Academic journal article International Perspectives on Sexual and Reproductive Health

Do Men and Women Report Their Sexual Partnerships Differently? Evidence from Kisumu, Kenya

Academic journal article International Perspectives on Sexual and Reproductive Health

Do Men and Women Report Their Sexual Partnerships Differently? Evidence from Kisumu, Kenya

Article excerpt

CONTEXT: It is generally believed that men and women misreport their sexual behaviors, which undermines the ability of researchers, program designers and health care providers to assess whether these behaviors compromise individuals'sexual and reproductive health.

METHODS: Data on 1,299 recent sexual partnerships were collected in a 2007 survey of 1,275 men and women aged 1 8-24 and living in Kisumu, Kenya. Chi-square and t tests were used to examine how sample selection bias and selective partnership reporting may result in gender differences in reported sexual behaviors. Correlation coefficients and kappa statistics were calculated in further analysis of a sample of 280 matched marital and nonmarital couples to assess agreement on reported behaviors.

RESULTS: Even after adjustment for sample selection bias, men reported twice as many partnerships as women (0.5 vs. 0.2), as well as more casual partnerships. However, when selective reporting was controlled for, aggregate gender differences in sexual behaviors almost entirely disappeared. In the matched-couples sample, men and women exhibited moderate to substantial levels of agreement for most relationship characteristics and behaviors, including type of relationship, frequency of sex and condom use. Finally, men and women tended to agree about whether men had other nonmarital partners, but disagreed about women's nonmarital partners.

CONCLUSIONS: Both sample selection bias and selective partnership reporting can influence the level of agreement between men's and women's reports of sexual behaviors. Although men report more casual partners than do women, accounts of sexual behavior within reported relationships are generally reliable.

International Perspectives on Sexual and Reproductive Health, 2011,37(4): l81-190, doi: 10.1363/3718111

In the wake of the HIV and AIDS pandemic-which has hit eastern and southern Africa particularly hard-knowing whether men and women accurately report their sexual behaviors has become increasingly important both to researchers seeking to understand how this epidemic has spread and to program designers attempting to identify ways to contain it. Nearly all previous studies have found marked gender differences in reported sexual behaviors, such as condom use, (1-3) frequency of sex, (4) relationship duration (3) and concurrent partners. (2), (3) Other research has tound evidence of gender bias in the reported use of contraceptives among matched married couples. (6), (7) Several studies have found a particularly large gap between the average number of sexual partners reported by men and women. (4), (5), (8), (9) Although most research has suggested that these differences reflect a systematic tendency for men to exaggerate their number of partners and for women to under-report theirs, one study has argued that much of this difference is driven by a handful of men who grossly inflate their number of sexual encounters. (10) Regardless of their source, these gender differences have led some researchers and many program designers to question the validity and usefulness of self-reported sexual behavior data. (11) Yet aggregate gender differences in reported behaviors may not be entirely attributable to simple gender-based misreporting.

At least two other explanations for such gender differences are plausible. First, differences may stem from sample selection bias, which may occur if, on average, men have more sexual partners outside the study area than do women, have partners younger than the minimum age of sample respondents (typically age 15 or 18) or have partners, such as commercial sex workers, who are not likely to be interviewed in standard surveys. These types of bias would tend to inflate aggregate gender differences in both the average number of partners and other reported sexual behaviors, such as condom use, frequency of sex and relationship duration.

To limit the effects of sample selection bias, one study in Tanzania attempted to interview all men and women of reproductive age in four villages and restricted their sample of partners to those who resided in these villages and were the same age as the respondents (aged 15-64). …

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