VALIDITY OF SELF-REPORTED SEXUAL BEHAVIORS IN ADOLESCENT WOMEN USING BIOMARKER OUTCOMES

Objectives: To determine the criterion-related validity of alternative approaches to the measurement of sexual intercourse using sexually tr ansmitted diseases (STD) as a biomarker (the criterion), Study Design: Analyses are based on an urban sample of 255 adolescent women, 15 to 19 years of age, treated for genitourinary infections with Neisseria g onorrhoeae, Chlamydia trachomatis or Trichomonas vaginalis who returne d 3 months later for reexamination, Subjects completed self-administer ed questionnaires at enrollment and at 3 months, Genitourinary culture s were obtained at enrollment, 2 to 4 weeks later at a test-of-treatme nt visit (TOT), and at 3 months, Results: Two hundred fourteen of the 255 adolescents also returned for a TOT culture; 186 of these 214 (73% ) were free of infection 2 to 4 weeks after enrollment and 30% (56/186 ) acquired a subsequent STD by 3 months, The validity of questions abo ut sexual behavior differed, No adolescent who denied interim intercou rse by reporting ''0'' sexual partners or ''0'' coitions acquired an i nterval STD, Adolescents who denied regular intercourse (vaginal sex) or failed to indicate the number of interim coitions were at high risk for new STD-23% and 21%, respectively, A new measure of sexual interc ourse using both the number of sexual partners and the number of coiti ons contained no missing data; adolescents classified as not having ha d interim sexual intercourse were free of infection at 3 months, where as 32% of those who reported intercourse acquired an interim infection , Conclusions: These data suggest that high-risk urban adolescent wome n can accurately report whether they have engaged in vaginal intercour se, The validity of the report appears sensitive to the wording and co ntent of the questions.