How Could I Forget? Inaccurate memories of sexually intimate moments

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Abstract
This study was based on data collected from 87 men during and immediately following participation in a counseling program aimed at assisting them to reduce sexual behaviors associated with high HIV risk. All the men reported having engaged in same‐gender anal or oral sex without condoms during the year prior to enrollment. Three‐month retrospective reports of sexual behavior, solicited just after participation, were compared with reports collected weekly during the same three‐month period. Accuracy of recall over an ensemble of 10 behavior items was quite low, with amount of error positively associated with behavior frequency. In general, exaggerated reports were associated with low‐frequency behavior and underreports with high‐frequency behavior. Because of observed differences in the average frequency of occurrence of the various specific types of sexual behavior, adjustment for event frequency was required to provide adequate analysis of between‐behavior differences in memory error. Estimated functional relationships between behavior frequency and average memory error illustrated that for sexual activity occurring between 1 and 20 times in the three‐month period, there was a significant association between the HTV‐risk level of a behavior and the average extent to which the behavior was forgotten (i.e., underreported). After event‐frequency adjustment, anal activity without condoms—the behavior believed to entail the highest level of risk for HIV transmission, and the behavior about which the counseling program provided the least ambiguous cues regarding risk—was associated with the greatest underreporting error, and the ensemble of unprotected behaviors (i.e., those unaccompanied by condom usage) involved significantly greater underreporting than did protected behaviors. Error rates over the ensemble of behaviors were strikingly low for zero‐frequency events, suggesting the utility of dichotomous ever/never measures in research evaluating activity levels and behavior change. Other analysis techniques for reducing potential recall bias, allowing finer evaluations of behavior frequency and change, were also discussed.