Assessing and Improving the Measurement of Sexual Behaviors
Council researchers are conducting a series of studies assessing the reporting of sexual behavior in survey research and the use of audio computer-assisted self-interviews (audio-CASI) as a technique for providing more reliable and valid information.
The AIDS pandemic has increased the need to gather comprehensive data on sexual behavior in developing countries. Not only is accurate self-reporting critical for household surveys that document risky sexual behavior, it is also essential for clinical trials that investigate the effectiveness of technologies to prevent transmission of HIV and other sexually transmitted infections (STIs), for example, female-controlled microbicides, the female condom, and the diaphragm. Through a series of methodological experiments and innovative research activities, the aim of this project is to:
- assess and improve the validity and reliability of reporting of sexual behavior in survey research implemented in developing countries;
- improve the quality of behavioral data collected in clinical trials of products and technologies aimed at reducing STI transmission; and
- evaluate the use of new technologies for collecting data on sexual behavior in developing countries, specifically computerized self-interviewing.
Computerized self-interviewing provides individuals greater privacy and confidentiality when responding to sensitive questions. For instance, in a school survey in Malawi, instead of answering aloud in a face-to-face interview, a respondent using an audio computer-assisted self-interviewing (ACASI) hand-held computer heard prerecorded questions through audio headphones and pressed numbers on a numeric keypad to answer them. Council researchers have found that most participants quickly learn how to use the interview program and prefer the computer over face-to-face interviews.
Related projects:
Research studies have been conducted or are underway in several countries.
Kenya 2000, 2002: In a study conducted in two districts, more than 6,000 interviews of unmarried adolescents aged 15–21 were collected as part of household-based surveys. Respondents were randomly assigned to three modes of data collection: face-to-face interviews, paper-and-pencil self-administered interviews, and audio computer-assisted self-interviews (ACASI). The purpose was to evaluate whether the increased privacy afforded by the two self-interviewing methods produced differential reporting of sensitive behaviors. Although the two self-administered methods did not produce more accurate reporting for certain behaviors (e.g., premarital sex, sex with a boyfriend, and alcohol use), these modes—in particular ACASI—elicited a higher percentage of positive responses to questions about more stigmatizing behaviors. Three articles based on these data were published.
Malawi 2004: In collaboration with researchers at the University of Pennsylvania, a household-based survey of adolescent girls was conducted in Balaka district in southern Malawi. The sample was experimentally randomized to face-to-face and ACASI interviews, in order to assess whether computerized interviews elicit higher reporting of sensitive sexual behaviors. The fieldwork also included testing for STIs and HIV status. . Results of this study have been presented at the Population Association of America Meeting in 2006 and a paper has been submitted for publication.
Brazil 2004–2005: As part of a larger clinical study of the effectiveness, acceptability, and feasibility of rapid tests for sexually transmitted infections (STIs) among women aged 18–40 in São Paulo, Brazil an experimental comparison of face-to-face versus computerized survey administration was conducted to assess the reporting of sexual and other STI risk behaviors. As with previous research in Malawi, the study design allows for comparisons between STI status and reported sexual activity by interview mode, however, in this case among an older population of women. Results of this study have been presented at the Population Association of America Meeting in 2006 and a paper has been submitted to the journal Sexually Transmitted Diseases.
Further Research 2006–2009: A series of methodological experiments and innovative research activities will be conducted on this subject in the coming years. Household and clinic-based research will be implemented in diverse settings and populations, including Malawi, South Africa, and Uganda. For instance:
- Uganda: In collaboration with the Ugandan Bureau of Statistics (UBOS) and ORC Macro International a sample of young women aged 18–24 will be randomly assigned to three different interview modalities (traditional face-to-face, computerized interview, and a conversational-style interview). Using the standard Demographic and Health Surveys (DHS) questionnaire for reproductive-aged women, self-reporting of sexual behavior and other sensitive topics will be evaluated by interview mode. Biomarkers for STIs will also be collected and used to validate self-reporting of risk behavior.
- South Africa: As a part of a series of studies in preparation for future microbicide clinical trials, an experiment evaluating face-to-face versus computerized interviewing is being conducted in the Population Council’s three Carraguard Phase 3 sites in South Africa to assess participant self-reported compliance to study protocols. The study will also investigate the reporting of sexual and other risk behaviors, collecting various STI biomarkers for validation of reporting.
