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Taking Technology to Malawi to Improve HIV/AIDS Research

About the Initiative

  • Dr. Pamina Gorbach, as part of a clinical trial of new HIV-prevention medications, interviewed 585 women research subjects in Malawi about sexual behavior by using a novel high-tech approach.
  • The study used visual and audio software developed by the Population Council to conduct Audio Computer-Assisted Self-Interviewing (ACASI). ACASI is a technology used by researchers to obtain self-reports of sensitive subjects, such as sexual behavior and drug use.
  • The study, as a sub-study of a clinical trial conducted by the NIH funded Microbicide Trials Network testing the safety and effectiveness of two topical HIV microbicides, showed significant differences in responses to questions on sexual behavior and gel use in the computer-assisted interview, which even non-numerically literate women were able to use, than when the study subject was interacting with an interviewer.
  • Women in the HIV prevention trial were more likely to reveal information about sensitive behaviors when undertaking an audio computer assisted self-interview than when asked the same questions face-to-face by a human interviewer.
  • The computer-assisted interviews used images in addition to audio to enhance comprehension for the low-literacy women.
  • In Malawi, 10 percent of the population has HIV/AIDS, making it the leading cause of death in that country.



 A graphical representation of the ACASI interview technology


The results of this work support the assumption that computer-assisted interviews can improve the accuracy of the data, since participants were more likely to reveal information about their sensitive behaviors in a computer-assisted interview than when asked the same questions face-to-face by a human interviewer.

  • Significantly, the women participating in the trial found the computer-assisted interviews preferable to face-to-face interviewing.
  • The study also demonstrated that consistency or edit checks can be programmed into the computer interview and may reduce, although not necessarily eliminate, internally discrepant responses.



Pamina Gorbach