16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

IMPACT OF LEVEL OF RESEARCHER SUPPORT ON COITAL DIARY RESULTS AND ACCEPTABILITY AMONG WOMEN AT HIGH RISK OF HIV IN THE MICROBICIDES DEVELOPMENT PROGRAMME FEASIBILITY STUDY IN MWANZA, TANZANIA

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAd0202

Allen C.F.¹, Lees S.S.², Desmond N.¹, Der G.¹, Chiduo B.³, Vallely A.², Hayes R.², Ross D.A.^2
1 Medical Research Council, Social and Public Health Sciences Unit, Glasgow, United Kingdom, ² London School of Hygiene and Tropical Medicine, London, United Kingdom, ³ National Institute for Medical Research, Mwanza, Tanzania, United Republic of

BACKGROUND: Low literacy and desire to conceal socially proscribed activities may hamper measurement of STI risk behaviour, especially in developing countries. Amongst vulnerable women, we compared reporting of sexual behaviour between pictorial coital diaries (CDs) and face-to-face interviews (FFIs), assessing which method was more sensitive to level of researcher support.

METHODS: A survey was conducted among female food and recreational facility workers in Mwanza, Tanzania recruited to the Microbicides Development Programme trial feasibility study. Three groups of 50 randomly selected women received differing levels of researcher support. Minimum support involved delivering and collecting CDs weekly. Participants with medium support also completed a weekly FFI and could discuss concerns with fieldworkers. Intensive support included an unscheduled mid-week visit when fieldworkers checked diaries and helped with concerns. All respondents participated in an exit FFI at the end of four weeks, including questions on CD acceptability.

RESULTS: Significantly higher frequencies of vaginal sex, male condom use, douching, sex with irregular and regular partners were reported in CDs than in exit interviews. Level of support was not significantly associated with reporting patterns in diaries, except for douching. In exit interviews, there were significant differences by level of support in frequencies for, and numbers of people reporting, vaginal sex, douching and sex with all three partner-types with highest frequencies in the intensive support group. Women with intensive support were least likely to find any CD pictures embarrassing and to have their diaries discovered, and most likely to complete their diaries daily and inform others about the study.

CONCLUSIONS: CDs result in higher reporting of socially stigmatised activities than FFIs, and are less sensitive to level of support. Convergence with interview results at higher levels of support also shows the relative validity of diaries. Intensive support improved the acceptability of the research process.

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2006-08-13
ThAd0202

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