Principal Investigators: Anthony P.Macmillan Coxon, PhD

January 2004 Sociology, University of Edinburgh

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Project SIGMA

Principal Investigators:Anthony P.Macmillan Coxon, PhD

Hon. Professorial Fellow, Graduate School of SPS, University of Edinburgh

Thomas J. McManus, FRCOGConsultant, Royal London Hospital

Project SIGMA, Edinburgh and Sigma Research (London) together constitute

PROJECT SIGMA

Researching and Serving the Gay and Bisexual Community for 18 years


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Project SIGMA

What’s

UNIQUE

about……. Sexual Diaries?

byProfessor Tony Macmillan CoxonSSPS, University of Edinburgh, Project Sigma

PARTICULARSPECIAL


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Project SIGMA

DIARIES

Only good girls keep diaries. Bad girls don’t have the time.

Tallulah Bankhead (1903 – 1968) US Actress

What is a diary as a rule? A document useful to the person who keeps it, dull to the contemporary who reads it, invaluable to the student, centuries afterwards, who treasures it!

Ellen Terry (1847–1928) British actress,The Story of

My Life, Ch. 14


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Project SIGMA

I never travel without my diary. One should always have something sensational to read in the train Oscar Wilde (1895) The Importance of Being

Earnest


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Project SIGMA

0: BACKGROUND From earliest SIGMA pre-tests in 1982, estimates and self-

reports of frequency of sexual behaviours were shown to be [1988b]:

unreliable (test-retest;repeat questions in interview)

retrospection- biased

detail and accuracy of reports dependent (inversely) on elapse time

1-week retrospective “work-back from today” showed even 3-day lapse distorted detail and only gross properties survived

“chunked” (suspicious rounding of numbers and “grossing up”


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Project SIGMA

... This led to basic re-thinking & development:

development of a schema/model of “structure of sexual behaviour” [1992] (which determined both form of Sexual Behaviour Inventory used in

interview schedule AND format for sexual diary method)


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Project SIGMA

method of sexual diaries (Self-administered; month-long) to make possible ....

reliable, valid, accurate measurement of

detailed sexual behaviour and sequences of behaviour

in a contextual and relational setting.

Reduce retrospection bias; S.D.s are a non (interviewer)-reactive method (cf interpretation of “the condom broke”)


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Project SIGMA

COLLECT / elicit (sexual diaries) (Qualitative) Transcribe

ENCODE Tag

SELECT

ANALYSE (Integrate) Analyze(SDA Programs) (Atlas/ti &c)

HOW? Sequence of Using Sexual Diary Methodology


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Abbreviated example of a one-week of a sexual diary


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Project SIGMA

ANALYSIS

By means of a SCHEMASCHEMA common to Project SIGMA Sexual Inventory and Sexual Diaries [JSR 1992]

• The Schema has linguistic analogies:

Sexual Session = SentenceSentenceSexual Act = WordWordSexual Behaviour = Word-stemWord-stem

• Schema puts eliciting format and encoding structure for sexual scripts into 1:1 correspondence


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SIGMA schema of sexual behaviour

(relevant to sexual transmission of HIV)


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Project SIGMA

The SCHEMASCHEMA has a well-defined grammar

…..usually shielded from the enquirers’ eyes…

Formal Grammar of Revised Sexual Diary Code

<session> ::= <act> <act> ' ' < session>

<act> ::= '(' <act> ')' '/' <accomps> <act> '/' <accomps> <partner_label> <session> <act> '&' <act> <modality> <behaviour> <modality> <behaviour> ',' <outcomes>…………/cont.


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OUTCOME (risk order)Code Destination

N No ejaculation

X Ejaculation `elsewhere'

I On Me (ie: on EGO)

O On Him (ie: on ALTER)

C into a Condom

H In Him (ie: in ALTER)

M In Me (ie: in EGO)


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Project SIGMA

PROGRAMNAME

FULL NAME & DESCRIPTION SDA(pp)

BAPN Both-Active-Passive-Neither: Modality (Sexual Role) Analysis by sexual act

5,35

COLLECT

Sexual Session length distribution and Mean length

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CONDOM Percentage of sessions in which a condom was used

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COOCUR Co-occurrence of sexual acts in a session. (Different definitions of co-occurrence: act-specific and session specific)

7-8;37

CPSANAL

Co-occurrence (similarity, symmetric), Precedence (asymmetric: how often a precedes b); Successor (asymmetric: how often a succeeds b). Output matrix to Scaling and Clustering programs.

