ࡱ>  '` 0i bjbj BbbbbbbbTv HBB(jjjppp$hGb+sYHp+s+sbbjjQIH+sbjbj+sfpbbj6 auDTF[<Dv4bpp|-qdqpppOXppp+s+s+s+sDSbbbbbb Illustrative Questionnaire for Interview-Surveys with Young People John Cleland  Introduction This instrument is intended to be no more than a point of departure for investigators wishing to study the sexual and reproductive health of young people. It should always be adapted to local circumstances and priorities and, wherever possible, be used in conjunction with qualitative methods of investigation. Study population The instrument is designed to be suitable for teenagers and young people who have reached puberty but have not yet married or entered stable cohabiting relationships. It is intended to be equally appropriate for males and females, for those who are attending school and those who have left school, and for individuals with experience of sexual intercourse and those without. In surveys that are likely to include married or cohabiting respondents, radical alterations will be needed. Purposes The instrument is designed to document knowledge, beliefs, behaviour and outcomes in the domain of sexual and reproductive health. It is thus best viewed as a tool to assess the needs and problems of young people, an essential preliminary to intervention or advocacy. Content The questionnaire will yield information on the following, overlapping topics. Sources of information on sexual and reproductive health Sexual and reproductive health knowledge Sexual conduct including number and types of sexual partner and details of first sexual partnership Sexual ideology/attitudes to gender Protective, or risk, behaviour Condoms (knowledge, attitudes, use) Characteristics of current (most recent) boy/girl friend Sexual and reproductive health services (knowledge, use, evaluation) Sexual and reproductive health outcomes Background characteristics A detailed list of variables is shown below. Features The questionnaire is designed to be used as a verbatim instrument, where the interviewer reads out each question exactly as it appears in print. It will require careful translation into local languages and pre-testing to ensure that respondents easily understand the meaning of each and every question. The English version here is a 'unisex' instrument, equally applicable to male and female respondents with minor alterations in certain words. In some languages, however, it may be advisable to have separate questionnaires for male and female respondents. List of Variables Sources of Information on Sexual and Reproductive Health Source QuestionsImportant sourcesMost important source about puberty2.1Second most important source about puberty2.1Most important source about reproductive systems2.3Second most important source about reproductive systems2.3Most important source about relationships2.5Second most important source about relationships2.5Preferred sourcesPreferred source about puberty2.2Preferred source about reproductive systems2.4Preferred source about relationships2.6ParentsFrequency of discussing sex with father1.27Frequency of discussing sex with mother1.31SchoolExposure to sex-education in school2.7Opinion on amount of sex-education in school2.8Health facilities/staffSaw posters on contraception at last visit to health facility11.5Received brochures on contraception at last visit to health facility11.6Attended talk on contraception at last visit to health facility11.7Doctor/nurse talked about contraception at last visit to health facility11.9Doctor/nurse talked about STIs at last visit to health facility11.9Doctor/nurse talked about pregnancy at last visit to health facility11.9 Sexual and Reproductive Health Knowledge SourceReproductive physiologyBelief that a woman can get pregnant at first intercourse2.9Belief that a woman stops growing after first intercourse2.10Belief that masturbation is a serious health threat2.11Belief that pregnancy is most likely to occur in mid-cycle2.12ContraceptionSpontaneous/prompted awareness of pill and supply source7.2Spontaneous/prompted awareness of injection and supply source7.3Spontaneous/prompted awareness of condom and supply source7.4Spontaneous/prompted awareness of emergency contraceptive pills and supply source7.5Spontaneous/prompted awareness of withdrawal 7.6Spontaneous/prompted awareness of periodic abstinence 7.7Spontaneous knowledge of IUD, Implant, jelly/foam, sterilisation7.8View on most suitable method for young people7.9Agree that condoms effectively protect against pregnancy9.6HIV/STDsAwareness of HIV/AIDS8.1Belief that it