Assessing sexual risk behaviour with the Timeline Followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients

This paper describes a series of 4 studies, designed to provide evidence of the feasibility, reliability, and validity of the Timeline Followback (TLF B) method when used to assess sexual risk behaviour with psychiatric outpat ients. This population was selected because patients often have difficulty completing assessments of sexual risk behaviours due to deficits in attenti on, memory, and communication skills. All 4 studies demonstrated the feasib ility of the HIV-risk TLFB. Study 1 also demonstrated that it can be comple ted in 20 min, and scored in less than 10 min. Qualitative data revealed th at both patients and assessors found the features of the TLFB helpful. Stud y 2 provided evidence that the HIV-risk TLFB can be reliably scored by inte rviewers whereas Study 3 demonstrated that this measure can be completed re liably by patients and that TLFB of sexual behaviour were consistent over t ime. Study 4 provided initial evidence for the validity of the HIV-risk TLF B but also suggested that the TLFB may yield frequency estimates that are s lightly less than those obtained with single-item measures. We conclude tha t the TLFB is feasible, reliable, and valid, even in a population known to have difficulty with self-report measures.