Original articleInconsistent Reports of Sexual Intercourse Among South African High School Students
Section snippets
Inconsistency in the U.S. context
Several studies have examined the short-term stability of reported sexual intercourse. In one such study, within a single assessment, between 4% and 8% of youth provided inconsistent responses as to whether they had ever engaged in sexual intercourse [5]. In another study, when two assessments were up to 3 weeks apart, the κ-value for responses on lifetime sexual intercourse was 90.5 [6]. Therefore although short-term consistency is high, it is not perfect.
It is also possible to examine
Causes of inconsistent reporting of sexual behavior
There are several potential explanations for inconsistent reporting of sexual behavior. First participants may not have accurate or complete memories of their sexual health and behavior histories [3], [4]. This argument is especially plausible for reports of repeated or complicated behavior; it is less applicable to reports of whether a presumably simple and salient one-time event such as first intercourse has ever occurred.
Alternatively inconsistencies in reporting sexual activity may arise
Inconsistent responses in the South African context
A few studies have measured the short-term consistency of reported sexual intercourse among South African adolescents. The high school participants in a study by Flisher et al [11] had more than 95% agreement in their responses to a lifetime sexual intercourse item in assessments that occurred up to 2 weeks apart. In their sample of 11–19-year-olds, Jaspan et al [12] found slightly lower agreement (86%) over a 2-week period; however this may be due in part to the fact that different modes of
Current study
The current study examines longitudinal reports of lifetime sexual intercourse in a sample of South African high school students. Specifically we examine the degree to which reports are consistent over time and whether inconsistency can be predicted by demographics, indicators of general reliability problems, or inconsistency in reporting of other types of risk behavior.
In addition to studying a unique population, this study is novel in the types of predictors that it examines; we are unaware
Sample
Participants were high school students from Mitchell’s Plain, a low-income township near Cape Town, South Africa. Students (N = 2,414) were participating in a research trial of a classroom-based leisure, life skill, and sexuality education program [13]. The sample for the present study was restricted to participants who reported lifetime sexual intercourse in at least one of the first four survey assessments (n = 713), given that these were the only participants for whom an inconsistent sexual
Results
Of the students who reported sexual intercourse at some point in the assessment process, nearly 40% (n = 283) eventually went on to report that they had never had sexual intercourse. Table 1 shows rates of inconsistency for the demographic subgroups of interest, as well as for individuals with inconsistent reports of other types of information. Intervention participants were no more or less likely to be inconsistent reporters than were members of the control group (not tabled; β = −.04, p =
Discussion
The results of this study show that the majority of adolescent participants were able to provide consistent reports of their sexual activity over the course of 2 years. However there was still a sizable proportion of youth who provided contradictory reports. To best address sexually related public health concerns for youth in South Africa, it is crucial that explanations of this inconsistency are sought, so that the reliability of data intended to inform prevention efforts is improved.
Almost
References (23)
- et al.
Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: Evidence from the scientific literature
J Adolesc Health
(2003) - et al.
The recission of behaviors: Inconsistent responses in adolescent sexuality data
Soc Sci Res
(1982) - et al.
Reliability of the 1999 Youth Risk Behavior Survey questionnaire
J Adolesc Health
(2002) - et al.
Self-reported honesty among middle and high school student responding to a sexual behavior questionnaire
J Adolesc Health
(1998) - et al.
Brief report: Test–retest reliability of self-reported adolescent risk behaviour
J Adolesc
(2004) - et al.
Brief report: Methods for collecting sexual behaviour information from South African adolescents—a comparison of paper versus personal digital assistant questionnaires
J Adolesc
(2007) - et al.
South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005
(2005) - et al.
HIV and Sexual Behaviour Among Young South Africans: A National Survey of 15–24 Year Olds
(2004) - et al.
Methodological problems in AIDS behavior research: Influences on measurement error and participation bias in studies of sexual behavior
Psychol Bull
(1990) - et al.
Inconsistencies in reporting the occurrence and timing of first intercourse among adolescents
J Sex Res
(2002)
Consistency of adolescents’ self-report of sexual behavior in a longitudinal study
J Youth Adolesc
Cited by (73)
Reproductive and relational trajectories leading to pregnancy: Differences between adolescents and adult women who had an abortion
2018, European Journal of Obstetrics and Gynecology and Reproductive BiologyEarly Sexual Onset and Alcohol Use and Misuse From Adolescence Into Young Adulthood
2017, Journal of Adolescent HealthThe validity of self-reported behaviors: methods for estimating underreporting of risk behaviors
2016, Annals of EpidemiologyCitation Excerpt :Underreporting of such behaviors may lead to bias (typically, attenuation) of the relative risk associated with that behavior [6]. Attempts to assess the validity of self-reported risk sexual behaviors have included interviewing sexual partners for discordant responses [7], interviewing the same individual at multiple time points [8–11], and using specific data collection strategies, such as computer-administered surveys [12,13], neutral interviewing strategies [14,15], and randomized response techniques [16]. Increasingly, researchers are using biomarkers, such as prostate-specific antigen (PSA), to assess the validity of self-reported condomless sex [17].
Behavioral Interventions for Preventing Sexually Transmitted Infections and Unintended Pregnancies: An Overview of Systematic Reviews
2016, Actas Dermo-SifiliograficasCitation Excerpt :The widespread use of subjective outcomes to assess the effect of behavioral interventions is a well recognized source of bias. In one study, 16% of participants who initially reported having had sexual relations at baseline stated 6 months later that they had never had any sexual intercourse.9 For this reason study designers increasingly insist on the inclusion of biological markers of sexual activity (tests to confirm STIs, pregnancy, and semen exposure, notably detection of plasma prostate antigen or Y chromosome DNA.10