is possible to cure AIDS8.2Belief that HIV-infected person always looks unhealthy8.3Belief that condoms reduce risk of HIV infection8.4, 9.10Awareness of STIs8.5Knowledge of symptoms of STIs in men8.6Knowledge of symptoms of STIs in women8.7Knowledge of sources of treatment of STIs8.7CondomsEver seen a condom9.5Agree that condoms effectively protect against pregnancy9.6Agree that condoms effectively protect against HIV9.10Agree that condoms can disappear inside a woman's body9.16Agree that condoms effectively protect against STIs9.18Agree that condoms can be used more than once9.7 Sexual Conduct SourceGeneral HeterosexualEver experienced sexual intercourse4.12, 4.13Age at first intercourse5.2 OR 3.25Life-time number of sexual partners4.14Number of coercive sex partners4.1, 4.2Number of casual sex partners4.6, 4.7Number of commercial sex partners4.9, 4.10Recency of last intercourse4.15Sexual intercourse with current boy/girl friend3.20Characteristics of First Sex partner/PartnershipNature of relationship IF BOY/GIRL FRIEND:5.4Age of partner5.5 or 3.4Marital status of partner5.6 or 3.5School/employment status of partner5.7 or 3.6When relationship started5.8 or 3.7Duration of relationship5.9/5.10 or 3.8/3.9Whether relationship has ended5.9 or 3.8Who ended the relationship5.11 or 3.10Whether there were concurrent relationships5.12 or 3.11Respondent's classification of relationship5.13 or 3.12Partner's perceived classification of relationship5.14 or 3.13Characteristics of First IntercourseRespondent's age at that time5.2 or 3.25Nature of coercion, if any5.15 or 3.22Whether planned5.16 or 3.23Whether regretted afterwards5.17 or 3.26Contraceptive method used5.18/19 or 3.27/28Whether contraception was discussed before or after5.20 or 3.29 Subsequent sexual conduct and outcomes with first partnerNumber of coital acts5.21 or 3.30Regularity of contraceptive used5.22 or 3.31Usual method use 5.23 or3.32Source of method5.24 or 3.33Who took contraceptive decisions5.25 or 3.34Whether pregnancy occurred5.26 or 3.35Outcome of pregnancy5.27 or 3.36Respondent's concern about HIV5.28 or 3.37Preventive steps taken against HIV5.29/30 or 3.38/9Homosexual ExperiencesEver sexually attracted6.1Ever had sexual contact6.2Masturbation6.3, 6.4Sexual orientation6.10MALES ONLY:Number of penetrative partners6.6, 6.7Number of receptive partners6.8, 6.9 Sexual Ideology/Gender SourceSexual permissivenessBelief that it is alright to 'date'10.1Belief that it is alright to hug/touch10.2Belief that sexual intercourse is alright if couple love each other10.3Personal belief that love is essential for sex1018Belief that sex should precede engagement10.8Belief in female/male pre-marital virginity10.9, 10.10Belief that sex is alright if contraceptive is used10.13Belief that one-night stands are alright10.24Peer influencesBelief that peers approve of one-night stands10.12Belief that peers think that sexual intercourse is alright if couple love each other10.22Perception of proportion of peers who have had intercourse10.25GenderBelief that a boy will not respect a girl who agrees to sex10.5Belief in female/male pre-marital virginity10.9, 10.10Belief in female/male regret about having intercourse10.6, 10.7Belief that contraception is girl's responsibility10.17Belief that men need more sex10.21PressurePerceived pressure to have intercourse4.27CoercionBelief that boys have to force sex10.4Belief that physical violence can be justifiable10.11AbortionPersonal attitude to abortion10.16Perceived attitude of peers to abortion10.20 Protective Behaviour SourceContraception with different types of partnerRegularity of contraception with coercive sex partners4.3Regularity of contraception with casual sex partners4.8Regularity of contraception with commercial sex partners4.11Current/most recent contraceptive statusMethod of contraception used at most recent act4.16, 4.17Contraception with first sex partnerMethod used at first sexual act5.18/5.19 or 3.27-3.28Regularity of contraceptive use with first sexual partner 5.22 or 3.31Usual method used5.23 or 3.32Contraception with current boy/girl friendMethod used at first sexual act with current boy/girl friend3.27/3.28Regularity of contraceptive use with current boy/girl friend3.31/3.32Ever use of specific contraceptive methodsMethods ever-used7.11Protection against HIV/STDs with first sex partnerConcern about infection5.28 or 3.37Preventive steps taken5.29/30 or 3.38/39Protection against HIV/STDS with current boy/girl friendConcern about infection 3.37Preventive steps taken3.38/39STD