Safer Sex Behaviors Research Articles

Status and associated characteristics of HIV disclosure among people living with HIV/AIDS in Liangshan, China: A cross-sectional study.

Human immunodeficiency virus (HIV) disclosure is a prerequisite to get access to antiretroviral therapy (ART) and social support. Increased disclosure of HIV status has been shown to reduce mother-to-child transmission and high-risk sexual behaviors. Limited studies were conducted to get an insight into HIV disclosure among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLWHA) in Liangshan.Our study aimed to investigate the status and associated characteristics of HIV disclosure among PLWHA in Liangshan.We conducted a cross-sectional study using a stratified, convenience sampling method from August to December in 2017. All of the participants were from Liangshan, a typical impoverished mountainous area which also has a long history of drug production and drug trade. Each participant completed a structured questionnaire including HIV disclosure status, demographic and HIV-related characteristics, social support, and perceived HIV-related stigma. We performed a binary regression analysis to detect associated characteristics of HIV disclosure among PLWHA in Liangshan.A final sample size of 318 participants was included in this study. The overall prevalence of HIV disclosure was 83.6% (266/318). In binary logistic regression analysis, PLWHA who had higher educational levels, and got infected by sexual transmission were less likely to disclose their HIV status (both P < .05). HIV nondisclosure was correlated with a higher level of perceived HIV-related stigma (P < .01).The prevalence of HIV disclosure was relatively low in Liangshan. Healthcare workers are suggested to conduct more counseling and education to promote safe sexual behaviors and reduce perceived stigma among PLWHA, then enhance HIV serostatus disclosure.

Assessment of Parent-Based Interventions for Adolescent Sexual Health

Parent-based sexual health interventions have received considerable attention as one factor that can increase safer sexual behavior among youth; however, to our knowledge, the evidence linking parent-based interventions to youth sexual behaviors has not been empirically synthesized. To examine the association of parent-based sexual health interventions with 3 primary youth outcomes-delayed sexual activity, condom use, and parent-child sexual communication-as well as several secondary outcomes. We also explored potential moderators of intervention effectiveness. A systematic search was conducted of studies published through March 2018 using MEDLINE, PsycINFO, Communication Source, and CINAHL databases and relevant review articles. Studies were included if they: (1) sampled adolescents (mean age, ≤18 years), (2) included parents in a key intervention component, (3) evaluated program effects with experimental/quasi-experimental designs, (4) included an adolescent-reported behavioral outcome, (5) consisted of a US-based sample, and (6) were published in English. Standardized mean difference (d) and 95% confidence intervals were computed from studies and meta-analyzed using random-effects models. A secondary analysis evaluated potential moderating variables. The primary outcomes were delayed sexual activity, condom use, and sexual communication. Independent findings from 31 articles reporting on 12 464 adolescents (mean age = 12.3 years) were synthesized. Across studies, there was a significant association of parent-based interventions with improved condom use (d = 0.32; 95% CI, 0.13-0.51; P = .001) and parent-child sexual communication (d = 0.27; 95% CI, 0.19-0.35; P = .001). No significant differences between parent-based interventions and control programs were found for delaying sexual activity (d = -0.06; 95% CI, -0.14 to 0.02; P = .16). The associations for condom use were heterogeneous. Moderation analyses revealed larger associations for interventions that focused on younger, compared with older, adolescents; targeted black or Hispanic youth compared with mixed race/ethnicity samples; targeted parents and teens equally compared with emphasizing parents only; and included a program dose of 10 hours or more compared with a lower dose. Parent-based sexual health programs can promote safer sex behavior and cognitions in adolescents, although the findings in this analysis were generally modest. Moderation analyses indicated several areas where future programs could place additional attention to improve potential effectiveness.

Psychosocial Factors Associated with Quality of Life in Young Men Who Have Sex with Men Living with HIV/AIDS in Zhejiang, China.

