Audio Computer-Assisted Self-Interviews Do Not Necessarily Yield Higher Reports of Sensitive Behaviors (Digests) (Clinical Report‪)‬

Women who participated in audio computer-assisted self-interviews (audio-CASI) were less likely than those in face-to-face interviews to report ever having had sex (35% vs. 48%) in response to a question on age at first sex, according to a randomized study among unmarried young women in rural Malawi. (1) However, women in the audio-CASI group were more likely than those in the conventional interview group to report having had multiple partners (27% vs. 17%) and having had sex with a friend or acquaintance (17% vs. 7%), as well as to give inconsistent responses regarding their sexual history. Respondents in the two interview groups had similar levels of STIs, although the association between sexual experience and STI status was stronger in the face-to-face group. Most studies of audio-CASI have been conducted in developed countries, where computer literacy is high. To compare the effectiveness of the technique with that of face-to-face interviews in eliciting reports of sexual behavior in a developing country, researchers questioned 501 unmarried Malawian women aged 15-21 regarding their sexual history. The women lived in villages near centralized market areas in Balaka district, located in the region with the country's highest rates of HIV infection, teenage pregnancy and risky sexual behavior. Women were randomly assigned to a face-to-lace interview or an audio-CASI interview on a laptop computer, during which they were asked about their age at first sex and, regardless of their answer, the types of partners they had had sex with (e.g., boyfriend, expected spouse, or friend or acquaintance). Following the interviews, researchers asked respondents whether they were willing to be tested for HIV and three other STIs (gonorrhea, chlamydia, trichomoniasis); 84% were tested for at least one infection using vaginal or oral swabs. Prior to testing, they were asked again--this time by trained nurses--about their age at first sex.