Lifting the Curtain on the Conditions of Sexual Initiation Among Youth in Ethiopia

Purpose: Deriving accurate estimates of the level of sexual coercion is challenging because of the stigma that is attached to the experience. This study examines the effectiveness of a nonverbal response card method to reduce social desirability bias in reports of the conditions of sexual initiation among youth in southwestern Ethiopia. Methods: The conditions surrounding sexual initiation are examined using data from a pilot survey and a final survey of youth aged 13 to 24. Half of the respondents in each survey were randomly assigned to a nonverbal response card method for sensitive questions on sexual attitudes and behavior, and the other half of the respondents were assigned to a control group that provided verbal responses. Responses for the two groups to questions regarding the conditions of sexual initiation are compared. Results: Respondents who used the nonverbal response card were more likely to report pressure from friends or a partner, having sex for money or another gain, and rape as conditions of sexual initiation than respondents who provided verbal responses. Among sexually experienced youth, 29.3% of respondents who used the card method reported some form of coercion during sexual initiation compared to 19.4% of respondents who gave verbal responses. Conclusions: The nonverbal response card provides an effective method for reducing social desirability bias when soliciting responses to sensitive questions in the context of an interviewer- administered survey. The analysis also suggests that coerced sexual initiation is underreported by youth in interviewer-administered surveys that use conventional verbal responses