Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia
Eric P. F. Chow A B E , John B. Carlin C D , Tim R. H. Read A B , Marcus Y. Chen A B , Catriona S. Bradshaw A B , Jun K. Sze A and Christopher K. Fairley A B
+ Author Affiliations
- Author Affiliations
A Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia.
B Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia.
C Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie Street, Carlton, Vic. 3053, Australia.
D Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Flemington Road, Parkville, Vic. 3052, Australia.
E Corresponding author. Email: Echow@mshc.org.au
Sexual Health 15(4) 350-357 https://doi.org/10.1071/SH18024
Submitted: 14 February 2018 Accepted: 16 April 2018 Published: 3 July 2018
Abstract
Background: The number of sexual partners is one of the most important risk factors for sexually transmissible infections (STIs), including HIV. The aim of the present study was to examine the association between declining to report the number of partners using computer-assisted self-interviewing (CASI) and HIV or STI positivity at a public sexual health centre in Melbourne, Australia, in 2016. Methods: Individuals were categorised into three risk populations: women, men who have sex with women only (MSW) and men who have sex with men (MSM). Logistic regression analysis was used to examine the association between declining to report the number of sexual partners in the past 12 months and HIV or STI positivity for women and MSW, with generalised estimating equations (GEE) used for estimation in MSM to address repeated-measures within individuals. Results: In all, 18 085 individuals (5579 women, 6013 MSW, 6493 MSM) were included in the final analysis. There was no association between chlamydia positivity and declining to respond among women and MSW. MSM who declined to respond were more likely to be chlamydia positive (adjusted odds ratio1.21; 95% confidence interval (CI) 1.01–1.43). Known HIV-positive MSM and MSM newly diagnosed with HIV had 3.31-fold (95% CI 2.48–4.42) and 2.82-fold (95% CI 1.84–4.32) greater odds respectively of declining to respond compared with HIV-negative MSM. Gonorrhoea and syphilis positivity in MSM were not associated with declining to respond. Conclusions: There was no association between declining to report the number of partners and chlamydia positivity among women and MSW. However, MSM who declined to report the number of partners were slightly more likely to have chlamydia and substantially more likely to be HIV positive.
Additional keywords: CASI, chlamydia, sexual history, sexual behaviours, sexually transmitted infections, men who have sex with men, HIV, heterosexuals.
References
[1] Fairley CK, Chow EP, Hocking JS. Early presentation of symptomatic individuals is critical in controlling sexually transmissible infections. Sex Health 2015; 12 181–2.| Early presentation of symptomatic individuals is critical in controlling sexually transmissible infections.Crossref | GoogleScholarGoogle Scholar |
[2] Fairley CK. Using information technology to control STIs. Sex Transm Infect 2011; 87 ii25–7.
| Using information technology to control STIs.Crossref | GoogleScholarGoogle Scholar |
[3] Dombrowski JC, Golden MR. Modernizing operations to improve efficiency and refine the role and mission of sexually transmitted infection clinics. Sex Transm Dis 2013; 40 81–4.
| Modernizing operations to improve efficiency and refine the role and mission of sexually transmitted infection clinics.Crossref | GoogleScholarGoogle Scholar |
[4] Hippisley-Cox J, Pringle M, Cater R, Wynn A, Hammersley V, Coupland C, Hapgood R, Horsfield P, Teasdale S, Johnson C. The electronic patient record in primary care–regression or progression? A cross sectional study. BMJ 2003; 326 1439–43.
| The electronic patient record in primary care–regression or progression? A cross sectional study.Crossref | GoogleScholarGoogle Scholar |
[5] Zou H, Fairley CK, Guy R, Bilardi J, Bradshaw CS, Garland SM, Sze JK, Afrizal A, Chen MY. Automated, computer generated reminders and increased detection of gonorrhoea, chlamydia and syphilis in men who have sex with men. PLoS One 2013; 8 e61972
| Automated, computer generated reminders and increased detection of gonorrhoea, chlamydia and syphilis in men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[6] Bourne C, Knight V, Guy R, Wand H, Lu H, McNulty A. Short message service reminder intervention doubles sexually transmitted infection/HIV re-testing rates among men who have sex with men. Sex Transm Infect 2011; 87 229–31.
| Short message service reminder intervention doubles sexually transmitted infection/HIV re-testing rates among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[7] Nyatsanza F, McSorley J, Murphy S, Brook G. ‘It’s all in the message’: the utility of personalised short message service (SMS) texts to remind patients at higher risk of STIs and HIV to reattend for testing-a repeat before and after study. Sex Transm Infect 2016; 92 393–5.
