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RESEARCH ARTICLE

Parents’ reactions to testing for herpes simplex virus type 2 as a biomarker of sexual activity in Botswana junior secondary school students

Haddi J. Cham A B C , Sarah M. Lasswell B and Kim S. Miller B

A SciMetrika, 2987 Clairmont Road NE # 220, Atlanta, GA 30329, USA.

B Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Mailstop E-04, Atlanta, GA 30333, USA.

C Corresponding author. Email: hcham@cdc.gov

Sexual Health 13(2) 148-154 http://dx.doi.org/10.1071/SH15092
Submitted: 2 May 2015  Accepted: 6 November 2015   Published: 18 February 2016

Abstract

Background: Use of sexual activity biomarkers in HIV prevention trials has been widely supported to validate self-reported data. When such trials involve minors, researchers may face challenges in obtaining parental buy-in, especially if return of results procedures uphold the confidentiality and privacy rights of minors and preclude parental access to test results. In preparation for a randomised controlled trial (RCT) with junior secondary school (JSS) students in Botswana, a formative assessment was conducted to assess parents’ opinions and concerns about testing for herpes simplex virus type 2 (HSV-2) (biomarker of sexual activity) as part of the RCT. Methods: Six focus groups were held with parents (n = 32) of JSS students from urban, peri-urban and rural communities. Parents were asked their opinions of students being tested for HSV-2 and procedures for blood sample collection and return of results. Results: Overall, parents were supportive of HSV-2 testing, which they thought was a beneficial sexual health resource for adolescents and parents, and a motivation for parent–child communication about HSV-2, sexual activity and sexual abuse. Some parents supported the proposed plan to disclose HSV-2 test results to adolescents only, citing the importance of adolescent privacy and the possibility of HSV-2 positive adolescents being stigmatised by family members. Conversely, opposing parents requested parental access to results. These parents were concerned that adolescents may experience distress following a positive result and withhold this information thereby reducing parents’ abilities to provide support. Parents were also concerned about support for victims of sexual abuse. Conclusion: Although the present study demonstrates that parents can be accepting of sexual activity biomarker testing of adolescents, more research is needed to identify best approaches for returning test results.

Additional keywords: biological outcomes, HIV research, parental acceptance, parental perception, sexual activity biomarkers.


References

[1]  The Joint United Nations Programme on HIV/AIDS (UNAIDS). Fact sheet: adolescents, young people, and HIV. Geneva: UNAIDS; 2012.

[2]  The Joint United Nations Programme on HIV/AIDS (UNAIDS). The Gap Report. Geneva: UNAIDS; 2010. p. 2.

[3]  Hervish A, Clifton D. Status report: adolescents and young people in sub-Saharan Africa. Opportunities and challenges. Johannesburg: United Nations Population Fund (UNFPA), Africa Regional Office; 2012.

[4]  Schroder KE, Carey MP, Vanable PA. Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med 2003; 26 104–23.
Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports.CrossRef | 14534028PubMed | open url image1

[5]  Weinhardt LS, Forsyth AD, Carey MP, Jaworski BC, Durant LE. Reliability and validity of self-report measures of HIV-related sexual behavior: progress since 1990 and recommendations for research and practice. Arch Sex Behav 1998; 27 155–80.
Reliability and validity of self-report measures of HIV-related sexual behavior: progress since 1990 and recommendations for research and practice.CrossRef | 1:STN:280:DyaK1c3itl2qtg%3D%3D&md5=28ce1225384d09b478cb1bd1f5a58cfeCAS | 9562899PubMed | open url image1

[6]  Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull 1990; 108 339–62.
Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior.CrossRef | 1:STN:280:DyaK3M7gt1WmtA%3D%3D&md5=1ef8ed8d658fb1813884be2b8d9668c0CAS | 2270232PubMed | open url image1

[7]  Bastien S, Mason-Jones AJ, De Koker P, Mmbaga EJ, Ross DA, Mathews C. Herpes simplex virus type 2 infection as a biomarker for sexual debut among young people in sub-Saharan Africa: a literature review. Int J STD AIDS 2012; 23 761–6.
Herpes simplex virus type 2 infection as a biomarker for sexual debut among young people in sub-Saharan Africa: a literature review.CrossRef | 1:STN:280:DC%2BC3s7js12muw%3D%3D&md5=f2f836710fbcf89ab6efadffea3591c6CAS | 23155093PubMed | open url image1

[8]  Plummer ML, Ross DA, Wight D, Changalucha J, Mshana G, Wamoyi J, Todd J, Anemona A, Mosha FF, Obasi AIN, Hayes RJ. “A bit more truthful”: the validity of adolescent sexual behaviour data collected in rural northern Tanzania using five methods. Sex Transm Infect 2004; 80 ii49–56.
“A bit more truthful”: the validity of adolescent sexual behaviour data collected in rural northern Tanzania using five methods.CrossRef | 15572640PubMed | open url image1

[9]  Cowan FM, Langhaug LF, Mashungupa GP, Nyamurera T, Hargrove J, Jaffar S, Peeling RW, Brown DWG, Power R, Johnson AM, Stephenson JM, Bassett MT, Hayes RJ. School based HIV prevention in Zimbabwe: feasibility and acceptability of evaluation trials using biological outcomes. AIDS 2002; 16 1673–8.
School based HIV prevention in Zimbabwe: feasibility and acceptability of evaluation trials using biological outcomes.CrossRef | 12172089PubMed | open url image1

