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

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

S. Yeatman and J. Trinitapoli jointly developed the tool that is best-friend. S. Yeatman developed the concept for the article, performed the analyses, and composed almost all of the article. J. Trinitapoli recommended in the analysis and contributed to your writing associated with the article.


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

Survey scientists battle to measure sensitive and stigmatizing actions that are crucial for understanding health threats, habits of infection transmission, and need that is contraceptive. 1–۴ Novel methodological ways to reduce underreporting, including sound computer-assisted self-interviewing and voting that is confidential, have actually had limited success. These processes can generate greater (and perhaps more accurate 5 ) reports of specific intimate habits and abortion, nonetheless they create reduced reports of other habits and that can increase errors that are reporting. 6–۱۱

To higher estimate the people prevalence of intimate danger behavior and abortion in a residential district in southern Malawi, we administered a study asking a number of questions about the habits associated with the respondent’s friend that is best. This process leverages 2 sociological insights. The very first is that friendship sites are homogenous; buddies are usually comparable with regards to characteristics that are sociodemographic actions. 12 the second reason is that social desirability bias need to have less impact on reports associated with stigmatizing or sensitive behaviors of your respective buddies than on self-reports. 13 right right right Here we provide the first outcomes acquired by making use of this effortlessly implemented approach to review research on painful and sensitive topics.

Malawi is within the midst of a general and mature AIDS epidemic. Young women can be especially more likely to become contaminated, 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 save lots of the life span of this woman that is pregnant. 17,18 however, clandestine abortion—largely unsafe—is a typical reaction to unwelcome or mistimed pregnancies throughout the nation. There are not any nationwide quotes of abortion in Malawi, but information from major hospitals claim that abortion problems will be the most typical cause for medical center admission to gynecological wards. 19,20


Tsogolo la Thanzi (TLT) is a brand new and ongoing longitudinal study of young (15–۲۵ years) Malawians living inside a 7-kilometer radius associated with the southern city of Balaka. The standard information had been gathered from the sample that is random of and males from June 2009 through August 2009. Just the information gathered through the test of females (N = 1493) are talked about right here.

Interviewers obtained the information in face-to-face interviews that lasted about 80 moments each. The study included questions regarding the respondent’s intimate behavior in addition to history and results of each pregnancy she had ever skilled. Due to the painful and sensitive nature of these questions, TLT complemented this direct approach with questions regarding the respondent’s friend that is best’s intimate 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. Picture her. Do you’ve got this person in your mind? ” Interviewers then asked the respondent a few questions regarding the closest friend, starting with less sensitive and painful concerns and shifting to more sensitive and painful concerns. Considering that the relationship between close friends is normally reciprocal, this process approximates a 1-to-1 relationship.


Within the aggregate, TLT respondents’ answers to nonsensitive questions regarding their very own marriage and childbearing closely mirrored the responses they offered to your exact exact exact same questions regarding their utmost friends ( Figure 1 ). As an example, 42.1percent of respondents reported being presently hitched, in contrast to 42.8% reporting that their utmost friends had been hitched. Exactly the same had been real for having kiddies (49.2% both for) and pregnancy that is current9.6percent for participants and 8.8% with their close friends). To get more sensitive and painful questions, nonetheless, significant distinctions emerged between self-reports and best-friend reports. The percentage of participants whom reported having had intercourse in past times year (61.3%) had been the full 11 portion points less than the portion whom stated that their finest friends had had sex into the previous year. Underreporting had been systematic by marital status; the essential difference between self-reports and best-friend reports ended up being minimal for married ladies and enormous for his or her unmarried counterparts, reflecting prevailing norms discouraging premarital activity that is sexual.

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

Note. BF = companion.

Furthermore, although hardly any participants acknowledged having had significantly more than 1 partner that is sexual the last 12 months (1.7%), multiple lovers had been reported to be reasonably common amongst close friends (20.3%). Into the retrospective maternity history, just 0.4% of participants admitted to using had an abortion inside their life time. By comparison, 7.6% of participants stated that they certainly were confident their closest friend had ever endured an abortion, and an extra 0.5% suspected as much


Best-friend reports usually do not re solve all difficulties with self-reports on sensitive and painful dilemmas. They’ve been insufficient for examining habits being not likely to be talked about between buddies and for establishing causal mechanisms. Nevertheless, best-friend reports can simply offer better quotes associated with the prevalence of sensitive and painful and underreported actions in populations. Soliciting a respondent’s reports from the traits and behavior of their friend that is best (who’s most likely like the respondent) is an efficient and affordable solution to gather informative data on sensitive and painful problems. During the populace degree, the best-friend approach might be validated with large-scale surveillance studies that compare habits of intimate behavior as established by best-friend reports to noticed styles in sexually transmitted infections. The best-friend approach could be validated with intensive network data attaching best-friend reports to biomarker data from respondents and their best friends at the individual level. As soon as best-friend reports have actually been validated thoroughly, they could have considerable applications, including gauging the precision of self-reported behavior and enhancing epidemiological models of this spread of intimately sent infections by increasing their inputs.

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