| ‘It’s all in the message’: the utility of personalised short message service (SMS) texts to remind patients at higher risk of STIs and HIV to reattend for testing-a repeat before and after study.Crossref | GoogleScholarGoogle Scholar |
[8] Burton J, Brook G, McSorley J, Murphy S. The utility of short message service (SMS) texts to remind patients at higher risk of STIs and HIV to reattend for testing: a controlled before and after study. Sex Transm Infect 2014; 90 11–13.
| The utility of short message service (SMS) texts to remind patients at higher risk of STIs and HIV to reattend for testing: a controlled before and after study.Crossref | GoogleScholarGoogle Scholar |
[9] Guy R, Wand H, Knight V, Kenigsberg A, Read P, McNulty AM. SMS reminders improve re-screening in women and heterosexual men with chlamydia infection at Sydney Sexual Health Centre: a before-and-after study. Sex Transm Infect 2013; 89 11–15.
| SMS reminders improve re-screening in women and heterosexual men with chlamydia infection at Sydney Sexual Health Centre: a before-and-after study.Crossref | GoogleScholarGoogle Scholar |
[10] Fairley CK, Sze JK, Vodstrcil LA, Chen MY. Computer-assisted self interviewing in sexual health clinics. Sex Transm Dis 2010; 37 665–8.
| Computer-assisted self interviewing in sexual health clinics.Crossref | GoogleScholarGoogle Scholar |
[11] Bangsberg DR, Bronstone A, Chesney MA, Hecht FM. Computer-assisted self-interviewing (CASI) to improve provider assessment of adherence in routine clinical practice. J Acquir Immune Defic Syndr 2002; 31 S107–11.
[12] Ghanem KG, Hutton HE, Zenilman JM, Zimba R, Erbelding EJ. Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients. Sex Transm Infect 2005; 81 421–5.
| Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients.Crossref | GoogleScholarGoogle Scholar |
[13] Vodstrcil LA, Hocking JS, Cummings R, Chen MY, Bradshaw CS, Read TR, Sze JK, Fairley CK. Computer assisted self interviewing in a sexual health clinic as part of routine clinical care; impact on service and patient and clinician views. PLoS One 2011; 6 e18456
| Computer assisted self interviewing in a sexual health clinic as part of routine clinical care; impact on service and patient and clinician views.Crossref | GoogleScholarGoogle Scholar |
[14] Dolezal C, Marhefka SL, Santamaria EK, Leu CS, Brackis-Cott E, Mellins CA. A comparison of audio computer-assisted self-interviews to face-to-face interviews of sexual behavior among perinatally HIV-exposed youth. Arch Sex Behav 2012; 41 401–10.
| A comparison of audio computer-assisted self-interviews to face-to-face interviews of sexual behavior among perinatally HIV-exposed youth.Crossref | GoogleScholarGoogle Scholar |
[15] Richens J, Copas A, Sadiq ST, Kingori P, McCarthy O, Jones V, Hay P, Miles K, Gilson R, Imrie J, Pakianathan M. A randomised controlled trial of computer-assisted interviewing in sexual health clinics. Sex Transm Infect 2010; 86 310–14.
| A randomised controlled trial of computer-assisted interviewing in sexual health clinics.Crossref | GoogleScholarGoogle Scholar |
[16] Scott HM, Irvin R, Wilton L, Van Tieu H, Watson C, Magnus M, Chen I, Gaydos C, Hussen SA, Mannheimer S, Mayer K, Hessol NA. Sexual behavior and network characteristics and their association with bacterial sexually transmitted infections among Black men who have sex with men in the United States. PLoS One 2015; 10 e0146025
| Sexual behavior and network characteristics and their association with bacterial sexually transmitted infections among Black men who have sex with men in the United States.Crossref | GoogleScholarGoogle Scholar |
[17] Chow EP, Tomnay J, Fehler G, Whiley D, Read TR, Denham I, Bradshaw CS, Chen MY, Fairley CK. Substantial increases in chlamydia and gonorrhea positivity unexplained by changes in individual-level sexual behaviors among men who have sex with men in an Australian sexual health service from 2007 to 2013. Sex Transm Dis 2015; 42 81–7.
| Substantial increases in chlamydia and gonorrhea positivity unexplained by changes in individual-level sexual behaviors among men who have sex with men in an Australian sexual health service from 2007 to 2013.Crossref | GoogleScholarGoogle Scholar |
[18] Chow EP, Fehler G, Chen MY, Bradshaw CS, Denham I, Law MG, Fairley CK. Testing commercial sex workers for sexually transmitted infections in Victoria, Australia: an evaluation of the impact of reducing the frequency of testing. PLoS One 2014; 9 e103081
| Testing commercial sex workers for sexually transmitted infections in Victoria, Australia: an evaluation of the impact of reducing the frequency of testing.Crossref | GoogleScholarGoogle Scholar |
[19] The Royal Australian College of General Practitioners (RACGP). Guidelines for preventive activities in general practice. Melbourne: RACGP; 2016.
