Application of computer-assisted interviews to sexual behavior research

Collection of sensitive data with the use of video-enhanced, computer-assis ted, self-administered interviews (V-CASI) has the potential to reduce inte rview bias and improve the validity of the study. The purpose of this study was to compare responses to sensitive questions elicited by V-CASI and by face-to-face interview (FTFI) methods. Women attending a New Orleans, Louis iana, public family planning or sexually transmitted disease clinic from Ju ly 1995 to July 1996, diagnosed with a Chlamydia trachomatis infection resp onded to eight close-ended behavioral questions (four socially undesirable, two socially desirable, and two neutral behaviors) using both FTFI and V-C ASI techniques in a randomized crossover design. Of the 280 women included, the mean age was 23 years, 95 percent were African American, and 71 percen t felt comfortable using computers. While kappa scores indicated good-to-ex cellent agreement between interview techniques, women tended to admit to so cially undesirable behaviors more often on V-CASI compared with FTFI. Thirt y percent of the women gave a discrepant response between V-CASI and FTFI t oward social desirability. Women who reported a socially undesirable behavi or in V-CASI (i.e., more than two sex partners and infrequent condom usage) were more likely to have a discrepant response. Utilization of the same lo gistic regression model to predict condom use yielded different results whe n data from V-CASI were used compared with data from FTFI. The V-CASI techn ique can reduce social desirability bias and improve validity in research r equiring information on sensitive sexual behaviors.