Objectives: To explore the quality of life (QOL) status and related factors in young human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) aged 16 to 24 years in Zhejiang province. Methods: A cross-sectional study was conducted in 22 counties of Zhejiang province, and 395 subjects took part in our research. A t-test, one-way Analysis of variance (ANOVA), and multivariate stepwise linear regression analysis were used to investigate the factors associated with QOL in young HIV-infected MSM. Results: The total score on the QOL was 86.86 ± 14.01. The multivariate stepwise linear regression analysis revealed that self-efficacy and discrimination were associated with all domains on the QOL assessment, monthly income was associated with QOL for all domains except spirituality and consistent condom use during oral sex with men in the past three months was associated with QOL for all domains except the relationship domain. Those individuals within the group of young HIV-infected MSM who have higher self-efficacy, a higher monthly income, greater social support, safer sexual behaviors, a higher level of education, and a higher cluster of differentiation 4 (CD4) count have a better QOL. Conclusions: These findings suggest that to improve the QOL of this population, greater emphasis should be placed on improving social support, self-efficacy, and antiviral therapy adherence and on reducing discrimination, disease progression, and high-risk behaviors.

HIV-related stigma, knowledge about HIV, HIV risk behavior and HIV testing motivation among women in Lampung, Indonesia

This study aims to identify factors that influence HIV testing motivation among women at the Dr. H. Abdul Moeloek General Hospitalin Lampung, Indonesia. A cross-sectional method was used in this study that employed a consecutive sampling technique involving 120 women with HIV. The participants were outpatients at the Voluntary Counseling and Testing (VCT) Dr. H. Abdul Moeloek General Hospital. This study utilized three instruments: the Berger HIV Stigma Scale, HIV Knowledge Questionnaire (HIV-KQ-18) and Safe Sex Behavior Questionnaire (SSBQ). The study examined factors that influence HIV testing motivation among women: HIV-related stigma, knowledge about HIV and HIV risk behavior. The results of the analysis showed that there is a significant relationship among the HIV-related stigma variable (p=0.019, OR=2.727), knowledge about HIV variable (p=0.011, OR=3.750) and HIV risk behavior variable (p=0.041, OR=2.381). The most dominant factor influencing HIV testing motivation is HIV risk behavior (p=0.016, ά=0.05 at 95% CI and OR=3.217). This indicates that Women Living With HIV (WLWH) who engage in risk HIV behavior demonstrate 3.2 times to HIV testing motivation. HIV-related stigma, knowledge about HIV and HIV risk behavior influence HIV testing motivation for women. Our findings have implications for nursing and healthcare practice as well as research, especially in supporting HIV testing for women who are at risk for HIV. Nurses should focus their attention on motivating women with a high risk of HIV to undergo early HIV testing.

Are current guidelines adapted for patient eligibility to PrEP? A case report

BackgroundDespite effective antiretroviral therapy developed over the last decade, HIV infection remains a major worldwide public health problem. Recently, a promising preventive treatment has been made available for HIV prophylaxis, PrEP for pre-ExPosure Prophylaxis. Indeed, it was shown to significantly reduce the risk of HIV infection in patients exposed to high risk of infection such as men having sex with men (MSM), heterosexuals and people who inject drugs. Several issues pertaining to PrEP remain uncertain including short and long-term adverse events, drug resistance, risk compensation and resurgence of other sexually transmitted infections.Case presentationWe report a case of a 52-year-old MSM eligible for PrEP as he was exposed to a high risk of HIV infection, presented no clinical symptoms of HIV primary infection and was seronegative for HIV. PrEP therapy was then initiated with fixed association of emtricitabine-tenofovir disoproxil. One month later, HIV tests using two different assays were positive, despite perfect compliance reported by the patient and confirmed by plasma drug level. A retrospective search for plasma viral RNA in the blood sample before PrEP initiation turned out positive. Genotyping and treatment sensitivity performed on sample after one month of PrEP showed a virus resistance to lamivudine and emtricitabine.Similar cases in the literature and pivotal studies have reported HIV infections in patients initiating or undergoing PrEP. These patients where either infected but still seronegative, displaying no clinical symptoms upon enrollment, or became infected during PrEP. Reasons are mainly poor compliance to treatment, resistance to PrEP, and lack of diagnosis before PrEP. Guidelines advocate safe sex behavior before initiation, search for clinical signs of HIV primary infection and two different serologic tests performed with one-month interval.Discussion and conclusionsOur patient newly HIV infected received PrEP as he was still seronegative. Current recommendations fail to screen recently HIV infected, but still seronegative patients who are initiating PrEP. This issue raises strong concerns regarding the lack of adequate selection for eligibility to PrEP and may contribute to exposing partners to HIV infection and select viral mutations. Infection risk could be minimized by search for plasma viral HIV RNA at pre-inclusion, at least for patients suspected of unsafe behaviors such as non-respect of the non-exposure period before PrEP initiation.

