Inconsistencies in reporting the occurrence and timing of first intercourse among adolescents

Journal of Sex Research, August, 2002 by Dawn M. Upchurch, Lee A. Lillard, Carol S. Aneshensel, Nicole Fang Li

Surveys of adolescent sexual behavior rely on the information obtained from self-report. These data are used to develop research and policy agendas for adolescent reproductive health issues. Age at first (heterosexual) intercourse is commonly used to classify adolescents who are at risk for sexually transmitted infections (STIs), unintended pregnancy, and other social and health consequences of sexual activity. The accuracy of self-reported behaviors is an enduring concern among researchers. Findings from numerous methodological studies suggest that reporting inconsistencies are not random, but rather are associated with a variety of factors. These factors include the sociodemographic attributes of the respondent (Alexander, Somerfield, Ensminger, Johnson, & Kim, 1993; Catania, 1999; Lauritsen & Swicegood, 1997; Wu, Martin, & Long, 1999), the ability and motivation of the respondent (Catania, 1999; Weinhardt, Forsyth, Carey, Jarworski, & Durant, 1998), survey design, interview modality, and setting (Catania, Gibson, Chitwood, & Coates, 1990; Gribble, Miller, Rogers, & Turner, 1999; Turner et al., 1998; Wu et al., 1999). Much of this research, however, investigates reporting problems using adult samples or adolescent samples reinterviewed during adulthood. Fewer studies have specifically examined reports by adolescent samples at two points in time (for exceptions see Alexander et al., 1993; Capaldi, 1996; McFarlane & St. Lawrence, 1999; Mott, 1985; Newcomer & Udry, 1988; Rogers, Billy, & Udry, 1982).

Self-reports of sexual behavior cannot be easily checked against more objective data--that is, externally validated against a gold standard. Consequently, research has focused on assessing the consistency of self-reports. In cross-sectional studies, consistency can be examined by comparing responses across different questions that ask for similar sensitive information (Rogers et al., 1982; Wislar & Fendrich, 2000). Longitudinal studies provide the additional opportunity to identify logical inconsistencies in reporting behavior over time: specifically, adolescents who report they are sexually experienced at one point in time and subsequently deny being experienced at a later point in time (Alexander et al., 1993; McFarlane & St. Lawrence, 1999; Rogers et al., 1982). Longitudinal studies also have the ability to identify inconsistencies in age (or date) of sexual experiences across panels of data when event-history data are collected (Lauritsen & Swicegood, 1997; Wu et al., 1999).

In this paper, we use information obtained from both waves of the National Longitudinal Study of Adolescent Health (Add Health) to assess the consistency in the reporting of virginity status and the date of first sexual intercourse among adolescents. The work contributes to the evaluation of self-reported sexual behaviors using sample surveys in several ways. First, we examine the reporting problems in a nationally representative sample of a contemporary cohort of both boys and girls, using information obtained from two panels of data. Second, we expand on the race and ethnic groups that have been previously studied and provide some of the first national estimates of reporting problems for Hispanic and Asian American youth. Third, we investigate two separate types of inconsistent reporting: (a) those pertaining to inconsistent event occurrence (i.e., reclaimed virginity status), and (b) those pertaining to inconsistent timing of the event (i.e., different dates of first intercourse). Lastly, we develop seven strategies for addressing inconsistent reporting in longitudinal data and present findings for each strategy.

MEASURING ADOLESCENT SEXUAL BEHAVIOR

Much of what is known about adolescent (1) sexual behavior is understood in the context of heterosexual vaginal intercourse. This emphasis reflects the long-standing public health concerns of the social and health consequences of that behavior: unintended pregnancy, adolescent childbearing, and STI infection and sequelae (U.S. Department of Health & Human Services, 2000). Conceptually, first heterosexual intercourse has been viewed as a highly salient event for adolescents and used as one marker in the transition to adulthood (Elder, 1997). Empirically, younger ages of first intercourse are associated with increased risks for these social and health consequences (Alan Guttmacher Institute, 1994). The current investigation draws from this overall approach. We recognize, however, that adolescent sexual expression is not limited to heterosexual intercourse or heterosexual contact alone. We argue that the assessment of reporting problems specific to heterosexual intercourse is a necessary first step, and that the behavior itself (although limited in scope) has important public health implications.

National prevalence estimates of sexual experience among teens are derived from surveillance data such as the Youth Risk Behavior Survey (YRBS), cross-sectional survey data such as the National Survey of Family Growth (NSFG), and longitudinal survey data such as the National Survey of Adolescent Males (NSAM) and, more recently, the National Longitudinal Study of Adolescent Health (Add Health). All of these databases (minimally) define adolescents as sexually experienced if they have ever had vaginal intercourse. In 1999, 49.4% of adolescents were sexually experienced, and the percentage varied by gender and race/ethnicity (Centers for Disease Control [CDC], 2000). Over half (52.2%) of boys and 47.7% of girls have had heterosexual intercourse; 45.1% of White, 54.1% of Hispanic, and 71.2% of Black teens have had intercourse (CDC, 2000). These findings, along with those from other studies, are influential because they inform researchers and policy makers in setting priorities for health-related concerns for adolescents. Consequently, the degree of accuracy in reporting sexual behaviors impacts how risk groups are identified and how they are characterized.