- Malawi: In 2009, a large household survey of adolescents age 15–24 will be implemented in Malawi in collaboration with Ann Biddlecom at the Guttmacher Institute. A focus of this study is to evaluate the feasibility and acceptability of using handheld computers in a household-based survey. As with other studies, respondents will be randomly assigned to different interview methods, in this case, computer-assisted personal interview (CAPI) and ACASI. Prior to the survey, a series of cognitive interviews will be conducted to acquire an understanding of how respondents interpret, process, and form answers to questions regarding sexual behavior.
Consistency in women's reports of sensitive behavior in an interview mode experiment, Sáo Paulo, Brazil (abstract) (HTML)
Mensch,Barbara S.; Hewett,Paul C.; Jones,Heidi E.; Luppi,Carla Gianni; Lippman,Sheri A.; Pinho,Adriana A.; Diaz,Juan
International Family Planning Perspectives 34(4): 169-176
Publication date: 2008
Sexual behavior and STI/HIV status among adolescents in rural Malawi: An evaluation of the effect of interview mode on reporting (abstract)
Mensch,Barbara S.; Hewett,Paul C.; Gregory,Richard; Helleringer,Stephane
Studies in Family Planning 39(4): 321-334
Publication date: 2008
Sexual behavior and STI/HIV status among adolescents in rural Malawi: An evaluation of the effect of interview mode on reporting (PDF)
Mensch,Barbara S.; Hewett,Paul C.; Gregory,Richard; Helleringer,Stephane
Poverty, Gender, and Youth Working Paper (no. 8)
Publication date: 2008
Using sexually transmitted infection (STI) biomarkers to validate the reporting of sexual behavior within a randomized experimental evaluation of interviewing methods (abstract)
Hewett,Paul C.; Mensch,Barbara S.; de A.Ribeiro,Manoel Carlos; Jones,Heidi E.; Lippman,Sheri A.; Montgomery,Mark R.; van de Wijgert,Janneke
American Journal of Epidemiology 168(2): 202-211
Publication date: 2008
Consistency in the reporting of sexual behaviour by adolescent girls in Kenya: A comparison of interviewing methods (abstract)
Hewett,Paul C.; Mensch,Barbara S.; Erulkar,Annabel S.
Sexually Transmitted Infections 80(suppl 2): ii43-ii48
Publication date: 2004
The feasibility of computer-assisted survey interviewing in Africa: Experience from two rural districts in Kenya (abstract)
Hewett,Paul C.; Mensch,Barbara S.; Erulkar,Annabel S.
Social Science Computer Review 22(3): 319-334
Publication date: 2004
Consistency in the reporting of sexual behavior among adolescent girls in Kenya: A comparison of interviewing methods (PDF)
Hewett,Paul C.; Mensch,Barbara S.; Erulkar,Annabel S.
Policy Research Division Working Paper (no. 182)
Publication date: 2003
Review of Douglas W. Maynard, Hanneke Houtkoop-Steenstra, Nora Cate Schaeffer, and Johannes van der Zouwen (eds.), Standardization and Tacit Knowledge: Interaction and Practice in the Survey Interview
Hewett,Paul C.
Population and Development Review 29(2): 305-
Publication date: 2003
The feasibility of computer-assisted survey interviewing in Africa: Experience from two rural districts in Kenya. (PDF)
Hewett,Paul C.; Erulkar,Annabel S.; Mensch,Barbara S.
Policy Research Division Working Paper (no. 168)
Publication date: 2003
The reporting of sensitive behavior by adolescents: A methodological experiment in Kenya (abstract)
Mensch,Barbara S.; Hewett,Paul C.; Erulkar,Annabel S.
Demography 40(2): 247-268
Publication date: 2003
The reporting of sensitive behavior among adolescents: A methodological experiment in Kenya (PDF)
Mensch,Barbara S.; Hewett,Paul C.; Erulkar,Annabel S.
Policy Research Division Working Paper (no. 151)
Publication date: 2001
Project Stats
Location: Brazil, Kenya, Malawi, South Africa, Uganda
Program(s):
Poverty, Gender, and Youth
Topic(s):
Sexuality and sexual behavior
Duration: 1/2000 - 1/2009
Population Council researchers:
Annabel Erulkar
Paul C. Hewett
Christine Kelly
Barbara S. Mensch
Non-Council collaborators:
Ann Biddlecom (Alan Guttmacher Institute)
Annie Cross (ORC Macro-International)
Hans-Peter Kohler (University of Pennsylvania)
Helen Nviiri (Uganda Bureau of Statistics)
Susan Watkins (University of California/Los Angeles)
Donors:
National Institutes of Health
The Andrew W. Mellon Foundation
The William and Flora Hewlett Foundation
UK Department for International Development
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