Characterizing herpes simplex virus type 1 and type 2 seroprevalence declines and epidemiological association in the United States.

ObjectiveAssessing the epidemiological association between herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) infections in the United States, and characterizing the trends in the standardized HSV-1 and HSV-2 antibody prevalences (seroprevalences), 1999–2016.MethodsSource of data was the cross-sectional and nationally-representative biennial surveys of the National Health and Nutrition Examination Survey (NHANES). All nine NHANES rounds for 1999–2016 were included in analysis. Datasets of these rounds were combined and analyzed accounting for survey design and applying weighting procedures. Logistic regressions were used to identify associations with seropositivity. Sensitivity analyses were conducted.ResultsOdds of HSV-1 infection declined by 2.84% (95% CI: 1.70%-4.00%) annually among men, and by 2.22% (95% CI: 1.23%-3.21%) among women. Declines were highest at younger ages. Odds of HSV-2 infection declined by 2.23% (95% CI: 0.71%-3.82%) annually among men, and by 2.89% (95% CI: 1.57%-4.28%) among women. Odds ratio of the association between HSV-2 and HSV-1 seropositivity was 0.71 (95% CI: 0.60–0.84) for men and 0.81 (95% CI: 0.72–0.91) for women, after adjustment for age, ethnicity, and year.ConclusionHSV-1 and HSV-2 seroprevalences showed a strong declining trend for at least two decades, for both sexes and for the different ethnicities, possibly reflecting improvements in hygiene and living conditions (for HSV-1), and safer sexual behavior (for HSV-2). HSV-1 seroprevalence declines are most pronounced among young individuals. There is evidence for cross protection between the two infections, suggestive of HSV-1 seropositivity being partially protective against HSV-2 infection.

The relationship between social norms and sexual risk-reduction intentions and behavior among men who have sex with men: Findings from an eHealth intervention.

Normative-based research has found that norms are significant predictors of safe sex behavioral intentions and behavior. Research shows that group identity moderates the relationship between norms and intentions/behavior. The present study used the theory of normative social behavior to evaluate whether identification with characters in an HIV-prevention interactive video moderated the relationship between sexual risk-taking norms and risk reduction intentions/behavior. Participants included 540 men between the ages 18 and 30 enrolled in a randomized controlled trial with a 3-month follow-up. We found support for the hypothesized interaction. At low levels of character identification, the negative relationship between sexual risk-taking norms and risk reduction intentions was strong. However, as character identification increased, the link between norms and intentions became weaker. The mean intentions score of high-risk norm participants was elevated to the level reported by low risk norm participants, demonstrating the favorable effect of character identification on narrative persuasion in entertainment-education. The utility of a social norms approach to health behavior change is discussed in the context of eHealth interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Smartphone Battery Levels and Sexual Decision-Making Among Men Who Have Sex with Men

Smartphone-dating and hook-up apps are undeniable factors in the modern landscape of sexuality. In particular, gay and bisexual men have bridged social and societal barriers for connection by using these apps. Despite advantages afforded by such technological advancements, when individuals are faced with a low phone battery, a sense of urgency may be experienced, which can increase risk-taking behaviours to accommodate an impending phone “death”. The purpose of this study was to determine whether a draining smartphone battery would facilitate a greater likelihood of agreeing to a hookup encounter. Participants were randomly assigned to one of three battery life condition groups (5%, 20%, 100%) and were asked how likely they were to agree to a hookup with a simulated potential sexual partner. We discovered that, relative to a full battery condition, participants were more likely to agree to a hookup in the lowest battery condition. Additionally, men who reported a greater likelihood of agreeing to a hookup also endorsed a greater propensity for sensation seeking, regardless of the battery condition. These findings have practical implications for educating smartphone users who utilize dating and hookup apps about how scarcity decision-making and sensation-seeking can impact the ability to practice safe sexual behaviours.

