Issues in behavioural data collection Validity of self reported data on sexual behaviour
Many questions have been raised about the validity of self-reported data on sexual behaviour. Growing experience in collecting data on sexual behaviour have indicated that the extent to which people answered questions openly and truthfully depended on factors such as the setting of the question, privacy and confidentiality, attitudes and profile of the interviewer. While it was not possible to validate data on sexual practices by direct observation, it was possible to triangulate them with data from other sources to see if the picture presented was consistent and credible. Still, some misreporting of risk behaviour could occur and true levels of risk may well be under or over reported.
However, for those tracking the HIV epidemic, the trends in risk behaviours are of greater concern than the exact level of risk behaviour at any given point of time. Even when there is misreporting, repeat behavioural surveys have indicated changes in trends over a period of time, provided the magnitude or direction of misreporting did not change significantly.
To ensure maximum validity, the survey was implemented with high levels of quality control. This included intensive sensitisation and training of the interviewers, provision of a setting conducive to privacy, assuring and maintaining confidentiality so that the respondents felt comfortable.
Survey Implementation
Qualitative exploratory research was first conducted to facilitate exposure to the target groups and to gain information that would contribute to the questionnaire development. The BSS questionnaires, based on those recommended by WHO/UNAIDS, were adapted for use in Malayalam after doing intensive pre-testing. The implementation team received training mainly in methods of data collection, basic facts on STIs and HIV/AIDS, sex and sexuality and socio-cultural issues related to such a survey. A supervisory team had closely monitored the quality of data collection. The questionnaires were administered after informed consent was obtained, either by an interviewer or as in the case of students, through self-administration. The field-work was done between August and October 1999. The data was analysed using SPSS.
Key findings
Key findings described briefly in this section mainly focus on demographic profile and knowledge and behaviour indicators in various sub-population groups included in the study.
Female Sex Workers
Key demographics
The mean age of the female sex workers was 32.6 years. While 15% of the sex workers were illiterate, rest 85% were literate (Figure 1).
Thirty seven percent FSWs had said that they were unmarried or had never married. Only 15% of them had stated that they were married and were living with their husbands. A total of 29% respondents were reported to be married but were not living with their husbands and 19% of them were either divorced/separated or widowed (Figure 2).
Behavioural indicators
Ninety-nine percent sex workers reported that they had sexual intercourse with one-time client during the preceding month. Forty five percent had stated that they had sex with a regular partner and 33% reported having sex with spouse or cohabitating partner during the same period.
Condom use
The study indicated that percentage of respondents who had reported consistent condom use was lower than the reported condom use during the last sex as shown in Figure 3. Consistent condom use with one-time clients during the preceding 12 months was reported by 52% FSWs, which was not significantly higher than the reported consistent condom use with regular clients (44%).
