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Scaling Sexual Behavior or “Sexual Risk Propensity” Among Men at Risk for HIV in Kisumu, Kenya

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An Erratum to this article was published on 06 January 2009

Abstract

We present a scale to measure sexual risk behavior or “sexual risk propensity” to evaluate risk compensation among men engaged in a randomized clinical trial of male circumcision. This statistical approach can be used to represent each respondent’s level of sexual risk behavior as the sum of his responses on multiple dichotomous and rating scale (i.e. ordinal) items. This summary “score” can be used to summarize information on many sexual behaviors or to evaluate changes in sexual behavior with respect to an intervention. Our 18 item scale demonstrated very good reliability (Cronbach’s alpha of 0.87) and produced a logical, unidimensional continuum to represent sexual risk behavior. We found no evidence of differential item function at different time points (except for reporting a concurrent partners when comparing 6 and 12 month follow-up visits) or with respect to the language with which the instrument was administered. Further, we established criterion validity by demonstrating a statistically significant association between the risk scale and the acquisition of incident sexually transmitted infections (STIs) at the 6 month follow-up and HIV at the 12 month follow-up visits. This method has broad applicability to evaluate sexual risk behavior in the context of other HIV and STI prevention interventions (e.g. microbicide or vaccine trials), or in response to treatment provision (e.g., anti-retroviral therapy).

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Acknowledgements

We thank all of the participants, without whom this work would not have been possible. We are grateful to Evans Otieno, Nicholas Ouma, Bob Ogollah, Kevine Kamollah, and the entire UNIM Project staff for their assistance in data collection and recruitment efforts and to Dr. Donald Hedeker, Dr. Ronald Hershow, and Nelli Westercamp for their helpful comments on the manuscript.

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., Chicago, IL, 60612, USA

    C. L. Mattson, Richard T. Campbell & Robert C. Bailey

  2. College of Education, University of Illinois at Chicago, Chicago, IL, USA

    George Karabatsos

  3. UNIM Project, Kisumu, Kenya

    Kawango Agot

  4. Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya

    J. O. Ndinya-Achola

  5. Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada

    Stephen Moses

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  1. C. L. Mattson
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  2. Richard T. Campbell
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  5. J. O. Ndinya-Achola
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  6. Stephen Moses
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Correspondence to C. L. Mattson.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s10461-008-9514-x

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Mattson, C.L., Campbell, R.T., Karabatsos, G. et al. Scaling Sexual Behavior or “Sexual Risk Propensity” Among Men at Risk for HIV in Kisumu, Kenya. AIDS Behav 14, 162–172 (2010). https://doi.org/10.1007/s10461-008-9423-z

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