Assessing consistent condom use among migrant men who have sex with men in Shanghai, China: validation of an information\u2013motivation\u2013behavioural skills model

BackgroundIn China, high prevalence of risky sexual behaviours and inequity in health services lead to situations in which migrant men who have sex with men face higher risk of contracting the human immunodeficiency virus. Consistent condom use is a primary means of preventing HIV infection during anal sex among MSM. This study aimed to apply the information–motivation–behavioural skills model to examine the predictors of consistent condom use among migrant MSM in Shanghai, and tested the associations between model constructs.MethodsA cross-sectional study was conducted among 412 migrant MSM in Shanghai. Data on HIV-related information, motivation, behavioural skills, and behaviours were collected via structured questionnaires. A structural equation model was used to assess the IMB model.ResultsOf the 412 participants, 4.4% reported HIV-positive status, and prevalence of consistent condom use in the previous 6 months was 44.9%. A restricted IMB model provided an acceptable fit to the data. Behavioural skills were found to directly predict consistent condom use (β = 0.629, P < 0.01). Neither information nor motivation could directly predict consistent condom use (P > 0.05), but motivation predicted it indirectly and was mediated by behavioural skills.ConclusionThe prevalence of consistent condom use was found to be relatively low among migrant MSM in Shanghai. The restricted IMB model was found to be a good predictor of consistent condom use among them. The results of this study indicate that intervention strategies for safer sexual behaviour should not only include information dissemination, but also emphasize motivation and behavioural skills among this population.

Health Education Training Embedded in a Microfinance Platform Associated with Safer Sexual Behavior in Haitian Women.

Sexual health education interventions have generally yielded modest impact, but may be more successful when integrated into programs designed to alleviate poverty and empower women. Between December 2017 and February 2018, we interviewed 304 Haitian female microfinance clients, 75 of whom had received health education training delivered within their regular meetings. Participants reported six key sexual health outcomes. We used log-binomial models to estimate the association between health education training and each outcome, and tested for interaction by age and literacy status. Women with health education training reported more condom use with unfaithful partners [PR (95% CI) 1.78 (1.04, 3.02)], more HIV testing [PR (95% CI) 1.56 (1.28, 1.90)], and fewer STI symptoms [PR (95% CI) 0.37 (0.19, 0.73)], compared to women with no training. Some of the associations were stronger among older women [e.g. HIV testing: PR (95% CI) 2.09 (1.49, 2.82)] and illiterate women [e.g. condom use: PR (95% CI) 3.46 (1.05, 11.38)]. These findings add to the growing body of evidence demonstrating the potential to use microfinance programs as platforms for health education delivery, and provide the first evidence for the association in Haiti.

Modifying Sexual Risk Health Behavior Change Models to Incorporate Alcohol-Related Factors

Objectives: Theories and models that address harmful health behaviors often do not incorporate factors related to alcohol.Methods: The aim of this article is to review the role of alcohol use on risky sexual behavior and to suggest how alcohol-related factors can be incorporated into health behavior change models.Results: Suggestions for modifying health behavior change models are presented, including integrating motivation and volition phases of models with a preconsumption and consumption phase of alcohol use.Conclusions: These modifications may be useful in developing interventions designed to increase the occurrence of safer sex behaviors affected by alcohol and other drugs.

Behavioral Interventions to Enhance PrEP Uptake Among Black Men Who Have Sex With Men

In the United States, nearly 500,000 men who have sex with men (MSM) are at risk of contracting HIV. Men who have sex with men constitute 70% of all new cases of HIV in the United States; within this population, the incidence of HIV infection is the highest among Black MSM. Our integrated review synthesized published behavioral interventions designed to enhance the uptake of and adherence to pre-exposure prophylaxis (PrEP) for the prevention of HIV in the Black MSM population. A search of 4 electronic databases revealed only 7 studies whose samples included Black MSM. Adherence to PrEP medication declined over time across all studies. No statistically significant changes in safer sexual behaviors were reported. Few studies described theory-driven interventions. Effective interventions are needed to enhance the uptake of PrEP and to reinforce behaviors that prevent HIV transmission among Black MSM.

Social cohesion, social trust, social participation and sexual behaviors of adolescents in rural Tanzania

