Is Audio Computer-Assisted Self-Interview (ACASI) Useful in Risk Behaviour Assessment of Female and Male Sex Workers, Mombasa, Kenya?

BACKGROUND: Audio computer-assisted self-interview (ACASI) may elicit more frequent reporting of socially sensitive behaviours than face-to-face (FtF)-interview. However, no study compared responses to both methods in female and male sex workers (FSW; MSW) in Africa. METHODOLOGY/PRINCIPAL FINDINGS: We sequentially enrolled adults recruited for an HIV-1 intervention trial into a comparative study of ACASI and FtF-interview, in a clinic near Mombasa, Kenya. Feasibility and acceptability of ACASI, and a comparative analysis of enrolment responses between ACASI and FtF on an identical risk assessment questionnaire were evaluated. In total, 139 women and 259 men, 81% of eligible cohort participants, completed both interviews. ACASI captured a higher median number of regular (2 vs. 1, p<0.001, both genders) and casual partners in the last week (3 vs. 2, p = 0.04 in women; 2 vs. 1, p<0.001 in men). Group sex (21.6 vs. 13.5%, p<0.001, in men), intravenous drug use (IDU; 10.8 vs. 2.3%, p<0.001 in men; 4.4 vs. 0%, p = 0.03 in women), and rape (8.9 vs. 3.9%, p = 0.002, in men) were reported more frequently in ACASI. A surprisingly high number of women reported in ACASI that they had paid for sex (49.3 vs. 5.8%, p<0.001). Behaviours for recruitment (i.e. anal sex, sex work, sex between males) were reported less frequently in ACASI. The majority of women (79.2%) and men (69.7%) felt that answers given in ACASI were more honest. Volunteers who were not able to take ACASI (84 men, and 37 women) mostly lacked reading skills. CONCLUSIONS/SIGNIFICANCE: About 1 in 5 cohort participants was not able to complete ACASI, mostly for lack of reading skills. Participants who completed ACASI were more likely to report IDU, rape, group sex, and payment for sex by women than when asked in FtF interview. ACASI appears to be a useful tool for high risk behaviour assessments in the African context

Degeneration of cleaned-up, virus-tested sweetpotato seed vines in Tanzania

Viruses pose a major challenge to sweetpotato production in Tanzania. Use of cleaned-up, virus-tested seed vines distributed through a formal seed system is among the proposed strategies to address this challenge. However, virus-tested seed vines can get infected once in the field and it is not known how they will perform following several seasons of on farm propagation. We assessed the performance of virus-tested seed vines and farmer-sourced seed vines of a susceptible variety, Ejumula, and a relatively tolerant variety, Kabode, over five seasons to understand the trend in root yields, vine yields and virus incidences. The experiments were done in high and low virus pressure areas. The most prevalent viruses were sweet potato chlorotic stunt virus (SPCSV) followed by sweet potato feathery mottle virus (SPFMV) and sweet potato leaf curl virus (SPLCV), respectively. Both farmer-sourced and cleaned-up, virus-tested seed of cv. Ejumula were rapidly infected with SPCSV. The incidence of this virus on Ejumula's farmer-sourced material at the high-virus-pressure area reached 100% by the second season. The incidences for all three viruses remained stable for cv. Kabode across the five seasons. Plants generated from cleaned-up, virus-tested seed had lower incidences for all viruses compared to those from farmer-sourced planting material. Virus-tested seed produced significantly higher root yields for cv. Ejumula in the high-virus-pressure site, with a gradual drop across the seasons. The findings show that regular replenishment of clean, virus-tested seed is more economical in high-virus-pressure areas and for more susceptible varieties like cv. Ejumula. They also indicate that farmers may be reluctant to invest in cleaned-up, virus-tested seed in cases where they have virus-tolerant varieties such as cv. Kabode due to lack of obvious virus effect on yields

UvA-DARE (Digital Academic Repository) Link to publication Citation for published version (APA): Sex Transm Infect

General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. ABSTRACT Objectives To assess the burden of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in high-risk HIV-1 negative men who have sex with men (MSM) in Africa. Methods Before the start of a pre-exposure prophylaxis trial, HIV-1 negative volunteers were screened for sexually transmitted infection (STI) including CT and NG, using a highly sensitive and specific nucleic acid amplification test. Samples positive for CT by Aptima testing, were evaluated for the presence of lymphogranuloma venereum (LGV) serovars using an inhouse PCR assay. All men were asked to submit a urine specimen, and all had a rectal swab collected by a clinician. Men were asked if they had dysuria, urethral or rectal discharge, or rectal pain. Results 43 HIV-1 negative MSM were screened, of whom 13 reported sex with men only; the majority (27/ 43) reported sex work. One volunteer had dysuria and another, rectal pain. Eleven MSM (26%, 95% CI 14% to 41%) had infections with either or both pathogens. Homosexual men had a higher prevalence of any infection than bisexual men (46% vs 17%, p¼0.04), and all cases of rectal infections, including one with CT, two with NG and two with CT/NG co-infection. All patients with CT were negative for LGV. One patient with a rectal NG infection reported rectal pain. Conclusions A remarkably high burden of STI infection was found among HIV-1 negative MSM. Most (12/13) infections, including three of four rectal NG infections, were subclinical. These findings suggest that high-risk MSM will benefit from effective STI screening in Kenya

Comparison of characteristics in 139 women in Audio Computer-Assisted Self-Interview (ACASI) and Face-to-Face (FtF) interview, at cohort enrolment, Kenya, 2008.

<p>IQR inter quartile range.</p>1<p>Spearman or kappa statistic.</p>2<p>Included those active in past week: 126 women in ACASI; 125 women in FtF.</p>3<p>Included those not active in past week: 13 women in ACASI; 14 in FtF.</p>4<p>Variable missing for 30 women who completed the study before this question added.</p>5<p>Missing values in 1 woman.</p

Acceptability of Audio Computer-Assisted Self-Interview (ACASI) of 139 women and 259 men, at cohort enrolment, Kenya, 2008.

2<p>Missing values in acceptability questions during start up period (March–April 2006; 22 women and 19 men).</p

A–D: Bland-Altman plots.

<p>The plots show differences between number of regular and casual partners in the last week collected by Audio Computer-Assisted Self-Interview (ACASI) and Face-to-Face interview (FtF) in the same volunteer on the same day, Mombasa, Kenya. The Y-axis presents the difference in partner counts in ACASI and FtF; the X-axis presents the mean number of partners in both methods. Top row: regular partners in the last week in women (A) and men (B); bottom row: casual partners in the last week in women (C) and men (D). Horizontal lines: mean of difference with the 95% limits of agreement. Interpretation figures A and B: ACASI captures a higher number of regular partners in women and men when the average number of regular partners captured in both interview methods is about two or higher. Interpretation figures C and D: For women, the variability between methods is more constant. For men, there is more variation between methods.</p

Characteristics of Audio Computer-Assisted Self-interview (ACASI)-participating and non-participating study participants, at cohort enrolment, Kenya, 2008.

<p>Characteristics of Audio Computer-Assisted Self-interview (ACASI)-participating and non-participating study participants, at cohort enrolment, Kenya, 2008.</p