7-8;39

EVER Prevalence (How often a sexual act has ever been done)

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Project SIGMA

FREQACT Frequency of (sexual) act by modality 40-41

GINI / LORENZ

Frequency (and cumulative) frequency of Individuals who do exactly n acts and of Acts (basis for Lorenz distribution, qv) and Gini Coefficient

Suppl.

KWIC Key-word-in-context: Instances of specified modality/act in context of session, centred and referenced

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MARKER Analysis of sexual acts that start and end sessions, and of the “destination” of the ejaculate/s, if it/they occur

44-5

MEDPOL Median Polish Tukey Means analysis of 2-way table, defined by SIGMA types

Suppl.

RISK Frequency of type and destination of outcome (ejaculation) by sexual act ( Anal Intercourse, Fellatio or Masturbation; denominator can be N Acts or N Individuals

8, 45-46

SESSTYPE

Session-Type: typology of sessions in terms of: Solo-Quick(1-act) - Role (preponderance of Active or Passive role) - Reciprocated - Other

9, 47


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WHAT FOR? Applications

Primarily...

Counts of incidence and prevalence of sexual practices & variants, on both {Individual/month} and {Acts/month} bases

In contextual / sequential / vocational environment

Within/Across subgroups (HIV+, condom usage, age, relationship-type ...)


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Project SIGMA

For example: Role-separation (“gendering” ( [1993]) Concentration of potential and actual risk

behaviour[1999] Inferring the contextual “rules” of risk [1994b, 1995b] Factors influencing risk behaviour (e.g. substance use;

alcohol) [1994a] Partner-specific sexual behaviour [1988] Differential: location/arenas – home; club; saunas,

Public Sex Environments (cottaging, tea-room) [1996] times – weekends, holidays, at parents

Different subgroups: SM/Leather [1996], Minority Ethnic groups; Young gay men


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Project SIGMA

BRIEF EXAMPLE ... Concentration

• Example which combines Individual with Acts data derived from diaries.

• Concentration is akin to Property/Income distribution: What Percent of Individuals “own” what Percent of Risk Activity?

• Inter-relating two distributions cumulatively

• Useful Equality baseline ... where n% of individuals own n% of risk activity ... allows us to see how far actual concentration departs from equal shares ... Gini Coefficient.


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Project SIGMA

BRIEF EXAMPLE ... Concentration/cont.

• This needs two cumulative distributions

• ... cross-related to each other

• to produce Lorenz diagram and

• measure of departure from “equal shares”

• and then go on to examine characteristics of the distribution and who the “risk-rich” are


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Project SIGMA

(i) No of acts of anal inter-course (to ejaculation)

per/month

(ii)N of men (diary/m)

(Iii)Percent of men

(iv)Cumulative % of men

(v) N of acts ofanal in-tercourse

(vi)Percentof acts

(vii)Cumulative % acts

1 244 38.9 38.9% 244 9.8% 9.8%

2 136 21.7 60.5 272 11.0 20.8

3 62 9.9 70.4 186 7.5 28.3

4 49 7.8 78.2 196 7.9 36.2

5 34 5.4 83.6 170 6.9 43.1

6 20 3.2 86.8 120 4.8 47.9

7 11 1.8 88.5 77 3.1 51.0

8 13 2.1 90.6 104 4.2 55.2

9 7 1.1 91.7 63 2.5 57.7

10-19 36 5.7 97.5 466 18.8 76.5

20-49 14 2.2 99.7 405 16.3 92.8

50-104 2 (=628)

0.3 100.0 178=2481

7.2 100.0

Distributions of acts of anal intercourse to ejaculation (AIE) per month

Mean = 3.8, Md = 2 acts of AI/month. IQR = 3


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Project SIGMA

% of Total Acts of AI per month

(SIGMA diary data)

