A daily process investigation of alcohol-involved sexual risk behavior among economically disadvantaged problem drinkers living with HIV/AIDS.

Alcohol use is believed to increase sexual risk behavior among people living with HIV/AIDS (PLWHA). As drinking and sexual risk acts often occur in the same social contexts, this association is difficult to confirm. In this study, electronic daily diaries were completed by 116 PLWHA over 5 weeks. This yielded a total of 1,464 records consisting of data pertaining to discrete occasions of anal and vaginal sex. Simultaneous within- and between-person multilevel analyses were conducted, including situational variables (partner type, partner serostatus, partner drinking) and individual difference variables (gender, level of alcohol dependence). The resulting model explains 27.5% of the variance and reveals that interactions among these situational and individual difference variables predict changes in the estimated rate of unprotected sex (US). Also, in defined contexts, the amount of alcohol consumed prior to sex significantly affects the rate of US among members of the sample. Implications are discussed.

Association between interactive voice response adherence and subject retention in a randomized controlled trial.

INTRODUCTION: Interactive voice response (IVR) technology uses the telephone to collect patient reports. This study examined whether IVR adherence during a year-long clinical trial was related to subject retention in the trial. METHODS: As part of a randomized, double-blind, placebo-controlled study of daily multivitamin supplementation for recurrent aphthous stomatitis, 160 study participants were asked to make 1 weekly IVR call for the one-year study duration. RESULTS: The 114 subjects who completed the study made 90.5% of their expected number of IVR calls, as compared to 55.7% of expected calls made by the 46 subjects who withdrew prematurely (p<0.001). Subjects who successfully completed the study were also more likely to initiate their IVR calls as compared to subjects who withdrew from the study (p<0.001). A multivariable model incorporating different adherence variables was able to successfully predict retention status of more than 80% of subjects. IVR adherence during the first few weeks of study participation was strongly predictive of subsequent retention and successful completion of this one-year study. DISCUSSION: Subjects who withdrew prematurely had more missing data than study completers, even after accounting for period of study participation, potentially introducing bias into IVR results. Sub-optimal adherence to weekly IVR might provide an early signal of subsequent premature withdrawal in clinical trials. IVR adherence could be used as a screening tool during a trial period, to identify subjects most likely to stay on long clinical trials. CONCLUSION: IVR adherence may be useful in anticipating retention in long-term clinical studies.

Electronic versus paper diaries: a pilot study of concordance and adherence in head and neck cancer patients receiving radiation therapy.

BACKGROUND: Interactive Voice Response Systems (IVRS) and other electronic data collection methods have begun to replace conventional paper diaries as a way to capture daily patient reports. However, these methods have not been compared in head and neck (H&N) cancer patients receiving radiation therapy. METHODS: 15 subjects with H&N cancer were asked to complete daily IVRS calls and daily paper diaries during radiation therapy. We compared response consistency and comparative adherence across the two methods. RESULTS: 86.1% (1920/2231) of participants' responses were consistent between IVRS and paper diaries. 79.5% of the expected number of paper diaries were completed, compared to 66.2% of IVRS phone calls. CONCLUSIONS: In this pilot study of H&N cancer patients undergoing radiation therapy, concordance was high between responses recorded by paper diaries and IVRS. Although adherence appeared to be higher for the paper diaries, it is possible that they may not have been completed at the proper time.