Original Paper

AIDS and Behavior

, Volume 17, Issue 6, pp 2260-2268

First online:

Color-Coded Audio Computer-Assisted Self-Interviews (C-ACASI) for Poorly Educated Men and Women in a Semi-rural Area of South India: “Good, Scary and Thrilling”

  • Tarun BhatnagarAffiliated withNational Institute of Epidemiology, Indian Council of Medical ResearchDepartment of Epidemiology, UCLA Fielding School of Public Health
  • , Joelle BrownAffiliated withDepartment of Obstetrics and Gynecology, University of California, San Francisco
  • , P. Sakthivel SaravanamurthyAffiliated withVoluntary Health Services – CHARTERED
  • , Raju Mohan KumarAffiliated withState Health Society, National Rural Health Mission, Government of Tamil Nadu
  • , Roger DetelsAffiliated withDepartment of Epidemiology, UCLA Fielding School of Public Health Email author 

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It is challenging to collect accurate and complete data on sensitive issues such as sexual behaviors. Our objective was to explore experience and perceptions regarding the use of a locally programmed color-coded audio computer-assisted self interview (C-ACASI) system among men and women in a semi-rural setting in south India. We conducted a mixed-methods cross-sectional survey using semi-structured interviews among 89 truck drivers and 101 truck driver wives who had participated earlier in the C-ACASI survey across a predominantly rural district in Tamil Nadu. To assess the color-coded format used, descriptive quantitative analysis was coupled with thematic content analysis of qualitative data. Only 10 % of participants had ever used a computer before. Nearly 75 % did not report any problem in using C-ACASI. The length of the C-ACASI survey was acceptable to 98 % of participants. Overall, 87 % of wives and 73 % of truck drivers stated that C-ACASI was user-friendly and felt comfortable in responding to the sensitive questions. Nearly all (97 %) participants reported that using C-ACASI encouraged them to respond honestly compared to face-to-face personal interviews. Both the drivers and wives expressed that C-ACASI provided confidentiality, privacy, anonymity, and an easy mechanism for responding truthfully to potentially embarrassing questions about their personal sexual relationships. It is feasible and acceptable to use C-ACASI for collecting sensitive data from poorly computer-literate, non-English-speaking, predominantly rural populations of women and men. Our findings support the implementation of effective and culturally sensitive C-ACASI for data collection, albeit with additional validation.


Color-coded ACASI Computer interview Sensitive questions Acceptability Rural India