TreatmentWhether most recent STI was treated8.11Source of treatment8.12Whether partner was treated8.13Use of ServicesNumber of visits to RH health facility in last 12 months11.1, 11.2Type of facility most recently visited11.3Reason for most recent visit11.4Whether contraception was requested at most recent visit11.8Reasons for virginityReasons for virginity4.21-4.25Future plans4.26 Condoms SourceAwareness/ Knowledge Spontaneous/prompted awareness of condoms7.4Awareness of source7.4Ever seen a condom9.5Agree that condoms effectively protect against pregnancy9.6Agree that condoms effectively protect against HIV9.10Agree that condoms effectively protect against STIs9.18Agree that condoms can disappear inside a woman's body9.16Agree that condoms can be used more than once9.7AttitudesAgree that a girl can initiate use9.8Agree that a boy can initiate use9.9Agree that condoms are suitable for casual relationship9.11Agree that condoms are suitable for steady relationships9.12Agree that it would be too embarrassing to buy condoms9.13Agree that girl's suggestion to use implies distrust9.14Agree that condoms reduce sexual pleasure9.15Agree that unmarried couples should use condoms9.17UseEver used9.3, 7.11Ever experienced condom breakage9.4Use at most recent coital act4.17Use at first coital act5.19 or 3.28Main method used with first partner5.23 or 3.32Source of supply5.24 or 3.33Use to prevent HIV with first partner5.30 or 3.39Use at first coital act with current boy/girl friend3.28Main method used with current boy/girl friend3.32Source of supply3.33Use to prevent HIV with current boy/girl friend3.39 Current (most recent) boy/girl friend SourceCharacteristics of friendAge of friend3.4Marital status of friend3.5School/employment status of friend3.6When relationship started3.7Duration of relationship3.8, 3.9Whether relationship has ended3.8Who ended the relationship3.10Whether there were concurrent relationships3.11Respondent's classification of relationship3.12Partner's perceived classification of relationship3.13Degree of physical intimacyEver held hands, hugged etc3.4Kissed on lips3.15Touched sex organs3.16Mutual masturbation3.17, 3.18Penetrative intercourse3.20Penetrative intercourse with climax3.21Characteristics of first intercourse with current boy/girl friendRespondent's age at that time3.25Nature of coercion, if any3.22Whether planned3.23Whether regretted afterwards2.26Contraceptive method used3.24, 3.28Whether contraceptive was discussed before or after3.29Subsequent sexual conduct and outcomes with current boy/girl friendNumber of coital acts3.30Regularity of contraceptive use3.31Usual method used3.32Source of method3.33Who took contraceptive decisions3.34Whether pregnancy occurred3.35Outcome of pregnancy3.36Respondent's concern about HIV3.37Preventive steps taken against HIV3.38, 3.39 Sexual and Reproductive Health Services SourceKnowledge of servicesKnowledge of supply sources for specific contraceptive methods7.2-7.5, Col. 3Knowledge of places of STI treatment8.7Use of servicesEver used RH services11.1Number of visits in last 12 months11.2Characteristics of most recent visitType of facility11.3Reason for visit11.4Exposure to information about contraception11.5-11.7Whether contraceptive services were requested11.8Whether staff spoke about contraception, STIs, pregnancy11.9Whether respondent felt able to ask questions11.10Whether questions were answered adequately11.11Whether there was sufficient privacy11.12Source of contraceptive methodsSource of method used with first partner5.24 or 3.33Source of method used with current boy/girl friend3.33Source of STI treatmentSource of treatment for most recent STI episode8.12 Sexual and Reproductive Health Outcomes SourcePregnancyLifetime number of pregnancies4.18Whether last pregnancy was wanted4.19Whether last pregnancy was aborted4.20Pregnancy by first partner5.26 or 3.35Outcome of pregnancy by first partner5.27 or 3.36Pregnancy by current boy/girl friend3.35Outcome of pregnancy by current boy/girl friend3.35STIsLifetime number of STIs 8.10Whether treatment was sought for last episode8.11Whether partner obtained treatment8.13Coercive/commercial sexLifetime number of coercive sex partners4.2Lifetime number of commercial sex partners4.10Frequency of physical sexual harassment4.4, 4.5Coercion at first intercourse5.15 or 3.22Coercion at first intercourse with current boy/girl friend3.22 Background Characteristics SourceAge SchoolingAge1.2, 1.3Literacy1.4Schooling attainment1.5-1.7(Projected) age at leaving regular schooling1.9, 1.10Currently in