IJE Advance Access originally published online on May 15, 2009
International Journal of Epidemiology 2009 38(4):1118-1127; doi:10.1093/ije/dyp210
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Improving epidemiological surveys of sexual behaviour conducted by telephone
1Queens College and the Graduate Center, City University of New York, Flushing, NY, USA.
2Program in Health and Behavior Measurement, Research Triangle Institute, Washington, DC, USA.
3Denver Public Health, Denver, CO, USA.
4Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
5Center for Survey Research, University of Massachusetts at Boston, Boston, MA, USA.
6Statistics and Epidemiology Division, Research Triangle Institute, Research Triangle Park, NC, USA.
7Research Computing Division, Research Triangle Institute, Research Triangle Park, NC, USA.
* Corresponding author. Queens College, City University of New York, Flushing, NY 11367, USA. E-mail: cfturner{at}popepi.org
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Abstract |
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Background This study assesses the impact of Telephone Audio Computer-Assisted Self-Interviewing (T-ACASI) on the reporting of sensitive (mainly heterosexual) behaviours.
Methods A randomized experiment was embedded in a telephone survey that drew probability samples of the populations of the USA (N = 1543) and Baltimore city (N = 744). Respondents were randomly assigned to have questions asked either by a T-ACASI computer or by a human telephone interviewer.
Results Compared with interviewer-administered telephone surveys, T-ACASI obtained more frequent reporting of a range of mainly heterosexual behaviours that were presumed to be sensitive, including recency of anal sex [adjusted odds ratio (A-OR) = 2.00, P < 0.001), sex during menstrual period (A-OR = 1.49, P < 0.001), giving oral sex (A-OR = 1.40, P = 0.001) and receiving oral sex (A-OR = 1.36, P = 0.002), and sexual difficulties for the respondent (A-OR = 1.45, P = 0.034) and their main sex partner (A-OR = 1.48, P = 0.0). T-ACASI also obtained less frequent reporting that respondent had a ‘main sex partner’ (A-OR = 0.56, P = 0.011) and discussed contraception prior to first sex with that sex partner (A-OR = 0.82, P = 0.094). For both males and females, T-ACASI obtained more frequent reports of first vaginal sex occurring at early ages (before ages 12 through 15). ‘For males only’, T-ACASI also elicited more frequent reports that first vaginal sex had ‘not’ occurred at later ages (i.e. by ages 20 through 24).
Conclusion T-ACASI increases the likelihood that survey respondents will report sensitive heterosexual behaviours.
Keywords Population surveys, methodology, sexual behaviours, STD risk behaviours, T-ACASI, computerized surveys, sexually transmitted infections
Accepted 9 April 2009