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American Journal of Epidemiology Vol. 152, No. 2 : 99-106
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health


PRACTICE OF EPIDEMIOLOGY

Randomized Controlled Trial of Audio Computer-assisted Self-Interviewing: Utility and Acceptability in Longitudinal Studies

David S. Metzger1, Beryl Koblin2, Charles Turner3, Helen Navaline1, Francesca Valenti2, Sarah Holte4, Michael Gross5, Amy Sheon6,8, Heather Miller3, Philip Cooley3 and George R. Seage III for the HIVNET Vaccine Preparedness Study Protocol Team5,7

1 University of Pennsylvania/VA Center for Studies of Addiction, Philadelphia, PA.
2 Laboratory of Epidemiology, New York Blood Center, New York, NY.
3 Research Triangle Institute, Washington, DC, and Research Triangle, NC.
4 Fred Hutchinson Cancer Research Center, Seattle, WA.
5 Abt Associates, Inc., Cambridge, MA, and Bethesda, MD.
6 University of Michigan, Ann Arbor, MI.
7 Harvard University School of Public Health, Cambridge, MA.
8 Previous address: National Institute of Allergy and Infectious Diseases, Bethesda, MD.

Recent studies have reported on the utility of audio computer-assisted self-interviewing (ACASI) in surveys of human immunodeficiency virus (HIV) risk behaviors that involve a single assessment. This paper reports the results of a test of ACASI within a longitudinal study of HIV risk behavior and infection. Study participants (gay men (n = 1,974) and injection drug users (n = 903)) were randomly assigned to either ACASI or interviewer-administered assessment at their second follow-up visit 12 months after baseline. Significantly more of the sexually active gay men assessed via ACASI reported having sexual partners who were HIV antibody positive (odds ratio = 1.36, 95% confidence interval: 1.08, 1.72), and a higher proportion reported unprotected receptive anal intercourse. Among injection drug users (IDUs), our hypothesis was partially supported. Significantly more IDUs assessed via ACASI reported using a needle after another person without cleaning it (odds ratio = 2.40, 95% confidence interval: 1.34, 4.30). ACASI-assessed IDUs reported similar rates of needle sharing and needle exchange use but a lower frequency of injection. Participants reported few problems using ACASI, and it was well accepted among members of both risk groups. Sixty percent of the participants felt that the ACASI elicited more honest responses than did interviewer-administered questionnaires. Together, these data are consistent with prior research findings and suggest that ACASI can enhance the quality of behavioral assessment and provide an acceptable method for collecting self-reports of HIV risk behavior in longitudinal studies and clinical trials of prevention interventions.

assessment, risk; HIV; homosexuality, male; questionnaires; sex behavior; substance abuse, intravenous

Abbreviations: ACASI, audio computer-assisted self-interviewing; HIV, human immunodeficiency virus; IAQ, interviewer-assisted questionnaire; IDUs, injection drug users; VPS, Vaccine Preparedness Study.


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