[20] Templeton DJ, Read P, Varma R, Bourne C. Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence. Sex Health 2014; 11 217–29.
| Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence.Crossref | GoogleScholarGoogle Scholar |
[21] Bauer M, Haesler E, Fetherstonhaugh D. Let’s talk about sex: older people’s views on the recognition of sexuality and sexual health in the health‐care setting. Health Expect 2016; 19 1237–50.
| Let’s talk about sex: older people’s views on the recognition of sexuality and sexual health in the health‐care setting.Crossref | GoogleScholarGoogle Scholar |
[22] Huang AJ, Luft J, Grady D, Kuppermann M. The day-to-day impact of urogenital aging: perspectives from racially/ethnically diverse women. J Gen Intern Med 2010; 25 45–51.
| The day-to-day impact of urogenital aging: perspectives from racially/ethnically diverse women.Crossref | GoogleScholarGoogle Scholar |
[23] Kessel B. Sexuality in the older person. Age Ageing 2001; 30 121–4.
| Sexuality in the older person.Crossref | GoogleScholarGoogle Scholar |
[24] Brogan M. The sexual needs of elderly people: addressing the issue. Nurs Stand 1996; 10 42–5.
| The sexual needs of elderly people: addressing the issue.Crossref | GoogleScholarGoogle Scholar |
[25] Griffiths E. No sex, please, we’re over 60. Nurs Times 1988; 84 34–5.
[26] Drench ME, Losee RH. Sexuality and sexual capacities of elderly people. Rehabil Nurs 1996; 21 118–23.
[27] Bodley-Tickell AT, Olowokure B, Bhaduri S, White DJ, Ward D, Ross JD, Smith G, Duggal HV, Goold P. Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. Sex Transm Infect 2008; 84 312–17.
| Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system.Crossref | GoogleScholarGoogle Scholar |
[28] Fish R, Robinson A, Copas A, Jungmann E, Lascar RM. Trends in attendances to genitourinary medicine services by older women. Int J STD AIDS 2012; 23 595–6.
| Trends in attendances to genitourinary medicine services by older women.Crossref | GoogleScholarGoogle Scholar |
[29] Dukers-Muijrers NH, Niekamp AM, Brouwers EE, Hoebe CJ. Older and swinging; need to identify hidden and emerging risk groups at STI clinics. Sex Transm Infect 2010; 86 315–17.
| Older and swinging; need to identify hidden and emerging risk groups at STI clinics.Crossref | GoogleScholarGoogle Scholar |
[30] Bourne C, Minichiello V. Sexual behaviour and diagnosis of people over the age of 50 attending a sexual health clinic. Australas J Ageing 2009; 28 32–6.
| Sexual behaviour and diagnosis of people over the age of 50 attending a sexual health clinic.Crossref | GoogleScholarGoogle Scholar |
[31] Minichiello V, Rahman S, Hawkes G, Pitts M. STI epidemiology in the global older population: emerging challenges. Perspect Public Health 2012; 132 178–81.
| STI epidemiology in the global older population: emerging challenges.Crossref | GoogleScholarGoogle Scholar |
[32] Poynten IM, Grulich AE, Templeton DJ. Sexually transmitted infections in older populations. Curr Opin Infect Dis 2013; 26 80–5.
| Sexually transmitted infections in older populations.Crossref | GoogleScholarGoogle Scholar |
[33] Fileborn B, Brown G, Lyons A, Hinchliff S, Heywood W, Minichiello V, Malta S, Barrett C, Crameri P. Safer sex in later life: qualitative interviews with older Australians on their understandings and practices of safer sex. J Sex Res 2018; 55 164–177.
| Safer sex in later life: qualitative interviews with older Australians on their understandings and practices of safer sex.Crossref | GoogleScholarGoogle Scholar |
[34] Lyons A, Heywood W, Fileborn B, Minichiello V, Barrett C, Brown G, Hinchliff S, Malta S, Crameri P. Sexually active older Australian’s knowledge of sexually transmitted infections and safer sexual practices. Aust N Z J Public Health 2017; 41 259–61.
| Sexually active older Australian’s knowledge of sexually transmitted infections and safer sexual practices.Crossref | GoogleScholarGoogle Scholar |
[35] Taylor A, Gosney MA. Sexuality in older age: essential considerations for healthcare professionals. Age Ageing 2011; 40 538–43.
