Mensch Barbara S, Hewett Paul C, Jones Heidi E, Luppi Carla Gianni, Lippman Sheri A, Pinho Adriana A, Diaz Juan
Population Council, New York, USA.
Int Fam Plan Perspect. 2008 Dec;34(4):169-76. doi: 10.1363/ifpp.34.169.08.
Inaccurate reporting of sexual behavior creates a misleading picture of individuals' risk for STI infection. Despite a substantial body of U.S. research on the consistency of self-reports of sensitive behavior, only a few such studies have been conducted in developing countries.
Consistency in the reporting of sexual activity and other sensitive behaviors was assessed among 818 women aged 18-40 who enrolled in 2004 in a study examining STI screening and diagnosis in São Paulo, Brazil. Participants were randomized into face-to-face interview and audio computer-assisted self-interview (audio-CASI) groups, and a six-week follow-up interview was conducted using audio-CASI for all participants. Differences between groups were assessed using t tests, and logistic regression analyses were used to estimate the likelihood of inconsistency within the enrollment interview and between the enrollment and follow-up interviews.
Consistency in reporting at the enrollment interview was higher in the face-to-face group than in the audio-CASI group, likely because interviewers prompted women to reconcile discrepant responses, whereas the audio-CASI program did not enforce logical consistency. However, consistency between enrollment and follow-up was significantly lower in the face-to-face group for abortion, marijuana use, transactional sex, coerced sex and number of lifetime sexual partners, because of increased reporting at follow-up using audio-CASI.
Although the analysis of internal consistency at enrollment suggests that computerized interviewing may increase random measurement error, it appears to reduce social desirability bias and encourage higher reporting of sensitive behaviors.
性行为报告不准确会造成对个体性传播感染风险的误导性认知。尽管美国有大量关于敏感行为自我报告一致性的研究,但在发展中国家开展的此类研究却寥寥无几。
在2004年参与巴西圣保罗一项性传播感染筛查与诊断研究的818名18至40岁女性中,评估性行为及其他敏感行为报告的一致性。参与者被随机分为面对面访谈组和音频计算机辅助自我访谈(音频-CASI)组,所有参与者均通过音频-CASI进行为期六周的随访访谈。使用t检验评估组间差异,并采用逻辑回归分析来估计入组访谈中以及入组访谈与随访访谈之间不一致的可能性。
在入组访谈中,面对面组的报告一致性高于音频-CASI组,这可能是因为访谈者促使女性协调不一致的回答,而音频-CASI程序并未强制逻辑一致性。然而,由于在随访中使用音频-CASI导致报告增加,面对面组在堕胎、使用大麻、交易性行为、强迫性行为及终身性伴侣数量方面,入组与随访之间的一致性显著降低。
尽管对入组时内部一致性的分析表明,计算机化访谈可能会增加随机测量误差,但它似乎能减少社会期望偏差,并鼓励更多地报告敏感行为。