Best-Friend Reports: an instrument for Measuring the Prevalence of Sensitive Behaviors

Best-Friend Reports: an instrument for Measuring the Prevalence of Sensitive Behaviors

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Best-Friend Reports: an instrument for Measuring the Prevalence of Sensitive Behaviors

S. Yeatman and J. Trinitapoli jointly developed the best-friend device. S. Yeatman developed the basic concept for the article, performed the analyses, and penned all the article. J. Trinitapoli encouraged in the analysis and contributed towards the writing associated with the article.


We introduce the methodology that is best-friend utilizing studies to assess the populace prevalence of painful and sensitive habits. We indicate the potency of this device by comparing self-reports to best-friend reports of sexual abortion and behavior history among young ladies in Malawi (letter = 1493). Best-friend reports reveal higher and much more believable quotes of abortion and numerous partners that are sexual. In contexts for which close friends commonly discuss such actions, best-friend reports are a relatively inexpensive and simply implemented tool.

Survey scientists battle to measure sensitive and stigmatizing actions that are crucial for understanding health problems, habits of infection transmission, and need that is contraceptive. 1–4 Novel methodological ways to reduce underreporting, including sound computer-assisted self-interviewing and confidential voting strategies, have actually had limited success. These procedures can generate greater (and perhaps more accurate 5 ) reports of specific intimate habits and abortion, however they create lower reports of other habits and that can increase reporting errors. 6–11

To higher estimate the populace prevalence of intimate danger behavior and abortion in a residential area in southern Malawi, we administered a study asking a few questions regarding the actions of this respondent’s closest friend. This process leverages 2 sociological insights. The very first is that relationship sites are homogenous; buddies are usually comparable pertaining to characteristics that are sociodemographic habits. 12 the second reason is that social desirability bias must have less impact on reports of this stigmatizing or sensitive behaviors of your respective buddies than on self-reports. 13 right Here we provide the original outcomes obtained by making use of this effortlessly implemented approach to review research on sensitive and painful subjects.

Malawi is within the midst of the generalized and AIDS that is mature epidemic. Young women can be especially more likely to become infected, with HIV incidence peaking when you look at the mid-20s. 14 Premarital intercourse, although typical, is nonnormative, producing a social desirability bias that encourages people, and feamales in specific, to underreport extramarital partnerships and sexual intercourse before wedding. 15,16

Abortion is unlawful in Malawi except to truly save the life span of this woman that is pregnant. 17,18 however, clandestine abortion—largely unsafe—is a response that is common undesirable or mistimed pregnancies throughout the united states. There are not any nationwide quotes of abortion in Malawi, but information from major hospitals suggest that abortion problems will be the many reason that is common medical center admission to gynecological wards. 19,20


Tsogolo la Thanzi (TLT) is a brand new and ongoing longitudinal research of young (15–25 years) Malawians residing within a 7-kilometer radius associated with southern town of Balaka. The standard information had been gathered from a random test of females and guys from June 2009 through August 2009. Just the information gathered through the test of females (N = 1493) are talked about right right right here.

Interviewers built-up the info in face-to-face interviews that lasted approximately 80 mins each. The study included questions regarding the respondent’s intimate behavior plus the past history and upshot of each maternity she had ever skilled. Due to the delicate nature of these concerns, TLT complemented this direct approach with questions regarding the respondent’s friend that is best’s sexual behavior and abortion history. The interviewer introduced the section that is best-friend asking the respondent to “think regarding the most useful feminine buddy in Balaka. Image her. Do this person is had by you in your mind? ” Interviewers then asked the respondent a number of questions regarding the companion, beginning with less sensitive and painful concerns and moving forward to more sensitive concerns. As the relationship between close friends is usually reciprocal, this method approximates a 1-to-1 relationship.


When you look at the aggregate, TLT respondents’ answers to nonsensitive questions regarding their own marriage and childbearing closely mirrored the responses they provided towards the exact exact same questions regarding their utmost buddies ( Figure 1 ). For instance, 42.1percent of participants reported being presently hitched, compared to 42.8% reporting that their finest buddies had been hitched. Exactly the same had been real for having young ones (49.2% both for) and present maternity (9.6percent for participants and 8.8% because of their close friends). To get more sensitive questions, nevertheless, significant distinctions emerged between self-reports and best-friend reports. The portion of participants whom reported having had intercourse within the previous year (61.3%) had been a complete 11 portion points less than the portion whom stated that their finest friends had had sex in past times year. Underreporting had been systematic by marital status; the essential difference between self-reports and best-friend reports ended up being minimal for married females and big with their unmarried counterparts, reflecting prevailing norms discouraging premarital activity that is sexual.

Comparison of female respondents’ self-reports to reports on their close friends: Malawi, 2009 (n = 1493).

Note. BF = companion.

Additionally, although hardly any participants acknowledged having had a lot more than 1 partner that is sexual days gone by 12 months (1.7%), numerous partners had been reported to be reasonably frequent among close friends (20.3%). Within the pregnancy that is retrospective, just 0.4percent of participants admitted to using had an abortion inside their life time. In comparison, 7.6% of participants stated that these were confident their closest friend had ever endured an abortion, and an extra 0.5% suspected as much.


Best-friend reports usually do not solve all issues with self-reports on delicate dilemmas. These are generally inadequate for examining habits being not likely to be talked about between buddies or even for developing mechanisms that are causal. Nevertheless, best-friend reports can very quickly offer better quotes associated with prevalence of sensitive and painful and underreported habits in populations. Soliciting a respondent’s reports from the faculties and behavior of his / her friend that is best (that is most most likely like the respondent) is an effectual and affordable option to gather home elevators painful and sensitive problems. The best-friend approach could be validated with large-scale surveillance studies that compare patterns of sexual behavior as established by best-friend reports to observed trends in sexually transmitted infections at the population level. During the specific degree, the best-friend approach could possibly be validated with intensive system data connecting best-friend reports to biomarker information from participants and their utmost buddies. As soon as best-friend reports have actually been validated completely, they could have substantial applications, including gauging the precision of self-reported behavior and enhancing epidemiological models of this spread of intimately sent infections by enhancing their inputs.

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