Getting Teens to Tell the Truth about Sex

Brown University sociologists have developed a low-cost, easy-to-use device to help obtain more reliable answers from teenagers about their sexual behaviors.

Brown University sociologists have developed a device that can more accurately gather reliable data about risky sexual behavior among Ethiopian teenagers and young adults compared with conventional face-to-face interviews. According to findings published in Studies in Family Planning, the new response card enables respondents to communicate nonverbally and confidentially during face-to-face interviews using portable, low-cost technology.

Successful programs to combat the spread of HIV/AIDS require accurate information about the prevalence of risky sexual behavior among populations. However, obtaining that information can often be tricky due to intentional misreporting on sensitive topics. A number of innovations in questionnaire methodology have been developed to address reporting bias, but those techniques can be expensive, technically unreliable, and dependant on basic literacy.

The new nonverbal response card, created by sociology professor David Lindstrom and colleagues, is a laminated sheet of paper with a respondent side and an interviewer side. Each side is divided into 35 cells with a small hole punched through the center of each cell. On the respondent side of the card, the cells contain written and color-coded responses.

For the study, the research team tested the card in a group of 1,269 Ethiopian men and women aged 13 to 24 who lived in rural communities and small urban centers in southwestern Ethiopia, which is a predominantly Muslim population. The respondents were interviewed at home (often with parents or other family members nearby) on topics including aspirations, food insecurity, and HIV knowledge, as well as romantic relationships, sexual intercourse, and condom knowledge and use. One half of the study sample used the cards, while the other half gave traditional verbal responses to interviewers.

Respondents were twice as likely to report having premarital sex when using a nonverbal response card, researchers founds. The effect of the response method on the willingness to report risk of acquiring HIV in the 12 months prior to the survey was “especially striking.” Virtually no respondents answering the questions verbally admitted to being at risk of acquiring HIV, compared to 3.8% of the respondents who used the card method.

The researchers found that young people over-report knowledge of condoms when they give verbal responses: About half of the single respondents giving verbal responses reported knowing where to obtain a condom, compared to only 37% of the single respondents in the card group.

“The difference in reported knowledge to access to condoms presents additional challenges for public health programs by suggesting that conventional survey estimates may significantly overestimate this knowledge, and most likely condom use as well, among subgroups who are often the target of outreach programs,” the authors wrote.

The response cards cost about $2 to produce, are highly portable and reliable, and are particularly useful in low-income rural settings where illiteracy is common.

“It’s clear that more sophisticated and costly survey technologies are not always the best solution when it comes to these types of surveys and questions,” said Lindstrom. “I hope this method is picked up and tried in research settings where sensitive questions are being asked.”

Source: Brown University