex with men. Journal of Sex Research, 50(2), 164–177. https://doi.org/10.1080/00224499.2011.636845.
Saltzman, S. P., Stoddard, A. M., McCusker, J., Moon, M. W., & Mayer, K. H. (1987). Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men. Public Health Reports, 102(6), 692–697.
Sanchez, D. M., Schoenbach, V. J., Harvey, S. M., Warren, J. T., Poole, C., Leone, P. A., … Agnew, C. R. (2016). Can young adults accurately report sexual partnership dates? Factors associated with interpartner and dyad agreement. Sexually Transmitted Diseases, 43(5), 324–331. https://doi.org/10.1097/OLQ.0000000000000428.
Sanders, S. A., Hill, B. J., Yarber, W. L., Graham, C. A., Crosby, R. A., & Milhausen, R. R. (2010). Misclassification bias: Diversity in conceptualisations about having had sex. Sexual Health, 7(1), 31–34. https://doi.org/10.1071/SH09068.
Schroder, K. E. E., Carey, M. P., & Vanable, P. A. (2003a). Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Annals of Behavioral Medicine, 26, 76–103. https://doi.org/10.1207/S15324796ABM2602_02.
Schroder, K. E. E., Carey, M. P., & Vanable, P. A. (2003b). Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Annals of Behavioral Medicine, 26(2), 104–123. https://doi.org/10.1207/S15324796ABM2602_03.
Shacham, E., & Cottler, L. B. (2010). Sexual behaviors among club drug users: Prevalence and reliability. Archives of Sexual Behavior, 39(6), 1331–1341. https://doi.org/10.1007/s10508-009-9539-x.
Sharma, A., Kahle, E. M., Sullivan, S., & Stephenson, R. B. (2020). Relationship characteristics associated with perceptions of partners’ HIV testing behavior among male couples. AIDS and Behavior, 24, 516–531. https://doi.org/10.1007/s10461-019-02740-0.
Starks, T. J., Tuck, A. N., Millar, B. M., & Parsons, J. T. (2016). Linking syndemic stress and behavioral indicators of main partner HIV transmission risk in gay male couples. AIDS and Behavior, 20(2), 439–448. https://doi.org/10.1007/s10461-015-1248-y.
Stephenson, R., Freeland, R., Sullivan, S. P., Riley, E., Johnson, B. A., Mitchell, J., … Sullivan, P. S. (2017). Home-based HIV testing and counseling for male couples (Project Nexus): A protocol for a randomized controlled trial. JMIR Research Protocols, 6(5), e101. https://doi.org/10.2196/resprot.7341.
Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23(9), 1153–1162. https://doi.org/10.1097/QAD.0b013e32832baa34.
Tourangeau, R., Rips, L. J., & Rasinski, K. (2000). The psychology of survey response. New York: Cambridge University Press.
Upchurch, D. M., Weisman, C. S., Shepherd, M., Brookmeyer, R., Fox, R., Celentano, D. D., … Hook, E. W. (1991). Interpartner reliability of reporting of recent sexual behaviors. American Journal of Epidemiology, 134(10), 1159–1166. https://doi.org/10.1093/oxfordjournals.aje.a116019.
Van Duynhoven, Y. T. H. P., Nagelkerke, N. J. D., & Van De Laar, M. J. W. (1999). Reliability of self-reported sexual histories: Test-retest and interpartner comparison in a sexually transmitted diseases clinic. Sexually Transmitted Diseases, 26(1), 33–42. https://doi.org/10.1097/00007435-199901000-00006.
Williams, M. L., Freeman, R. C., Bowen, A. M., Zhao, Z., Elwood, W. N., Gordon, C., … Signes, C. A. (2000). A comparison of the reliability of self-reported drug use and sexual behaviors using computer-assisted versus face-to-face interviewing. AIDS Education and Prevention, 12(3), 199–213.
Witte, S. S., El-Bassel, N., Gilbert, L., Wu, E., & Chang, M. (2007). Predictors of discordant reports of sexual and HIV/sexually transmitted infection risk behaviors among heterosexual couples. Sexually Transmitted Diseases, 34(5), 302–308. https://doi.org/10.1097/01.olq.0000240288.90846.6a.
Zimmerman, R. S., Morisky, D. E., Harrison, L., & Mark, H. D. (2014). Validity of behavioral measures as proxies for HIV-related outcomes. Journal of Acquired Immune Deficiency Syndromes, 66(03), S285–S292. https://doi.org/10.1097/QAI.0000000000000241.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interests.
Financial Support
This work is supported by the National Child Health and Human Development of the National Institutes of Health under award number R01HD078131. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Ethical Standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Walsh, A.R., Stephenson, R. Assessing the Reliability of Self-Reported Sexual Behavior Among Male Couples. Arch Sex Behav 50, 1067–1086 (2021). https://doi.org/10.1007/s10508-020-01857-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-020-01857-x