PREDICTORS OF UNDERREPORTING OF UNPROTECTED SEX WITH CLIENTS AS MEASURED BY SEMEN DETECTION AMONG FEMALE SEX WORKERS UNDER HIV TREATMENT AS PREVENTION OR PRE-EXPOSURE PROPHYLAXIS IN BENIN
Bibliographic record
Abstract
Background:New biological HIV preventive interventions, such as treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP), may result in condom migration and therefore require careful monitoring of unprotected sex. Self-report of unprotected sex is subject to biases and underreporting has been observed through vaginal detection of prostate-specific antigen (PSA), a biomarker of recent semen exposure, among female sex workers (FSW). However, little is known about the factors leading to underreporting of unprotected sex in this population.Methods:At baseline of a TasP/PrEP prospective demonstration project (2014-2016) among FSW in Benin, unprotected sex in the previous 2 days was assessed by face-to-face interview and vaginal detection of PSA. Underreporting was defined as not reporting any unprotected sex but testing positive for PSA. Socio-demographic, behavioural, and biological variables were tested for their association with underreporting using bivariate Poisson regression models. Variables significantly associated (pu22640.05) with underreporting were included in a multivariate Poisson regression model. Analyses were restricted to FSW reporting no sex with a regular partner in the last 2 days because self-reported condom use was uncommon with such partners.Results:Of the 361 recruited FSW, 274 reported no sex with a regular partner in the last 2 days. Among those, 65 (24%) underreported unprotected sex with clients. In multivariate analysis, underreporting was less common among Christian FSW (prevalence ratio (PR)=0.58; 95% confidence interval (CI): 0.38-0.88), FSW reporting alcohol use (PR=0.60; 95%CI: 0.40-0.91), and FSW having had a regular partner in the last year (PR=0.65; 95%CI: 0.42-0.99).Conclusion:Our results suggest that religion, alcohol use and having had a regular partner in the last year were predictors of underreporting of unprotected sex with clients among FSW from Benin. Awareness of the predictors of underreporting of unprotected sex might improve our capacity to better target FSW having unprotected sex with effective prevention approaches.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".