Fear, hope and social desirability bias among women at high risk for HIV in West Africa

Background: Self-reports are widely used for measuring behaviour in HIV research and prevention, yet the accuracy of these measures has been shown to be questionable in many cases. Social desirability bias (SDB) is one of the key factors identified as affecting self-report accuracy. Methods: Using in-depth interviews, we examined SDB from the perspective of 60 women at high risk for HIV in two West African countries: Ghana and Nigeria. We solicited suggestions for reducing SDB in the context of HIV research and prevention, and asked for feedback regarding methods currently being employed to reduce SDB. Results: Themes pertaining to fear and a desire to have a better life were pervasive throughout the data. Thematic structure was similar between sites and age groups, although younger women tended to be more concerned about the interview context. Conclusions: Vulnerability of a population should be considered when asking sensitive questions. Audio-computer-assisted self-interviews may not be appropriate for vulnerable populations in developing countries, particularly for older respondents.