Pivoting from in-person to phone survey assessment of alcohol and substance use: effects on representativeness in a United States prospective cohort of women living with and without HIV

ABSTRACT

Background: Many clinical and population-based research studies pivoted from in-person assessments to phone-based surveys due to the COVID-19 pandemic. The impact of these transitions on survey response remains understudied, especially for people living with HIV. Given that there are gender-specific trends in alcohol and substance use, it is particularly important to capture these data for women.

Objective: Identify factors associated with responding to an alcohol and substance use phone survey administered during the COVID-19 pandemic in the Women’s Interagency HIV Study, a multicenter US prospective cohort of women living with and without HIV.

Methods: We used multivariable logistic regression to assess for associations of pre-pandemic (April–September 2019) sociodemographic factors, HIV status, housing status, depressive symptoms, alcohol use, and substance use with response to an early-pandemic (August–September 2020) phone survey.

Results: Of 1,847 women who attended an in-person visit in 2019, 78% responded to a phone survey during the pandemic. The odds of responding were lower for women of Hispanic ethnicity (aOR 0.47 95% CI 0.33–0.66, ref=Black/African American) and those who reported substance use (aOR 0.63 95% CI 0.41–0.98). By contrast, the odds were higher for White women (aOR 1.64 95% CI 1.02–2.70, ref=Black/African American) and those with stable housing (aOR 1.74 95% CI 1.24–2.43).

Conclusions: Pivoting from an in-person to phone-administered alcohol and substance use survey may lead to underrepresentation of key subpopulations of women who are often neglected in substance use and HIV research. As remote survey methods become more common, investigators need to ensure that the study population is representative of the target population.

KEYWORDS:

• COVID-19 pandemic
• HIV
• women
• alcohol consumption
• substance use
• survey methods

Acknowledgments

The authors gratefully acknowledge the contributions of the study participants and dedication of the staff at the MWCCS sites.

Author contributions

HRT, PCT, JCP, and YM contributed the original concept and design of the study. MCK, DLJ, LFC, AAA, AC, ALF, ABS, JD, AS, JCP, PCT were involved in data collection. YM and HRT performed data analysis and all authors interpreted the data. HRT drafted the manuscript. PCT and JCP are responsible for project supervision. All authors have critically revised this article and approved the final version to be published.

Disclosure statement

RJD has received consulting fees from the Department of Defense, Morehouse School of Medicine, Benten Technologies, and Northwell Health. AAA has received consulting fees from Merck and Gilead; Merck and Gilead have provided her institution with funding for her research. AS has received consulting fees from Gilead; Gilead has provided her institution with funding for her research. Gilead, Merck, and Abbvie have provided JCP’s institution with funding for her research. Merck and Gilead have provided PCT’s institution with funding for her research. JAH has received consulting fees from Pear Therapeutics. The other authors have no conflicts of interest.

Data availability statement

Access to individual-level data from the MWCCS may be obtained upon review and approval of a MWCCS concept sheet. Links and instructions for online concept sheet submission are on the study website (http://mwccs.org/).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Bronx CRS (Kathryn Anastos, David Hanna, and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Topper), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Northern California CRS (Bradley Aouizerat, Jennifer Price, and Phyllis Tien), U01-HL146242; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora and Michelle Floris-Moore), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from thirteen institutes of the NIH and in coordination and alignment with the research priorities of the Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR003098 (JHU ICTR), UL1-TR001881 (UCLA CTSI), P30-AI-050409 (Atlanta CFAR), P30-AI-073961 (Miami CFAR), P30-AI-050410 (UNC CFAR), P30-AI-027767 (UAB CFAR), and P30-MH-116867 (Miami CHARM). HRT’s time on this project was supported by the Infectious Disease Society of America Foundation/HIV Medicine Association Grant for Emerging Researchers/Clinicians Mentorship Program, which had no role in the study design, analysis, manuscript preparation or approval. Support was also provided to JAH (NIH K24 AA022586) and PCT (NIH K24 AI108516) in the preparation of this manuscript.