education1.8Characteristics of school attended1.11-1.13EmploymentWork status1.14, 1.16, 1.20Age at starting work1.15Hours worked per week1.17Weekly earnings1.19Type of work1.18ReligionReligion1.21Frequency of attending religious services1.22Religiosity1.23FamilyCo-residence with father1.24, 1.25Co-residence with mother1.28, 1.29Co-residence with older brother1.32, 1.33Co-residence with older sister1.34, 1.35Ease of communication with father1.26Ease of communication with mother1.30Life-styleFrequency of going to clubs/parties1.36Frequency of going to movies1.37Alcohol consumption1.38Cigarette consumption1.39Life-time number of boy/girl friends3.1, 3.2 Illustrative Questionnaire for Interview-Surveys with Young People John Cleland  Questionnaire Section 1: Socioeconomic and family characteristics Section 2: Sources of information on, and knowledge of reproductive health Section 3: Current/most recent heterosexual relationship Section 4: Types of heterosexual contact Section 5: First sexual relationship Section 6: Homosexual experiences Section 7: Knowledge and ever-use of contraceptive methods Section 8: Knowledge of HIV/AIDS and sexually transmitted diseases Section 9: Condom knowledge and attitudes Section 10: Sexuality, gender and norms Section 11: Use and perceptions of health services Section 1: Socioeconomic and family characteristics This section addresses key characteristics of the respondent's life (school, work, family communication, recreation) that may shape sexual conduct and sexual health. Much scope exists for expanding the information collected about recreations, pastimes and social activities. Age Q1.2-1.3 Both date of birth and age at last birthday are asked to maximise accuracy of this critically important variable. Interviewers should be instructed to check the consistency of the two answers and reconcile if necessary. Schooling Length of schooling and educational performance are likely to be powerful influences on sexual conduct. Investigators might consider the addition of questions on (a) reasons for leaving full-time schooling (b) schooling aspirations (c) subjective self rating of academic performance. Q1.6-1.7 These questions may need adaptation to be local school system. For instance, some countries have a 'middle' tier of schools in between primary and secondary schools. In Q1.6 codes 03-05 are to be used for respondents who received further, or tertiary, training without having attended secondary school. Codes 06-10 are to be used for respondents who received tertiary training and who also attended secondary school Q1.9-1.10 The objective of these two questions is to permit a classification of all respondents in terms of actual projected age at leaving regular schooling. Respondents saying don't know to Q1.9 should be probed to obtain a reasonable estimate. Q1.11-1.13 These questions relate to the most recent (i.e. highest) school/college that the respondent attended regularly. Work Work experience is of interest in several ways. First, the transition from schooling to employment is an important marker of social position. Second, receipt of pay brings opportunities for expenditure an entertainment, alcohol etc that may be related to sexual conduct. Third, the nature of the part- or full-time occupation may also determine exposure to different types of opportunity and influence. Interviewers should stress the words "for pay". Unpaid work (e.g. household chores, helping in family business) does not count. 1.18 If a thorough pre-test is conducted, it may be possible to provide a pre-coded list of types of work with an 'other-specify' category. Religion 1.21 Investigators should adapt this answer list to local circumstances to capture important sects. Religiosity (Q1.22-1.23) Religiosity, though difficult to measure, may act as a more powerful influence on behaviour than formal religious affiliation. Family Composition and Communication (Q1.24-1.35) Ability to communicate with parents (if alive) and older siblings on sex-related matters has been found in some societies to influence sexual conduct and sexual risk. However, in some cultures relatives other than parents of siblings may be traditionally more important confidants (e.g. aunties) and the questionnaire may need to be adapted to such cultural variations. The model questionnaire permits a very simple measure of household composition - namely whether the respondent lives with mother, father, older brothers and sisters. Investigators may wish to obtain a complete listing of usual household members. Other