Consistency in the Reporting of Sexual Behavior among Adolescent Girls in Kenya:A Comparison of Interviewing Methods

The authors gratefully acknowledge the role of the project supervisors, Francis Ayuka (in Kisumu) and Arjmandbanu Khan (in Nairobi), as well as the 18 interviewers and three supervisors who carried out the field research in Kisumu. They also recognize the technical assistance provided by Stanley Mierzwa at the Population Council, New York, and Mike Shamku at the Population Council, Nairobi. Abstract This paper explores the consistency in reporting of sexual behavior in a household survey of adolescents aged 15–21 in the Kisumu district of Kenya. Respondents were randomly assigned to different interviewing modes: face-to-face interviews , paper-and-pencil self-administered interviews, and audio computer-assisted self-interviewing (ACASI). The analysis focuses on the reporting of sexual behavior by adolescent girls in the face-to-face and ACASI modes and compares responses to a variety of questions about sexual activity, including sexual initiation, risky sexual behavior, and coerced sex. All sexual behavior questions were asked of each adolescent girl even if she answered " no " to the initial question about ever having had sex. The paper also compares the consistency of reporting for questions that were asked twice during the survey—once in the main interview and again in a face-to-face exit interview. By comparison with ACASI, the interviewer-administered mode produces highly consistent reporting of sexual activity both within the main interview and between the main and exit interviews. On the other hand, ACASI produces higher reporting of sex with a relative, stranger, or older man, and higher reporting of co-erced sex. We argue that the level of consistency and the high response rates in the interviewer-administered mode are suspect and suggest reasons why one might expect inconsistent responses to survey questions about sexual behavior. In sub-Saharan Africa, where the major route of transmission of HIV is through heterosexual intercourse and where rates of infection among young people, particularly adolescent girls, are high, it is critical to collect accurate information on sexual activity prior to marriage (UNAIDS 1998; UNAIDS and WHO 1998). Yet recent studies from the region raise questions about the accuracy of reporting of sexual behavior. An analysis of trends in age at first sex in Africa using the Demographic and Health Surveys indicates discrepancies in reporting within birth cohorts, consistent with young women denying and young men exaggerating their sexual activity (Zaba et al. 2002). An epidemiological investigation of the large gender disparity in HIV prevalence among young people in two African cities reveals …