[10]  Beguy D, Kabiru CW, Nderu EN, Ngware MW. Inconsistencies in self-reporting of sexual activity among young people in Nairobi, Kenya. J Adolesc Health 2009; 45 595–601.
Inconsistencies in self-reporting of sexual activity among young people in Nairobi, Kenya.CrossRef | 19931832PubMed | open url image1

[11]  Palen L-A, Smith EA, Caldwell LL, Flisher AJ, Wegner L, Vergnani T. Inconsistent reports of sexual intercourse among South African high school students. J Adolesc Health 2008; 42 221–7.
Inconsistent reports of sexual intercourse among South African high school students.CrossRef | 18295129PubMed | open url image1

[12]  Minnis AM, Steiner MJ, Gallo MF, Warner L, Hobbs MM, Van der Straten A, Chipato T, Macaluso M, Padian NS. Biomarker validation of reports of recent sexual activity: results of a randomized controlled study in Zimbabwe. Am J Epidemiol 2009; 170 918–24.
Biomarker validation of reports of recent sexual activity: results of a randomized controlled study in Zimbabwe.CrossRef | 19741042PubMed | open url image1

[13]  Upchurch DM, Lillard LA, Aneshensel CS, Li NF. Inconsistencies in reporting the occurrence and timing of first intercourse among adolescents. J Sex Res 2002; 39 197–206.
Inconsistencies in reporting the occurrence and timing of first intercourse among adolescents.CrossRef | 12476267PubMed | open url image1

[14]  Brown J, Sales J, DiClemente R, Salazar L, Vanable P, Carey M, Brown LK, Romer D, Valois RF, Stanton B. Predicting discordance between self-reports of sexual behavior and incident sexually transmitted infections with African American female adolescents: results from a 4-city study. AIDS Behav 2012; 16 1491–500.
Predicting discordance between self-reports of sexual behavior and incident sexually transmitted infections with African American female adolescents: results from a 4-city study.CrossRef | 22323006PubMed | open url image1

[15]  Pequegnat W, Fishbein M, Celentano D, Ehrhardt A, Garnett G, Holtgrave D, Jaccard J, Schachter J, Zenilman J. NIMH/APPC workgroup on behavioral and biological outcomes in HIV/STD prevention studies: a position statement. Sex Transm Dis 2000; 27 127–32.
NIMH/APPC workgroup on behavioral and biological outcomes in HIV/STD prevention studies: a position statement.CrossRef | 1:STN:280:DC%2BD3c7ovFWktQ%3D%3D&md5=e0740039fe45090c09efcff34291a625CAS | 10726643PubMed | open url image1

[16]  Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ 2008; 337 1–11. open url image1

[17]  Cowan FM, Pascoe SJS, Langhaug LF, Dirawo J, Chidiya S, Jaffar S, Mbizvo M, Stephenson JM, Johnson AM, Power R, Woelk G, Hayes RJ. The Regai Dzive Shiri Project: a cluster randomised controlled trial to determine the effectiveness of a multi-component community-based HIV prevention intervention for rural youth in Zimbabwe – study design and baseline result. Trop Med Int Health 2008; 13 1235–44.
The Regai Dzive Shiri Project: a cluster randomised controlled trial to determine the effectiveness of a multi-component community-based HIV prevention intervention for rural youth in Zimbabwe – study design and baseline result.CrossRef | 18778329PubMed | open url image1

[18]  Hayes RJ, Changalucha J, Ross DA, Gavyole A, Todd J, Obasi AIN, Plummer ML, Wright D, Mabey DC, Grosskurth H. The MEMA kwa Vijana Project: Design of a community randomised trial of an innovative adolescent sexual health intervention in rural Tanzania. Contemp Clin Trials 2005; 26 430–42.
The MEMA kwa Vijana Project: Design of a community randomised trial of an innovative adolescent sexual health intervention in rural Tanzania.CrossRef | 15951245PubMed | open url image1

[19]  Ryan GW, Bernard HR. Techniques to identify themes. Field Methods 2003; 15 85–109.
Techniques to identify themes.CrossRef | open url image1

[20]  Ross DA, Changalucha J, Obasi AI, Todd J, Plummer ML, Cleophas-Mazige B, Anemona A, Everett D, Weiss HA, Mabey DC, Grosskurth H, Hayes RJ. Biological and behavioural impact of an adolescent sexual health intervention in Tanzania: a community-randomized trial. AIDS 2007; 21 1943–55.
Biological and behavioural impact of an adolescent sexual health intervention in Tanzania: a community-randomized trial.CrossRef | 17721102PubMed | open url image1

[21]  Luseno WK, Hallfors DD, Cho H, Iritani BJ, Adze J, Rusakaniko S, Mbai I, Milimo B, Hobbs M. Use of HIV and HSV-2 biomarkers in Sub-Saharan adolescent prevention research: a comparison of two approaches. J Prim Prev 2014; 35 181–91.
Use of HIV and HSV-2 biomarkers in Sub-Saharan adolescent prevention research: a comparison of two approaches.CrossRef | 24682861PubMed | open url image1



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