Behavioral Surveys

MSM Outreach Survey (MOS)

Overview: During 1995–2000, outreach surveys were conducted across Louisiana at bars that serve MSM. The survey was a 1-page, self-administered questionnaire distributed by outreach workers from local CBOs. Each CBO surveyed 50 to 150 MSM twice per year at 1 to 2 bars where they conducted outreach activities. Every person at the bar was approached. However, if the bar was very busy, workers chose a representative sample of persons at the bar (e.g., they approached every third person who entered the bar). Respondents were asked about sex partners, history of condom use, history of receptive and insertive anal sex, and HIV status.

Population: MSM men who attend bars that serve gay and bisexual men Strengths: Data on HIV-related behaviors among MSM are very limited. The MOS is one of the only sources of statewide behavioral data for MSM. Because the survey was conducted every year for 6 years, trends in risk behaviors can be analyzed. Information collected from the MOS is useful for planning prevention strategies for MSM.

Limitations: MOS data are self-reported; thus, the information may be subject to recall bias. Because these data were collected in bars, the data are representative only of MSM who go to gay bars and cannot be generalized to all MSM.

Street Outreach Survey (SOS)

Overview: SOS has been administered by CBOs in every region of the state since 1995. The survey was a 1-page, self-administered questionnaire distributed each quarter by outreach workers at 3 sites where they actively conducted street outreach activities. These sites were in neighborhoods with 1 or more of the following characteristics: high rates of HIV/STDs, high levels of drug use, exchange of sex for money or drugs, or "crack" houses. Questionnaires were collected between 3:00 p.m. and 8:00 p.m. at outdoor locations (i.e., street corners, bus stops, public housing developments, and locations outside convenience stores and apartment complexes). The survey was generally conducted at the same sites each quarter. Every person at the site was approached, but a representative sample of persons was selected if the site was very busy (e.g., every third person was approached). Respondents were asked about sex partners, history of condom use, drug use, HIV testing history, and exposure to prevention programs.

Population: High-risk persons in neighborhoods where street outreach activities are actively conducted

Strengths: This survey provides data on the sexual and drug-use behaviors of persons at particularly high risk for HIV. These persons are likely to be missed by other survey approaches (e.g., BRFSS telephone survey). Because the survey is conducted every year, trends in risk behaviors can be analyzed. Data from the SOS may be used to help plan prevention strategies for persons at high risk for HIV and STDs. The data can also be used to determine the extent to which persons have been exposed to prevention activities and to monitor and evaluate state and local prevention programs.

Limitations: SOS data are self-reported; thus, the information may be subject to recall bias. These data represent persons at particularly high risk for HIV and are not generalizable to the general population in the local community.

Behavioral Risk Factor Surveillance System (BRFSS)

Overview: The BRFSS is a state-based random-digit-dialed telephone survey of adults that monitors state-level prevalence of the major behavioral risks associated with premature morbidity and mortality. Each month, a sample of households is contacted, and 1 person in the household who is 18 years or older is randomly selected for an interview. Multiple attempts are made to contact the sampled household. A Spanish translation of the interview is available. Respondents to the BRFSS questionnaire are asked a variety of questions about their personal health behaviors and health experiences. A sexual behavior module was added to this survey in 1994, 1995, 1996, 1998, and 2000. The questions in this module, for adults (aged 18-49), concerned number of sex partners, condom use, and treatment for STDs.

Population: All noninstitutionalized adults, 18 years and older, who reside in a household with a telephone

Strengths: Data from the BRFSS survey are population-based; thus, estimates about testing attitudes and practices can be generalized to the adult population of a state. Information collected from the BRFSS survey may be useful for planning community-wide education programs.

Limitations: BRFSS data are self-reported; thus, the information may be subject to recall bias. Because BRFSS respondents are contacted by telephone, the data are not representative of households that do not have telephones. In addition, BRFSS data are representative of the general noninstitutionalized adult population in an area, not just persons at highest risk for HIV/AIDS. The extent of HIV behavioral risk information collected by the BRFSS questionnaire is limited, and inferences can be made only at the state level.

Youth Risk Behavior Surveillance System (YRBSS)

Overview: The YRBSS was established to monitor 6 high-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and young adults in the United States. YRBSS was developed to collect data that are comparable nationally, statewide, and locally. It is a self-administered questionnaire that is given to a representative sample of students in grades 9 through 12 at the state and local levels. In Louisiana, the survey is administered at the state level and in Orleans Parish public schools. However, only the survey administered to Orleans Parish high school students includes questions related to sexual behavior. The Orleans Parish Youth Risk Behavior Survey (YRBS) collects information on 6 categories of behaviors; sexual behaviors that contribute to unintended pregnancy and STDs, including HIV, constitute 1 category. Questions are also asked about exposure to HIV prevention education materials, sexual activity (age at initiation of sexual activity, number of partners, condom use, past drug or alcohol use), contraceptive use, and pregnancy history.

Population: A representative sample of students in grades 9 through 12 at the state and local level

Strengths: In New Orleans, YRBSS samples adolescents in public schools and is population-based. The YRBS questionnaire is administered to students anonymously during school. Repeated attempts are made to contact students who are not in attendance. Inferences from YRBSS estimates can be drawn about behaviors and attitudes of adolescents in school, which makes the information useful for developing community-wide prevention programs aimed at younger persons. YRBSS uses a standardized questionnaire so that comparisons can be made across participating jurisdictions. Jurisdictions have the option of asking specific questions to meet local needs.

Limitations: The YRBSS project relies upon self-reported information; therefore, reporting of sensitive behavioral information may not be accurate (may be underreported or overreported). Also, because the YRBSS questionnaire is administered in school, the data are representative only of students and cannot be generalized to all youth. For example, students at highest risk, who may be more likely to be absent from school or to drop out of school, may be underrepresented in this survey, especially among upper grades. The questionnaire does not include questions about homosexual or bisexual behavior.

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