Comparing the unmatched count technique and direct self-report for sensitive health-risk behaviors in HIV+ adults

ABSTRACT

Researchers often rely on self-report measures to assess sensitive health-risk behaviors in HIV+ individuals, yet the accuracy of self-report has been questioned, particularly when inquiring about behaviors that may be embarrassing, risky, and/or taboo. We compared an anonymous reporting method – the unmatched count technique (UCT) – to direct self-report (DSR) in order to assess reporting differences for several health-risk behaviors related to medication adherence and sexual risk. Contrary to hypotheses, the UCT only produced a significantly higher estimated base rate for one sensitive behavior: reporting medication adherence to one's physician, which may have been contextually primed by our study design. Our results suggest that anonymous reporting methods may not increase disclosure compared to DSR when assessing several health-risk behaviors in HIV+ research volunteers. However, our results also suggest that contextual factors should be considered and investigated further, as they may influence perception of sensitive behavior.

KEYWORDS:

• HIV
• health-risk behavior
• medication adherence
• sexual risk behavior
• self-report
• unmatched count
• item count
• list experiment

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Alyssa Arentoft http://orcid.org/0000-0002-4235-4638

Additional information

Funding

This work was supported by National Institutes of Health [grant number R01 DA013799] (PI: C.H. Hinkin) and a Ruth L. Kirschstein National Research Service Award (T32 MH019535; PI: C.H. Hinkin). Dr Thames is supported by an NIMH Career Development Award (K23 MH095661; PI: A. Thames).