Prostate-Specific Antigen to Ascertain Reliability of Self-Reported Coital Exposure to Semen

Authors:
  • FBFrieda M. Behets
    Frieda M. Behets
  • MSMarkus J. Steiner
    Markus J. Steiner
  • MHMarcia M. Hobbs
    Marcia M. Hobbs
  • THTheresa Hatzell Hoke
    Theresa Hatzell Hoke
  • KDKathleen Van Damme
    Kathleen Van Damme
  • LRLouisette Ralimamonjy
    Louisette Ralimamonjy
  • LRLeonardine Raharimalala
    Leonardine Raharimalala
  • MCMyron S. Cohen
    Myron S. Cohen
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Abstract
The objective of this study was to assess the validity of women's reports of recent unprotected sex by testing for prostate-specific antigen (PSA) in vaginal samples. The authors conducted prospective research with 332 female sex workers attending 2 public dispensaries in Madagascar. Among women who reported no sex or protected sex only within the past 48 hours, 21% and 39%, respectively, tested positive for PSA. Among those testing positive for PSA, no differences in PSA concentrations were found among those reporting no sex, protected sex only, or at least one unprotected act. The substantial disagreement between self-reports and measurement of a biologic marker of semen exposure in vaginal specimens substantiates that self-reports of sexual behavior cannot be assumed to be valid measures. Future sexually transmitted infection/HIV and pregnancy prevention studies should confirm the validity of self-reports or use end points that do not rely on self-reported data.

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