Objective Studies identifying risks and evaluating interventions for human
immunodeficiency virus (HIV) and other sexually transmitted infections
often rely on self-reported measures of sensitive behaviours.
Such self-reports can be subject to social desirability bias.
Concerns over the accuracy of these measures have prompted efforts
to improve the level of privacy and anonymity of the interview
setting. This study aims to determine whether such novel tools
minimize misreporting of sensitive information.
Methods Systematic review and meta-analysis of studies in low- and
middle-income countries comparing traditional face-to-face interview
(FTFI) with innovative tools for reporting HIV risk behaviour.
Crude odds ratios (ORs) and 95% confidence intervals (CIs) were
calculated. Cochran’s chi-squared test of heterogeneity was performed
to explore differences between estimates. Pooled estimates
were determined by gender, region, education, setting and question
time frame using a random effects model.
Results We found and included 15 data sets in the meta-analysis. Most
studies compared audio computer-assisted self interview (ACASI)
with FTFI. There was significant heterogeneity across studies for
three outcomes of interest: ‘ever had sex’ (I2¼93.4%, P<0.001),
non-condom use (I2¼89.3%, P<0.001), and number of partners
(I2¼75.3%, P<0.001). For the fourth outcome, ‘forced sex’, there
was homogenous increased reporting by non-FTFI methods (OR
1.47; 95% CI 1.11–1.94). Overall, non-FTFI methods were not consistently
associated with a significant increase in the reporting of all
outcomes. However, there was increased reporting associated with
non-FTFI with region (Asia), setting (urban), education (460% had
secondary education) and a shorter question time frame.