title: Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Johns Hopkins University School of Medicine, Bayview Medical Center, Division of Infectious Diseases, Baltimore, MD 21224, USA. kghanem@jhmi.edu
authors.forename: K G
authors.initials: KG
authors.lastname: Ghanem
authors.forename: H E
authors.initials: HE
authors.lastname: Hutton
authors.forename: J M
authors.initials: JM
authors.lastname: Zenilman
authors.forename: R
authors.initials: R
authors.lastname: Zimba
authors.forename: E J
authors.initials: EJ
authors.lastname: Erbelding
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D015982:Bias; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013637:Tape Recording; D047568:Unsafe Sex