Comparison of self-reported and test-identified chlamydial infections among young adults in the United States of America.
Comparison of self-reported and test-identified chlamydial infections among young adults in the United States of America.
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DOI：
10.1071/sh06040
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发表时间：
2006-12-01
期刊：
影响因子：
1.6
通讯作者：
Halpern, Carolyn Tucker
中科院分区：
文献类型：
--
作者：
Iritani, Bonita J;Ford, Carol A;Halpern, Carolyn Tucker
背景：许多研究依赖于之前诊断性传播感染(STI)的受访者报告，但这些自我报告可能低估了感染流行率。使用自我报告的STI数据的偏见程度，以及偏见是否因性别和种族而异，在很大程度上是未知的。这一差距是通过一个具有全国代表性的大样本来解决的。方法：对全国青少年健康纵向研究第三波的横断面分析。参与者年龄在18-26岁(n=12,359)。将过去一年基于自我报告的诊断对衣原体感染流行率的估计与数据收集时基于核酸扩增测试(NAAT)的实际流行率进行比较。测试确定的流行率与自我报告的诊断流行率的比率按性别和种族/民族计算。结果：约4.2%的样本目前有NAAT鉴定的衣原体感染，但只有3.0%的样本报告在过去一年中被诊断为衣原体，比率为1.43。在男性中，检测确定的感染流行率与通过自我诊断确定的流行率的比率高于女性(2.07比1.14，P<；0.05)。在男性中，非西班牙裔黑人的这一比例(2.40)高于非西班牙裔白人(1.07，P<；0.05)。结论：使用自我报告的诊断低估了衣原体感染的流行率，特别是在男性中，在非西班牙裔黑人男性中。因此，对自我报告的性传播感染的依赖可能导致有偏见的结论，特别是对这些群体。建议在研究研究中使用性传播感染的生物检测。
BACKGROUND: Many studies rely on respondent reports of prior diagnosed sexually transmissible infections (STIs), but these self reports are likely to under-estimate infection prevalence. The extent of bias from using self-reported STI data, and whether bias varies by sex and race, is largely unknown. This gap is addressed using a large, nationally representative sample.METHODS: Cross-sectional analyses of Wave III of the National Longitudinal Study of Adolescent Health. Participants were 18-26 years old (n = 12,359). Estimates of the prevalence of chlamydial infection based on self-reported diagnoses in the past year were compared with actual prevalence based on nucleic acid amplification testing (NAAT) at the time of data collection. Ratios of test-identified prevalence to self-reported diagnosis prevalence were calculated by sex and race/ethnicity groups. Larger ratios indicate greater extent of self reports under-estimating infection prevalence.RESULTS: About 4.2% of the sample had a current NAAT-identified chlamydial infection, but only 3.0% reported having been diagnosed with chlamydia in the past year, yielding a ratio of 1.43. The ratio of test-identified infection prevalence to prevalence identified from self-reported diagnoses was larger among men than women (2.07 versus 1.14, P < 0.05). Among men, the ratio was larger among non-Hispanic blacks (2.40) compared with non-Hispanic whites (1.07, P < 0.05).CONCLUSIONS: Use of self-reported diagnoses under-estimates chlamydial infection prevalence, particularly among men, and among non-Hispanic black men. Reliance on self-reported STIs may consequently lead to biased conclusions, particularly for these groups. Use of biological testing for STIs in research studies is recommended.