Original article
Inconsistent Reports of Sexual Intercourse Among South African High School Students

https://doi.org/10.1016/j.jadohealth.2007.08.024Get rights and content

Abstract

Purpose

This study aims to describe patterns of inconsistent reports of sexual intercourse among a sample of South African adolescents.

Methods

Consistency of reported lifetime sexual intercourse was assessed using five semiannual waves of data. Odds ratios related inconsistent reporting to demographic variables and potential indicators of general and risk-behavior–specific reliability problems.

Results

Of the sexually active participants in the sample, nearly 40% reported being virgins after sexual activity had been reported at an earlier assessment. Inconsistent reporting could not be predicted by gender or race or by general indicators of poor reliability (inconsistent reporting of gender and birth year). However individuals with inconsistent reports of sexual intercourse were more likely to be inconsistent reporters of substance use.

Conclusions

These results suggest that researchers need to undertake efforts to deal specifically with inconsistent risk behavior data. These may include modification of data collection procedures and use of statistical methodologies that can account for response inconsistencies.

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

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