Direct and indirect estimation of adolescent sexual intercourse and contraceptive use in Rajasthan India: an application of the best friend methodology.

Suzanne O Bell, Danish Ahmad, Anoop Khanna, Haley L Thomas, Caroline Moreau

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Article in BMC women's health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

Measurement innovation for sensitive behaviours: applying direct and social network-based estimation approaches to intimate partner violence in Burkina Faso and the Democratic Republic of the Congo using cross-sectional data.BMJ open · 2026
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5 authors.

Suzanne O BellDepartment of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.

Danish AhmadIndian Institute of Health Management Research, Rajasthan, India.

Anoop KhannaIndian Institute of Health Management Research, Rajasthan, India.

Haley L ThomasDepartment of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. hthoma29@jh.edu.

Caroline MoreauDepartment of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.

Funding

Bill and Melinda Gates Foundation IVN009630Children's Investment Fund Foundation 1712-02294

6 · The paper itself

Abstract

backgroundExisting estimates of adolescent sexual and reproductive health (ASRH) behaviors may be a gross undercount given the sensitivity of this behavior in Indian culture. The objective of this study was to estimate ASRH behaviors in Rajasthan, India using direct questions and the best friend approach that seeks to reduce social desirability bias.

methodsWe used population-based data of adolescents aged 15-19 in Rajasthan collected between September and December 2022. Data include whether the respondent and her closest female friend ever had a partner, ever had sex, ever used contraception, and were currently using contraception. We estimated respondent and best friend ASRH outcomes separately, overall and among unmarried adolescents for whom we anticipate social desirability bias is greatest.

resultsThe best friend approach performed well, with method assumptions largely met even before adjustments. Respondent and best friend estimates were similar among all adolescents except for current contraceptive use, which was higher for friends (though not significantly so). However, we observed large differences in ASRH behaviors between unmarried respondents and friends, with a significantly higher percentage of friends who ever had a partner (4.3% respondents, 11.6% friends), and a slightly higher percentage who ever had sex (2.4%, 3.8%) and who were currently using contraception (17.0%, 19.7% among those in need of contraception).

conclusionsWe observed potential benefits of using the best friend methodology in estimating premarital sexual activity, but further work is needed to refine social network-based measures of sensitive adolescent behaviors in larger study samples to better understand ASRH needs.

Indexed as

Adolescent BehaviorCoitusContraception BehaviorFriendsAdolescentContraceptionFemaleHumansIndiaMaleSexual BehaviorSexual PartnersSurveys and QuestionnairesYoung AdultAdolescentsContraceptionCross-sectional studiesIndiaReproductive healthSexual behaviorSurveys and questionnaires

Identifiers

PMID38926696

DOI10.1186/s12905-024-03209-6

PMCPMC11210037

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LicenceCC BY

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.