Objective: To compare sexual behavior data obtained using a weekly-recall questionnaire, a daily-recall questionnaire, and a coital diary.
Design: Cross-sectional survey of female sex workers from KwaZulu-Natal, South Africa between August and October 1998.
Methods: In this study, 52 weekly-recall questionnaires, 27 daily-recall questionnaires, and 79 coital diaries for dates corresponding to the questionnaires were obtained from female sex workers. Variables examined included: number of clients, number of condoms used with clients and partners, and number and type of sexual acts with clients and partners. Statistical analyses were conducted to examine the degree of agreement between the data collection methods and to assess differences between the mean values of the variables in the questionnaires versus the diary.
Results: Comparison of weekly-recall questionnaires with coital diaries indicated a significantly greater mean number of clients (P < 0.001), number of condoms used (P < 0.001), vaginal acts (P < 0.001), and anal acts (P = 0.044) reported in the diary versus the questionnaire. On comparison of daily-recall questionnaire with coital diary, significant differences were revealed between the means detected for the number of clients (P = 0.027), number of days worked (0.009), and anal acts with clients (P = 0.004).
Conclusions: The use of coital diaries for the collection of sexual behavior data may be limited to cross-sectional community surveys. A recall questionnaire may provide more reliable and a better quality of data for longitudinal studies and for human immunodeficiency virus/sexually transmitted disease evaluation programs.
PIP: This study aimed to compare data obtained from coital diaries (CD) with those collected using weekly recall (WR) and daily recall (DR) questionnaires. 79 female sex workers aged 18-44 coming from KwaZulu-Natal, South Africa, were studied. They were followed up every month with clinical examination and treatment of STDs, provision of condoms, and CD collection. There were 52 WR, 27 DR, and 79 CD records collected from the participants. Results showed that CD records showed a significantly greater mean number of clients compared to the questionnaires (23.3 vs. 13.6, P 0.001), number of condoms used (2.7 vs. 0.5, P 0.001), vaginal acts (6.8 vs. 2.9, P 0.001), and anal acts (1.9 vs. 0.7, P = 0.044). Daily accounts of weekly sexual activity showed significant differences in 1) the number of days worked (6.2 vs. 5.2, P = 0.009), 2) the number of clients (21.7 vs. 17.4, P = 0.027), and 3) the number of anal acts with clients (3.9 vs. 0.8, P = 0.004), with higher means reported in the CD records for all cases. The CD records are an important instrument for gathering preliminary sexual behavioral information; however, their use is limited to long-term data collection. Therefore, a comprehensive recall questionnaire is recommended for future trials.