Understanding human sexual behaviors is essential for the effective prevention of sexually transmitted infections (STI). Analysis of longitudinally measured sexual behavioral data, however, is often complicated by zero-inflation of event counts, nonlinear time trend, timevarying covariates, and informative dropouts. Ignoring these complicating factors could undermine the validity of the study findings. In this article, we put forth a unified joint modeling structure that accommodates these features of the data. Specifically, we propose a pair of simultaneous models for the zero-inflated event counts: Each of these models contains an auto-regressive structure for the accommodation of the effect of recent event history, and a nonparametric component for the modeling of nonlinear time effect. Informative dropout and time varying covariates are modeled explicitly in the process. Model fitting and parameter estimation are carried out in a Bayesian paradigm by the use of a Markov chain Monte Carlo (MCMC) method. Analytical results showed that adolescent sexual behaviors tended to evolve nonlinearly over time, and they were strongly influenced by the day-to-day variations in mood and sexual interests. These findings suggest that adolescent sex is, to a large extent, driven by intrinsic factors rather than being compelled by circumstances, thus highlighting the need of education on self-protective measures against infection risks.
- Joint modeling
- Markov Chain Monte Carlo
- Sexually transmitted infections
- Zero-inflated Poisson
ASJC Scopus subject areas
- Statistics and Probability
- Statistics, Probability and Uncertainty