No. of acts of AI/month

Pe

rc

en

ta

ge

0

10

20

30

40

5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80

Percentage of acts of AI accounted for by those who do exactly x acts a month

Constituent Distributions of anal intercourse


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Project SIGMA

% of Individuals who have exactly X acts of AI/month

(SIGMA diary data)

No. of acts of AI/month

Percen

tag

e

0

5

10

15

20

25

30

35

40

5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80

Percentage of individuals who do exactly x acts of AI a month


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Lorenz curve of all acts of Anal Intercourse/month


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TYPE OF AIE[1]

UNPROTECTED WITH CONDOM

SummaryCharacteristics:

ACTIVE

PASSIVE

ACTIVE

PASSIVE

NUMBERS INVOLVED:No. of fuck-acts/month No. of individuals

434

188

442

154

362

163

380

172

SUMMARY INFO:Average no. acts/month Dispersion (IQR)

2.31, Md=1 1

2.87, Md=1 2

2.22, Md=1 1

2.21, Md=1 1

LOW-END CONCENTRATION:% of individuals who do exactly 1 act/month% who do 1 or 2 acts/month

54%

75%

51%

73%

55%

75%

60%

75%HIGH-END CONC.Top 1/10th individuals account for: (%acts)

34%

46%

32%

34%OVERALL CONCENTRATION: (Gini)

0.42

0.51

0.42

0.43

Characteristics of four types of AIE


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Project SIGMA

Use & Development of Sexual Diaries in Project SIGMA

Largest

Most extensive (in time, location, age, etc)

Well-documented data set of sexual diaries

With associated special-purpose software

Enabling session-based, act-based or individual-based analysis


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Project SIGMA

• 1,661 individuals from

• 25 sites in the UK produced

• 1,963 month-long diaries

consisting of

• 32,142 sexual sessions


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Project SIGMA

ARCHIVING : SEXUAL DIARY DATA……Exist in two forms:Natural-language (anonymised)

originals • hard-copy diaries have been anonymised,

indexed, documented and reduced to micro-fiche form;

• now archived and lodged in Wellcome Contemporary Medical Archives Centre, London;

• accessible to any bona fide researcher. • http://www.wellcome.ac.uk/en/library/homlib/

HOMlibCOLspeCMCaccGENmtr.html#P


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Project SIGMA

ARCHIVING : SEXUAL DIARY DATA……Machine-readable (flat) database of

diary records • SIGMA Panel members’ (and additional

groups’) diary data in pre-database format (.dmp files) for entry into other database and special purpose analytic software;

• To be lodged at Data Archive, Essex (http://dawww.essex.ac.uk/);

• Plans for dissemination of these data, and wider SIGMA data in NESSTAR environment:

• http://www.nesstar.org/


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Project SIGMA

ARCHIVING : SEXUAL DIARY DATA……Cross-linking index

• In preparation to enable original diary, machine readable version and interview data to be cross-accessed;

Special-purpose software• Written to store and analyse these

data (SDA: Sexual Diary Analysis) • These data & programs also available

from Data Archive / Project SIGMA Essex


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WEBSITE

Contains Documentation, Programs, Sample Data, Diary Form, Publications, Conference OHP’s:

http://www.sigmadiaries.com/


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CONCLUSIONS

Sexual Diaries….. At the humblest level, offer a markedly

different, non-reactive contrast to SAQ/interview data on sexual behaviour

data are more like a “trace” than an account; the significant data are “read-off” the sexual accounts, not estimated by the respondent

relate both acts and individuals and allow their integration ( e.g. concentration)


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Project SIGMA

CONCLUSIONSSexual Diaries…..

can be interpreted not only as scripts, but linguistically as a simple code (language) and as free text, thus making semantic and grammatical analysis possible ( e.g. KWIC, co-occurr)

allow development and definition of higher-level categories (risk; “oriented risk”, power session...)

allow definition of rules, patterns sequences of any complexity, which can be defined, retrieved, & tested


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Project SIGMA

WEBSITE

Contains Documentation, Programs, Sample Data, Diary Form, Publications, Conference OHP’s:

http://www.sigmadiaries.com/

Principal Investigators: Anthony P.Macmillan Coxon, PhD

Documents

Transcript of Principal Investigators: Anthony P.Macmillan Coxon, PhD