Audio computer assisted interviewing to measure HIV risk behaviours in a clinic population

Abstract

Objectives: To examine whether audio computer assisted survey interviewing (ACASI) influenced responses to sensitive HIV risk behaviour questions, relative to interviewer administration of those questions (IAQ), among patients attending a sexually transmitted infection (STI) clinic and whether the impact of interview mode on reporting of risk behaviours was homogeneous across subgroups of patients (defined by age, sex, and previous STI clinic experience). Methods: 1350 clinic patients were assigned to complete a detailed behavioural survey on sexual risk practices, previous STIs and symptoms, condom use, and drug and alcohol use using either ACASI or IAQ. Results: Respondents assigned to ACASI were more likely to report recent risk behaviours such as sex without a condom in the past 24 hours (adjusted OR = 1.9), anal sex (adjusted OR = 2.0), and one or more new partners in the past 6 months (adjusted OR = 1.5) compared to those interviewed by IAQ. The impact of ACASI varied by sex but, contrary to expectations, not by whether the patient had previously visited an STI clinic. Mode of survey administration made little difference within this population in reports of STI knowledge, previous STIs, STI symptoms, or illicit drug use. Conclusion: ACASI provides a useful tool for improving the quality of behavioural data in clinical environments.

Risk Behavior Disclosure During HIV Test Counseling

“…Previous research in North Carolina documented that young men newly diagnosed with HIV were more likely to accurately disclose the gender of their sexual partners during postdiagnosis partner notification and referral services interviews than during pretest counseling. 15 Additional research has shown that STD clinic patients provide more or different information when completing an audio and computer-assisted self-interview (ACASI) than in clinician interviews [16][17][18] suggesting that a face-to-face, counselor implemented HIV counseling risk assessment may also be incomplete.…”

Examining the Role of Serostatus Disclosure on Unprotected Sex Among People Living with HIV

“…Data on serostatus disclosure and unprotected sex, based as they often are on participant self-report without substantiation from partners, may be subject to recall and social desirability biases. We stressed participant confidentiality and used an ACASI to help minimize these biases 56,57 but it is still possible that people overreported disclosure and under-reported unprotected sexual activity. The question used to operationalize serostatus disclosure was purposely designed to be double-barreled, which participants could have misinterpreted.…”

Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model

“…Several alternative interview formats have been tested in an attempt to reduce this bias, including audio-computer-assisted self-interviews (ACASI), informal confidential voting interviews (ICVI), and self-administered questionnaires (SAQ). Using these more impersonal interview techniques, it has been found that women's odds of reporting multiple sexual partners are between 1.0 and 5.2 times those reported in FTFIs (Ghanem et al 2005;Kissinger et al 1999;Rogers et al 2005;Gregson et al 2004;Gregson et al 2002), with this multiple being considerably higher in married women than in unmarried women (Gregson et al 2002). Men's odds of reporting multiple partners in the more impersonal interview formats are between 1.1 and 1.7 times those in FTFIs (Ghanem et al 2005;Rogers et al 2005;Gregson et al 2004;Gregson et al 2002).…”

“…Sexual behaviour data have traditionally been captured in face-to-face interviews (FTFIs), but such interviews have been shown to elicit significantly lower reported numbers of sexual partners when compared with recently developed interview formats that are more impersonal and anonymous (Ghanem et al 2005;Kissinger et al 1999;Rogers et al 2005;Mensch, Hewett, and Erulkar 2003;Gregson et al 2004). Studies have also shown that prompting individuals with additional questions can lead to enhanced recall of past sexual relationships (Brewer et al 2005).…”