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Well-conducted telephone surveys provide an economical means of estimating the prevalence of sexual and reproductive behaviors in a population. There is, however, a nontrivial potential for bias since respondents must report sensitive information to a human interviewer. The National STD and Behavior Measurement Experiment (NSBME) evaluates a new survey technology-telephone audio computer-assisted self-interviewing (T-ACASI)-that eliminates this requirement. The NSBME embedded a randomized experiment in a survey of probability samples of 1,543 U.S. and 744 Baltimore adults ages 18 to 45. Compared with NSBME respondents interviewed by human interviewers, respondents interviewed by T-ACASI were 1.5 to 1.6 times more likely to report same-gender sexual attraction, experience, and genital contact. The impact of T-ACASI was more pronounced (odds ratio = 2.5) for residents of locales that have historically been less tolerant of same-gender sexual behaviors and for respondents in households with children (odds ratio = 3.0).

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Context: Adolescents' sexual behavior is an important issue in developing countries and a focus of programmatic efforts for reducing pregnancy and sexually transmitted disease. Yet the accuracy of young people's reports of their sexual activity has rarely been carefully examined. Methods: Data from a three-round longitudinal study of 698 young adolescents in Jamaica were used to examine consistency in the reporting of first sexual intercourse. Adolescents were asked to respond to multiple questions about their first intercourse within each round of the survey, and the items were repeated in subsequent rounds. A multivariate logistic regression analysis was conducted to examine the factors independently influencing the likelihood that adolescents would report their sexual experience inconsistently. Results: The vast majority of respondents (95-100%) reported their sexual experience status consistently within a given survey round. However, when agreement of responses between rounds was examined, 37% of respondents-12% of girls and 65% of boys-responded inconsistently. Multivariate logistic regression analysis indicated that boys were nearly 14 times as likely as girls to report their sexual experience inconsistently. Conclusions: Pervasive inconsistency in the reporting of sexual activity, especially among boys, highlights the limitations of relying on self-reported data to identify sexually active adolescents and to quantify that activity. Using such data to evaluate the impact of interventions designed to delay first intercourse may also be problematic.