The more you learn the less you know? Interpretive ambiguity across three modes of qualitative data

Background: Researchers across disciplines face a similar challenge ensuring our methods can give us valid, usable answers to our questions. But what happens when multiple strategies of inquiry give us different answers to the same research question? We explore this issue through three different modes of qualitative inquiry - interviews, focus groups, and participant observation - oriented around local attitudes to HIV testing. Objective: We introduce the notion of "research awareness" - the extent to which participants are continuously reminded that they are taking part in a research project, which is a function of the mode of research itself. We hypothesize that as participants’ research-awareness decreases across modes, from interviews to focus groups to participant observation, the proportion of statements that conform to officially sanctioned normative discourse about HIV/AIDS will decrease and the proportion expressing non-normative or counter-normative ideas will increase. Methods: We tabulated positive and negative references to three themes - knowing one’s HIV status, counseling messages, and antiretroviral treatment - across the three qualitative modes. Results: The distribution is non-uniform, with favorable responses to testing themes predominating in interviews, mixed responses in the focus groups, and negative responses predominating in the observational data. At least a third of references to testing across all three modes, however, do not support officially sanctioned normative discourse. Conclusions: Researchers who use mixed methods approaches for triangulation should consider the influence of research-awareness on their methods. These situational specifics are crucial for understanding the applicability of research to real life. Substantively, our study revealed a robust level of ambivalence about HIV testing despite normative discourses supporting it at local and global levels.