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      Inconsistencies in Self-Reporting of Sexual Activity Among Young People in Nairobi, Kenya

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          Abstract

          Purpose

          Accurate and reliable data on the prevalence of adolescents' sexual behavior are paramount for effective sexual and reproductive health intervention. Adolescents' sexual behavior has been widely studied. However, scholars have raised concerns about the accuracy and reliability of self-reported sexual behavior by adolescents. Previous research shows high levels of adolescent sexual activity in urban informal settlements; yet, the accuracy of self-reported sexual experience in these settings is understudied.

          Methods

          The objective of this article is to assess consistency of self-reported sexual activity among 2324 adolescents living in slum and nonslum settlements in Nairobi, Kenya. We examine two forms of inconsistencies, namely, what we term “reborn virgins” and inconsistent timing of sexual debut, during two rounds of survey. Factors influencing inconsistent reporting are explored through logistic regression.

          Results

          A total of 469 (20%) adolescents gave inconsistent information on whether they have ever had sex (n = 190) or timing of first intercourse (n = 279). Males, slum residents, and adolescents attending school were more likely to give inconsistent sexual information. Among inconsistent reporters, slum residents, adolescents reporting substance use, and those with secondary (vs. primary) education were more likely to reclaim virginity status than to misreport the timing of first sex. However, older adolescents were less likely to reclaim virginity status.

          Conclusions

          We found significant differences between adolescents who provide consistent reports and those who misreport sexual behavior data. We argue that researchers should account for biases stemming from misreporting of sensitive information among young people and, in particular, should be cognizant of how reporting quality may vary across demographic groups.

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          Most cited references27

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          Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology.

          Surveys of risk behaviors have been hobbled by their reliance on respondents to report accurately about engaging in behaviors that are highly sensitive and may be illegal. An audio computer-assisted self-interviewing (audio-CASI) technology for measuring those behaviors was tested with 1690 respondents in the 1995 National Survey of Adolescent Males. The respondents were randomly assigned to answer questions using either audio-CASI or a more traditional self-administered questionnaire. Estimates of the prevalence of male-male sex, injection drug use, and sexual contact with intravenous drug users were higher by factors of 3 or more when audio-CASI was used. Increased reporting was also found for several other risk behaviors.
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            The reporting of sensitive behavior by adolescents: a methodological experiment in Kenya.

            Does audio computer-assisted self-interviewing (ACASI) produce more valid reporting of sexual activity and related behaviors than face-to-face interviews or self-administered interviews? This analysis, based on data collected from over 6,000 unmarried adolescents in two districts of Kenya--Nyeri and Kisumu--indicates substantial and significant differences in reported rates of premarital sex across interview modes, although not always in the expected direction. Our assumption that girls underreport sexual activity in face-to-face interviews by comparison with ACASI is not confirmed by the Nyeri data, but our results from Kisumu are considerably more promising. As for boys, who we believe exaggerate their level of sexual activity in face-to-face interviews, a more nuanced set of expectations regarding the reporting of sensitive behaviors was offered; our results from Kisumu, although not always significant, by and large conform to expectations.
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              "A bit more truthful": the validity of adolescent sexual behaviour data collected in rural northern Tanzania using five methods.

              To assess the validity of sexual behaviour data collected from African adolescents using five methods. 9280 Tanzanian adolescents participated in a biological marker and face to face questionnaire survey and 6079 in an assisted self-completion questionnaire survey; 74 participated in in-depth interviews and 56 person weeks of participant observation were conducted. 38% of males and 59% of females reporting sexual activity did so in only one of the two 1998 questionnaires. Only 58% of males and 29% of females with biological markers consistently reported sexual activity in both questionnaires. Nine of 11 (82%) in-depth interview respondents who had had biological markers provided an invalid series of responses about sex in the survey and in-depth interview series. Only one of six female in-depth interview respondents with an STI reported sex in any of the four surveys, but five reported it in the in-depth interviews. In this low prevalence population, biological markers on their own revealed that a few adolescents had had sex, but in combination with in-depth interviews they may be useful in identifying risk factors for STIs. Self-reported sexual behaviour data were fraught with inconsistencies. In-depth interviews seem to be more effective than assisted self-completion questionnaires and face to face questionnaires in promoting honest responses among females with STIs. Participant observation was the most useful method for understanding the nature, complexity, and extent of sexual behaviour.
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                Author and article information

                Journal
                J Adolesc Health
                The Journal of Adolescent Health
                Elsevier
                1054-139X
                1879-1972
                December 2009
                December 2009
                : 45
                : 6
                : 595-601
                Affiliations
                African Population and Health Research Center, Nairobi, Kenya
                Author notes
                []Address correspondence to: Donatien Beguy, Ph.D., African Population and Health Research Center, Shelter Afrique Centre, 2 nd Floor, Longonot Road, Upper Hill. P. O. Box 10787-00100, Nairobi, Kenya. dbeguy@ 123456aphrc.org dbeguy@ 123456yahoo.fr
                Article
                JAH7910
                10.1016/j.jadohealth.2009.03.014
                2784947
                19931832
                a1652815-9eec-4c83-88af-fa31c38ebe22
                © 2009 Elsevier Inc.

                This document may be redistributed and reused, subject to certain conditions.

                History
                : 30 September 2008
                : 19 March 2009
                Categories
                Original Article

                Health & Social care
                adolescents,inconsistency,nairobi,sexual activity,informal settlements,kenya,slum
                Health & Social care
                adolescents, inconsistency, nairobi, sexual activity, informal settlements, kenya, slum

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