| Sexuality in older age: essential considerations for healthcare professionals.Crossref | GoogleScholarGoogle Scholar |
[36] Gott M, Hinchliff S, Galena E. General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 2004; 58 2093–103.
| General practitioner attitudes to discussing sexual health issues with older people.Crossref | GoogleScholarGoogle Scholar |
[37] Boyd M, Cooper D, Crock EA, Crooks L, Giles ML, Grulich A, Lewin SR, Nolan D, Yarwood T. Sexual transmission of HIV and the law: an Australian medical consensus statement. Med J Aust 2016; 205 409–12.
| Sexual transmission of HIV and the law: an Australian medical consensus statement.Crossref | GoogleScholarGoogle Scholar |
[38] Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, Hakim JG, Kumwenda J, Grinsztejn B, Pilotto JH, Godbole SV, Mehendale S, Chariyalertsak S, Santos BR, Mayer KH, Hoffman IF, Eshleman SH, Piwowar-Manning E, Wang L, Makhema J, Mills LA, de Bruyn G, Sanne I, Eron J, Gallant J, Havlir D, Swindells S, Ribaudo H, Elharrar V, Burns D, Taha TE, Nielsen-Saines K, Celentano D, Essex M, Fleming TR, HPTN 052 Study Team Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365 493–505.
| Prevention of HIV-1 infection with early antiretroviral therapy.Crossref | GoogleScholarGoogle Scholar |
[39] Read P, Fairley CK, Chow EP. Increasing trends of syphilis among men who have sex with men in high income countries. Sex Health 2015; 12 155–63.
| Increasing trends of syphilis among men who have sex with men in high income countries.Crossref | GoogleScholarGoogle Scholar |
[40] Chow EPF, Callander D, Fairley CK, Zhang L, Donovan B, Guy R, Lewis DA, Hellard M, Read P, Ward A, Chen MY. Increased syphilis testing of men who have sex with men: greater detection of asymptomatic early syphilis and relative reduction in secondary syphilis. Clin Infect Dis 2017; 65 389–95.
| Increased syphilis testing of men who have sex with men: greater detection of asymptomatic early syphilis and relative reduction in secondary syphilis.Crossref | GoogleScholarGoogle Scholar |
[41] Cornelisse VJ, Chow EP, Huffam S, Fairley CK, Bissessor M, De Petra V, Howden . Cornelisse VJ, Chow EP, Huffam S, Fairley CK, Bissessor M, De Petra V, Howden . Cornelisse VJ, Chow EP, Huffam S, Fairley CK, Bissessor M, De Petra V, Howden . Increased detection of pharyngeal and rectal gonorrhea in men who have sex with men after transition from culture to nucleic acid amplification testing. Sex Transm Dis 2017; 44 114–17.
| Increased detection of pharyngeal and rectal gonorrhea in men who have sex with men after transition from culture to nucleic acid amplification testing.Crossref | GoogleScholarGoogle Scholar |
[42] Savage EJ, Marsh K, Duffell S, Ison CA, Zaman A, Hughes G. Rapid increase in gonorrhoea and syphilis diagnoses in England in 2011. Euro Surveill 2012; 17 pii=20224
[43] Jasek E, Chow EP, Ong JJ, Bradshaw CS, Chen MY, Hocking JS, Lee D, Phillips T, Phillips T, Temple-Smith M, Fehler G, Fairley CK. Sexually Transmitted Infections in Melbourne, Australia from 1918 to 2016: nearly a century of data. Commun Dis Intell Q Rep. 2017; 41 E212–E222.
[44] Cheung KT, Fairley CK, Read TR, Denham I, Fehler G, Bradshaw CS, Chen MY, Chow EP. HIV incidence and predictors of incident HIV among men who have sex with men attending a sexual health clinic in Melbourne, Australia. PLoS One 2016; 11 e0156160
| HIV incidence and predictors of incident HIV among men who have sex with men attending a sexual health clinic in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar |
[45] Barbee LA, Khosropour CM, Dombrowksi JC, Golden MR. New human immunodeficiency virus diagnosis independently associated with rectal gonorrhea and chlamydia in men who have sex with men. Sex Transm Dis 2017; 44 385–9.
| New human immunodeficiency virus diagnosis independently associated with rectal gonorrhea and chlamydia in men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[46] Katz DA, Dombrowski JC, Bell TR, Kerani RP, Golden MR. HIV incidence among men who have sex with men after diagnosis with sexually transmitted infections. Sex Transm Dis 2016; 43 249–54.
| HIV incidence among men who have sex with men after diagnosis with sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar |
