Randomized Controlled Trial of Audio Computer-assisted Self-Interviewing: Utility and Acceptability in Longitudinal Studies

TLDR

ACASI has been shown useful in single‑assessment HIV risk surveys. The study evaluates ACASI’s utility and acceptability in a longitudinal HIV risk assessment. Participants (1,974 gay men and 903 injection drug users) were randomized to ACASI or interviewer assessment at a 12‑month follow‑up. ACASI led gay men to report more HIV‑positive partners and unprotected sex, and injection drug users to report more needle sharing, while overall acceptability was high, with 60 % reporting greater honesty, supporting ACASI’s utility in longitudinal HIV risk studies.

Abstract

Recent studies have reported on the utility of audio computer-assisted self-interviewing (ACASI) in surveys of human immunodeficiency virus (HIV) risk behaviors that involve a single assessment. This paper reports the results of a test of ACASI within a longitudinal study of HIV risk behavior and infection. Study participants (gay men (n = 1,974) and injection drug users (n = 903)) were randomly assigned to either ACASI or interviewer-administered assessment at their second follow-up visit 12 months after baseline. Significantly more of the sexually active gay men assessed via ACASI reported having sexual partners who were HIV antibody positive (odds ratio = 1.36, 95% confidence interval: 1.08, 1.72), and a higher proportion reported unprotected receptive anal intercourse. Among injection drug users (IDUs), our hypothesis was partially supported. Significantly more IDUs assessed via ACASI reported using a needle after another person without cleaning it (odds ratio = 2.40, 95% confidence interval: 1.34, 4.30). ACASI-assessed IDUs reported similar rates of needle sharing and needle exchange use but a lower frequency of injection. Participants reported few problems using ACASI, and it was well accepted among members of both risk groups. Sixty percent of the participants felt that the ACASI elicited more honest responses than did interviewer-administered questionnaires. Together, these data are consistent with prior research findings and suggest that ACASI can enhance the quality of behavioral assessment and provide an acceptable method for collecting self-reports of HIV risk behavior in longitudinal studies and clinical trials of prevention interventions.