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

Best-Friend Reports: something 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 published the majority of the article. J. Trinitapoli encouraged from the analysis and contributed into the writing associated with article.


We introduce the best-friend methodology for utilizing studies to gauge the populace prevalence of delicate habits. We show the potency of this device by comparing self-reports to best-friend reports of intimate behavior and abortion history among young feamales in Malawi (letter = 1493). Best-friend reports reveal higher and much more believable quotes of abortion and numerous intimate lovers. In contexts for which close friends commonly discuss such behaviors, 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 contraceptive need. 1–4 Novel methodological ways to reduce underreporting, including sound computer-assisted self-interviewing and voting that is confidential, have actually had limited success. These procedures can generate greater (and perhaps more accurate 5 ) reports of particular sexual actions and abortion, however they create reduced reports of other habits and that can increase errors that are reporting. 6–11

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

Malawi is within the midst of the general and AIDS that is mature epidemic. Young ladies are especially very likely to become infected, with HIV incidence peaking within the mid-20s. 14 Premarital intercourse, although typical, is nonnormative, making 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 regarding the woman that is pregnant. 17,18 however, clandestine abortion—largely unsafe—is a typical response to undesired or mistimed pregnancies throughout the nation. There are not any nationwide quotes of abortion in Malawi, but data from major hospitals declare that abortion problems will be the many typical reason behind medical center admission to gynecological wards. 19,20


Tsogolo la Thanzi (TLT) is an innovative new and ongoing longitudinal study of young (15–25 years) Malawians residing 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 guys from June 2009 through August 2009. Just the information gathered through the test of females (N = 1493) are discussed right here.

Interviewers obtained the information in face-to-face interviews that lasted around 80 mins each. The study included questions regarding the respondent’s intimate behavior therefore the past history and results of each maternity she had ever skilled. Due to the painful and sensitive nature of these concerns, TLT complemented this direct approach with questions regarding the respondent’s closest friend’s intimate behavior and abortion history. The interviewer introduced the section that is best-friend asking the respondent to “think regarding your most useful sex chat rooms feminine buddy in Balaka. Picture her. Do this person is had by you in your mind? ” Interviewers then asked the respondent a number of questions regarding the friend that is best, beginning with less sensitive and painful concerns and moving forward to more sensitive and painful concerns. Since the relationship between close friends is usually reciprocal, this method 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 into the exact same questions regarding their finest buddies ( Figure 1 ). For instance, 42.1% of participants reported being presently hitched, weighed against 42.8% reporting that their finest buddies had been hitched. The exact same had been real for having kiddies (49.2% both for) and pregnancy that is current9.6percent for participants and 8.8% with regards to their close friends). To get more sensitive and painful concerns, nonetheless, significant distinctions emerged between self-reports and best-friend reports. The portion of participants whom reported having had intercourse in past times 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 had been minimal for married females and enormous with regards to their unmarried counterparts, reflecting prevailing norms discouraging premarital activity that is sexual.

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

Note. BF = friend that is best.

Also, although not many respondents acknowledged having had significantly more than 1 intimate partner in days gone by 12 months (1.7%), numerous lovers had been reported to be reasonably frequent among close friends (20.3%). In the retrospective maternity history, just 0.4percent of participants admitted to using had an abortion inside their life time. By comparison, 7.6% of participants stated that these people were confident their friend that is best had ever endured an abortion, and an extra 0.5% suspected as much.


Best-friend reports usually do not re re solve all nagging difficulties with self-reports on painful and sensitive dilemmas. They truly are inadequate for examining habits being unlikely to be talked about between buddies and for establishing causal mechanisms. However, best-friend reports can simply offer better quotes associated with the prevalence of delicate 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 most likely much like the respondent) is an efficient and cheap solution to gather information about sensitive and painful dilemmas. 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. At the specific degree, the best-friend approach might be validated with intensive community data connecting best-friend reports to biomarker information from participants and their utmost friends. As soon as reports that are best-friend 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 transmitted infections by enhancing their inputs.