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Current HIV/AIDS Reports

Erschienen in:

16.05.2021 | Behavioral-Bio-Medical Interface (RJ DiClemente and JL Brown, Section Editors)

The Value of Assessing Self-Reported and Biological Indicators of Outcomes in Evaluating HIV Programs

verfasst von: Rick S. Zimmerman, Purnima Mehrotra, Tessa Madden, Rachel Paul

Erschienen in: Current HIV/AIDS Reports | Ausgabe 4/2021

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Abstract

Purpose of Review

In this manuscript, we present recent findings concerning concordance and discrepancy between biological measures and self-reports of these three outcomes of HIV programs: HIV status, adherence to antiretroviral medications (ARVs) and use of and adherence to pre-exposure prophylaxis medication (PrEP), and condom use/unprotected sex.

Recent Findings

Recent studies suggest that three successive rapid HIV tests (for those whose first test in positive) might be reasonably inexpensive and valid biological data to collect to combine with self-reports of HIV status, dried blood spots sufficiently affordable to combine with self-reports of adherence to ARVs and use of or adherence to PrEP, and that the discrepancy between self-reports of condom use and biomarkers of unprotected sex may be relatively small in high-income countries. Additional work on assessment of incorrect condom usage and breakage, standardized self-report measures of condom use, and more private data collection methodologies in low-income settings might reduce the recent observed discrepancies even further.

Summary

Concordance between self-reports of HIV and biomarkers indicating HIV positive status has varied considerably, with much lower rates in low-income countries, where the stigma of HIV is still very high. Recommendation is for combining self-report data with the results of three successive rapid tests for those testing positive. For adherence, again agreement between self-reports and a variety of more objective and/or biological measures is only moderate. Dried blood spots (DBS) may be sufficiently inexpensive in low-resource settings that this may be the best biological method to combine with self-reports. In publications over the last 8 years, the discrepancy between self-reports of condom use and biomarkers for unprotected sex may be even lower than 20% after controlling for other features of the study, particularly in high-income countries. Our results suggest that more careful assessment of incorrect condom use and breakage as reasons other than intentional misreporting should be investigated more carefully and that more private data collection methods such as audio, computer-assisted self-interviewing (ACASI) might be employed more often in low-resource settings to reduce this discrepancy in those settings further. In addition, further analysis of the discrepancy between self-reports of condom use and biomarkers should be conducted of published studies using the correct calculation methods to be more certain of these findings.

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Titel: The Value of Assessing Self-Reported and Biological Indicators of Outcomes in Evaluating HIV Programs
verfasst von: Rick S. Zimmerman
Purnima Mehrotra
Tessa Madden
Rachel Paul
Publikationsdatum: 16.05.2021
Verlag: Springer US
Erschienen in: Current HIV/AIDS Reports / Ausgabe 4/2021
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-021-00560-3

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