BackgroundSocial cohesion, defined as a glue holding society together, has been found to influence several aspects of human behavior. Social cohesion, being composed of social trust and social participation, is a social factor that may influence sexual behaviors. Unfortunately, studies investigating the influence of social cohesion on sexual behaviors among young people are scarce. This study examined the influence of social cohesion on safe sexual behavior among adolescents in rural Tanzania.MethodsA cross-sectional study was conducted among 403 school adolescents of the Newala district, between May and August 2010. Socio-demographic characteristics, social cohesion (social trust and social participation) and sexual behavior (age at sexual debut, intention to use and reported condom use, number of sexual partners) were obtained through self-administered questionnaires. Data analysis was performed using descriptive statistics and binary logistic regression.ResultsSexual debut at under 13 years of age was reported by 12% of the respondent. A majority (71%) reported multiple sexual partnerships and half of the participants reported to have used a condom at their last sexual encounter. The intention to use a condom was reported by 77% of the respondents. Having multiple sexual partnerships was associated with social trust only (odds ratio: 3.5, 95% CI 1.01–12.3) whereas reported condom use was related with social cohesion (odds ratio 4.8 95% CI 1.66–14.06). Social cohesion, trust or participation was not associated with young age at sexual debut or intention to use a condom. Being a female (odds ratio 2.07 95% CI 1.04–4.12.) was associated with intention to use a condom.ConclusionThis study indicates that social cohesion and socio-demographic factors influence actual behavior performance and behavioral intentions. The findings point to the importance of collecting more evidence on social cohesion and sexual behaviors in different settings and designing interventions that enhance social cohesion among adolescents in order to reinforce positive sexual behaviors.

HIV priorities by Italian AIDS advocacy groups: information on prevention (still) comes first. An on-line survey.

to define a list of priorities for activities and research projects based on the consultation of Italian AIDS advocacy groups through an online survey. a multidisciplinary advisory board was set up to define the survey and discuss the findings. Five areas - and related items - were listed: prevention, continuity of care, discrimination, research, key populations. Fifty-eight AIDS advocacy groups were identified and invited through e-mail to the survey, which lasted two months. Responders were asked to select a priority area and vote two items. Then, as second choice, they had to choose up to three items across the other areas. The final step of the prioritization process was the discussion of the survey findings with the advisory board. Italian HIV advocacy groups. thirty-seven groups responded (64%). The priority selected by most was prevention (around 80%), particularly preventive information addressed to teenagers and the general population. For the second choice, the most chosen items referred to discrimination and the continuity of care. The advisory board members underlined the need for a planned, organized, monitored, and evidence-based approach for HIV prevention information in different settings. different strategies to provide HIV prevention information should be proposed and monitored according to different targets, following an evidence-based approach. The stigma and discrimination against people with HIV and AIDS must be cleaned up to foster safe sex behaviours, providing education interventions at school. Wider structural issues have to be addressed, such as the availability and affordability of health services, contraceptive choices and condoms, poverty, and cultural gender norms.

Laboring to Make Sex “Safe”: Sexual Vigilance in Young U.S. College Women

Definitions of “safe sex” often focus on the use of condoms and contraception, but largely ignore other dimensions of safety, such as efforts to feel emotionally or physically safe. These gaps in the definition of the term safety demand greater attention to how being safe and feeling safe are interpreted by individuals who live and engage in sexual lives marked by social and political inequality. In the current study, we draw on interviews with 17 young women ages 18–28 from a U.S. urban university to examine efforts they used to protect themselves in sexual relationships. When having sex with men, we found young women relied on a range of efforts to keep themselves safe, such as controlling their own sexual desire, developing strict contraceptive regimens, and building relational contexts characterized by physical and emotional safety. We argue that sexual safety labor (i.e., “good” contraceptive behavior, “waiting” to have sex, and “careful” decision-making) offers evidence of what safe sex requires of young women. We examine this range of cognitions and behaviors as forms of labor directed at making sex feel and be safe; however, young women did not describe these efforts in terms of their own time or energy. In our analysis, we suggest that vigilance in sexual relationships has become part of young women’s required repertoire of safe sex behaviors, but largely goes unnoticed by them. We connect these findings with public health campaigns that teach young people about safety and offer alternatives for researchers looking to understand and study what is imagined as “safe sex.”

How Alcohol, Space, and Time Influence Young People\u2019s Sexual Encounters in Tanzania: A Qualitative Analysis

A significant under-addressed issue in the global adolescent health agenda is the interaction between alcohol use and sexual encounters among adolescent boys and girls in sub-Saharan Africa. The aim of this study was to explore the structural and environmental factors influencing young people’s access to and use of alcohol, and subsequent engagement in safe or unsafe sexual behaviors in such contexts, from the perspective of young people themselves. We used qualitative and participatory methodologies to explore the experiences and perspectives of 177 adolescent girls and boys in and out of school in four sites across Dar es Salaam, Tanzania. Findings suggest that alcohol use intersects with a spatial dimension in relation to where youths are consuming alcohol and subsequently engaging in sex. This in turn influences young people’s likelihood of using condoms and practicing safer sex. The spatial dimension was found to be influenced by time, gender, age, economics, and social norms around the carrying of and use of condoms. Interventions are needed that both address the gendered and social sanctioning of youth carrying condoms in Tanzania and that increase the availability of condoms where alcohol is sold and consumed.

