Ghanem K G, Hutton H E, Zenilman J M, Zimba R, Erbelding E J
Johns Hopkins University School of Medicine, Bayview Medical Center, Division of Infectious Diseases, Baltimore, MD 21224, USA.
Sex Transm Infect. 2005 Oct;81(5):421-5. doi: 10.1136/sti.2004.013193.
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.
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.
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.
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.
音频计算机辅助自我访谈（ACASI）在确定敏感行为时可将社会期望偏差降至最低。本研究的目的是描述在公共性传播疾病（STD）诊所就诊者中，与面对面访谈（FFI）相比，ACASI在报告风险行为方面的差异。
随机选择在马里兰州巴尔的摩一家公共STD诊所就诊的患者，依次进行ACASI格式的风险行为评估，随后由一名临床医生进行FFI，两种访谈方式均调查性行为和药物使用行为。使用符号检验比较二元反应，使用Wilcoxon符号秩检验比较分类反应以考虑重复测量。
在795名接受筛查的诊所就诊者中，671人（52%为男性，平均年龄30岁，95%为非裔美国人）同意参与。与FFI相比，受试者通过ACASI更频繁地确认敏感性行为，如同性接触（p = 0.012）、直肠接受性性暴露（p < 0.001）、口交接触（p < 0.001）以及过去一个月内有更多性伴侣（p < 0.001）。然而，参与者对非法药物使用或共用针头问题的回答没有差异。
在STD诊所患者中，向临床医生报告敏感性风险行为比报告非法药物使用行为更容易受到社会期望偏差的影响。在将性风险筛查作为STD预防重要组成部分的STD诊所中，使用ACASI可能是比传统FFI更可靠的评估方法。
