No. 8, 2008

Mensch, Barbara S., Paul C. Hewett, Richard Gregory, and Stephane Helleringer. "Sexual behavior and STI/HIV status among adolescents in rural Malawi: An evaluation of the effect of interview mode on reporting," Poverty, Gender, and Youth Working Paper no. 8. New York: Population Council. (PDF)

ABSTRACT

Our understanding of the dynamics of HIV transmission in developing countries is compromised by unreliable data concerning sexual behavior. This paper represents an effort to investigate young people’s reporting of sexual behavior. It summarizes the results from an interview-mode experiment conducted with unmarried young women aged 15–21 in rural southern Malawi in which respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. In addition, biomarkers were collected for HIV and three STIs: gonorrhea, chlamydia, and trichomoniasis. Prior to collecting the biomarkers, nurses conducted a brief face-to-face interview with participants in which they repeated questions about sexual behavior asked earlier. The paper builds on earlier research among adolescents in Kenya where we first investigated the feasibility and effectiveness of ACASI. In both Kenya and Malawi, clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity. Yet, the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode. When we ask about other partners as well as multiple lifetime partners, however, the reporting is consistently higher with ACASI, in many cases significantly so. As in Kenya, in Malawi the interview-administered mode produced more consistent reporting of sexual activity between the main interview and a subsequent interview. Finally, the association between infection status and reporting of sexual behavior is stronger in the FTF mode, although in both modes, some young women who denied ever having had sex tested positive for STIs/HIV.

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