Understanding women’s postpartum sexual experiences

This study aimed to understand women’s sexual health experiences, specifically knowledge, attitudes and norms related to sexual behaviour resumption during the postpartum period. Semi-structured, reproductive health-focused interviews (N = 70) were conducted among women aged 18 years or older (range: 19–78) residing in South Carolina. Findings demonstrated that women identified clinicians as most influential concerning when they should and could resume sexual activity. Some women noted returning to sex earlier than anticipated due to personal and partner desire and indicated achieving considerable sexual satisfaction during the postpartum period. However, other participants noted difficulties resuming sexual activity, including pain and exhaustion from caring for a new baby. Findings provide practical recommendations for health professionals to further develop tailored, timely health messaging related to safe and healthy postpartum sexual behaviours. We discuss recommendations for health professionals to bring further awareness to varied postpartum sexual experiences.

Reproductive Health Promotion Behavior of Infertility Women and Normal Women.

To compare reproductive health promoting behaviors (RHPBs) of infertile women with those of normal women and identify effects of RHPB on infertility. A total of 148 females (73 infertile women and 75 normal women) were enrolled in this study. Measurements included their general characteristics and RHPB using self-report questionnaires. Data were analyzed with descriptive statistics, χ2 test, ANCOVA, and hierarchical logistic regression using SPSS. There were significant difference in incomes, number of family, number of term deliveries, and number of abortions according to infertility diagnosis. Mean duration of infertility was 32.16 months. Only 12.32% women had known cause of infertility. The most common cause of infertility was unknown. Mean RHPB score was 3.98 for infertile women and 4.41 for normal women. In logistic regression, total RHPB (odds ratio [OR], 0.21) and safe sex of RHPB (OR, 0.66) were significant factors influencing infertility. Infertile women's total RHPB and subcategories of RHPB (safe sex behavior and sexual transmitted disease [STD] prevention) were lower than those of normal women. For infertility women, RHPB-related intervention programs are needed, especially information about safe sex behavior and STD prevention.

Application theory of planned behavior on promotion of safe sexual behaviors among drug users

ABSTRACTThe aim of this study was to apply the theory of planned behavior on the promotion of safe sexual behaviors among drug users covered by Fasa’s drug user’s center. In the phase I of this study, 225 men drug users referring to rehabilitation centers in Fasa City, Fars Province, Iran were selected by simple sampling method in 2016. Also, in a quasi-experimental study in the second phase, 120 drug users participated (60 participants in the experimental group and 60 participants in the control group). Data were collected using a questionnaire containing demographic information and the theory of planned behavior constructs which was distributed before and three months after the intervention.61. 33% of the participants had the history of extramarital sexual intercourse and 28% had used condoms in their last sexual intercourse. After educational intervention, the mean scores of the theory constructs, in the intervention group increased significantly (P < 0.001), while the changes were not significant in the control group. Moreover, 65% of the drug users in the intervention group had safe sex behaviors.

How reliable and valid are the self-reports of sexual behavior among HIV discordant couples in Pune, INDIA

ABSTRACTReliability of self-reported sexual and safe sex behavior among heterosexual HIV discordant couples was assessed by matching individual responses of couples to a common set of questions and validated by matching with pregnancy and seroconversion during study period. Demographic, clinical and sexual behavior information was collected individually from 457 consenting married discordant couples using structured questionnaires at screening, enrollment and at four quarterly visits. Reliability of self-reports tested using Kappa statistics. At screening, level of agreement about spouse being regular partner (Kappa = 0.96) and having had sexual intercourse with spouse in the last quarter (Kappa = 0.84) was noted. Moderate agreement observed about frequency of condom use (Kappa = 0.639) and condom tear (Kappa = 0.428). Agreement on reporting sexual contacts with spouse and consistent condom use increased (P < 0.001) over follow-ups. Four of 6 couples that seroconverted reported using condoms consistently, and 2 of these seroconverted. Couple histories of all 11 sero-discordant couples reporting pregnancy matched, of these 8 couples reported use of condoms and only 3 couples reported non-use of condoms during the preceding period. Sensitive sexual information can be collected using self-reports but it should be used with caution. Involving couples and using biological parameters concurrently may enhance validity of self-reports.