IN PRACTICE

Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients

K G Ghanem¹, H E Hutton¹, J M Zenilman¹, R Zimba², E J Erbelding^1,3

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA
² New York City Department of Health and Mental Hygiene, New York, NY, USA
³ Baltimore City Health Department, Baltimore, MD, USA

Correspondence to:
Correspondence to:
Khalil G Ghanem
MD, Johns Hopkins University, Bayview Medical Center, Division of Infectious Diseases, 4940 Eastern Avenue, B3 North, Suite 352, Baltimore, MD 21224, USA; kghanem{at}jhmi.edu

Background: Audio computer assisted self interview (ACASI) may minimise social desirability bias in the ascertainment of sensitive behaviours. The aim of this study was to describe the difference in reporting risk behaviour in ACASI compared to a face to face interview (FFI) among public sexually transmitted diseases (STD) clinic attendees.

Study design: Randomly selected patients attending a public STD clinic in Baltimore, Maryland, sequentially took an ACASI formatted risk behaviour assessment followed by an FFI conducted by a single clinician, with both interview modalities surveying sexual and drug use behaviours. Binary responses were compared using the sign test, and categorical responses were compared using the Wilcoxon signed rank test to account for repeated measures.

Results: 671 (52% men, mean age 30 years, 95% African American) of 795 clinic attendees screened consented to participate. Subjects affirmed sensitive sexual behaviours such as same sex contact (p = 0.012), receptive rectal sexual exposure (p<0.001), orogenital contact (p<0.001), and a greater number of sex partners in the past month (p<0.001) more frequently with ACASI than with an FFI. However, there were no differences in participant responses to questions on use of illicit drugs or needle sharing.

Conclusions: Among STD clinic patients, reporting of sensitive sexual risk behaviours to clinicians was much more susceptible to social desirability bias than was reporting of illegal drug use behaviours. In STD clinics where screening of sexual risk is an essential component of STD prevention, the use of ACASI may be a more reliable assessment method than traditional FFI.

Abbreviations: ACASI, audio computer assisted self interview; FFI, face to face interview; IDU, injection drug users; STD, sexually transmitted diseases

Keywords: audio computer assisted self interview; sexually transmitted diseases clinics

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