Vaginal practices diary:  development of a pictorial data collection tool for sensitive behavioral data.
BACKGROUND
Intravaginal practices (IVP) are highly prevalent behaviors among women at increased risk for HIV in sub-Saharan Africa. IVP data collected by face-to-face interviews (FTFI) may be subject to recall or social desirability bias. Daily self-administered diaries may help to decrease bias associated with FTFI. IVP data from a diary and FTFI were compared during a multisite microbicide feasibility study in Tanzania and Uganda.


METHODS
In all, 200 women were recruited and given diaries to complete daily for 6 weeks. Data obtained in the diary were compared with data from the FTFI during clinical visits to assess the consistency of reporting of IVP between the data collection methods.


RESULTS
In Tanzania, proportions of overall vaginal cleansing and insertion were similar for the FTFI and the diary, but the diary indicated higher frequency of cleansing and use of a cloth or other applicator. In Uganda, proportions of overall vaginal cleansing were similar for FTFI and the diary, but the diary indicated higher frequency of cleansing, use of soaps and cloths for cleansing, and insertion. Most of the inconsistencies between the 2 data collection methods were from reported frequency of IVP or IVP related to sexual intercourse.


CONCLUSIONS
The comparison of FTFI and the vaginal practice diary suggests that recall of IVP may be improved by a daily self-administered diary, especially for frequency of cleansing and cleansing in proximity to sexual intercourse. The vaginal practices diary can provide a more detailed understanding of IVP and aid in the interpretation of findings from FTFI.
London School of Hygiene and Tropical Medicine, London, United Kingdom. suzanna.francis@lshtm.ac.uk
Suzanna C
SC
Francis
Shelley S
SS
Lees
Bahati
B
Andrew
Flavia
F
Zalwango
Judith
J
Vandepitte
Trong
T
Ao
Kathy
K
Baisley
Saidi
S
Kapiga
Heiner
H
Grosskurth
Richard
R
Hayes
D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016488:Medicine, African Traditional / Q000009:adverse effects; D011939:Mental Recall; D010349:Patient Compliance; D010353:Patient Education as Topic; D011446:Prospective Studies; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D057566:Self Report; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013636:Tanzania / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology; D014621:Vagina; D055815:Young Adult
D000891:Anti-Infective Agents, Local