Pivoting from in-person to phone survey assessment of alcohol and substance use: effects on representativeness in a United States prospective cohort of women living with and without HIV

Background: Many clinical and population-based research studies pivoted from in-person assessments to phone-based surveys due to the COVID-19 pandemic. The impact of these transitions on survey response remains understudied, especially for people living with HIV. Given that there are gender-specific trends in alcohol and substance use, it is particularly important to capture these data for women. Objective: Identify factors associated with responding to an alcohol and substance use phone survey administered during the COVID-19 pandemic in the Women’s Interagency HIV Study, a multicenter US prospective cohort of women living with and without HIV. Methods: We used multivariable logistic regression to assess for associations of pre-pandemic (April–September 2019) sociodemographic factors, HIV status, housing status, depressive symptoms, alcohol use, and substance use with response to an early-pandemic (August–September 2020) phone survey. Results: Of 1,847 women who attended an in-person visit in 2019, 78% responded to a phone survey during the pandemic. The odds of responding were lower for women of Hispanic ethnicity (aOR 0.47 95% CI 0.33–0.66, ref=Black/African American) and those who reported substance use (aOR 0.63 95% CI 0.41–0.98). By contrast, the odds were higher for White women (aOR 1.64 95% CI 1.02–2.70, ref=Black/African American) and those with stable housing (aOR 1.74 95% CI 1.24–2.43). Conclusions: Pivoting from an in-person to phone-administered alcohol and substance use survey may lead to underrepresentation of key subpopulations of women who are often neglected in substance use and HIV research. As remote survey methods become more common, investigators need to ensure that the study population is representative of the target population.