topics that could be added here include: (a) parental restrictions on respondent's activities/mobility; (b) household amenities and possessions to obtain an indirect measure of wealth: (c) education/occupation of parents to obtain a social status indicator. Social Activities and Habits (Q1.36-1.39) This sub-section will nearly always require adaptation to local circumstances. In some settings, forms of substance abuse other than alcohol and tobacco may merit investigation. Exposure to pornographic videos is yet another possible topic. Section 1: Socioeconomic and family characteristics 1.1 SEX OF RESPONDENTMALE 1 FEMALE 21.2 What day, month and year were you born?Day Month Year How old were you at your last birthday? Years old CROSS-CHECK WITH DATE OF BIRTH AND RECONCILECan you read, for example, a newspaper? Yes 1 No 2Have you ever-attended school?Yes 1 No 2 1.14What is the highest level of schooling you completed? (CIRCLE HIGHEST SCHOOL LEVEL)  Primary 01 Secondary 02 Tertiary without Secondary School: Technical 03 Commercial or Secretarial 04 Preparatory 05 Tertiary with secondary School: Technical 06 Commercial or Secretarial 07 Teacher Training College (TTC) 08 University 09 Postgraduate 10What class/form/grade/year did you complete at this school..?Class/ Form etcAre you currently attending regular school, college or university? Full-time or part-time?Yes, full-time 1 Yes, part-time 1 No 2 1.10How many more years of education do you expect to receive?Years 1.11How old were you when you left school, college or university?Age Is the school, college or university that you attend(ed) a government or private institution?Government 1 Private 2Is it run by a particular religion or religious group?Yes 1 No 2Is the school or university that you attend(ed) for READ OUTBoys and girls? 1 Only boys (only girls)? 2Now I have some questions about work. Have you ever worked for pay?Yes 1 No 2 1.20How old were you when you started working for pay?Age in yearsAre you currently working for pay?Yes 1 No 2 1.20About how many hours a week do you work?HoursWhat type of work do (did) you do? PROBEHow much do (did) you earn in a week?Weekly wage Enter Unit. 1.21Are you looking for work?Yes 1 No 2What is your religion?None 01 Catholic 02 Protestant 03 Muslim 04 Hindu 05 Jew 06 Other.. 07 (SPECIFY) 1.24 How often do you usually attend religious services?Every day 1 At least once a week 2 At least once a month 3 At least one a year 4 Less than once a year 5 Never 6How important is religion in your life?Very important 1 Important 2 Not important 3Now I have some questions about your family. Is your father alive?Yes 1 No 2 1.28Does he live in the same household as you?Yes 1 No 2Do you find it difficult or easy to talk with your father about things that are important to you?Very easy 1 Easy 2 Average 3 Difficult 4 Very difficult 5 Do not see him 6 1.38Have you ever discussed sex-related matters with your father? If YES Often or occasionally?Often 1 Occasionally 2 Never 3Is your mother alive?Yes 1 No 2 1.32Does she live in the same household as you?Yes 1 No 2Do you find it difficult or easy to talk with your mother about things that are important to you?Very easy 1 Easy 2 Average 3 Difficult 4 Very difficult 5 Do not see her 6 Have you ever discussed sex-related matters with your mother? If YES Often or occasionally?Often 1 Occasionally 2 Never 3Do you have any older brothers?Yes 1 No 2 1.34Do any live in the same household?Yes 1 No 2Do you have any older sisters?Yes 1 No 2 1.36Do any live in the household?Yes 1 No 2And now I have some questions about your social activities. Do you ever go to clubs or parties where young people dance? IF YES. How many times in the last month? Number of times Never 88 Do you ever go to the movies? IF YES. How many times in the last month?Number of times Never 88Do you ever drink alcohol? IF YES. On how many days in the last month have you drunk alcohol?Number of days Never 88Do you ever smoke cigarettes? IF YES. How many have you smoked in the last 7 days?Number of Never 88 Cigarettes Section 2: Sources of information on, and knowledge of reproductive health This section divides sexual and reproductive health information into three broad categories: (1) physical maturation, or puberty, namely the acquisition during the teenage years of secondary sexual characteristics: (2) biological aspects of the sexual/reproductive system which might include contraception and sexual intercourse: (3) social aspects of relationships between men and women, which might include moral aspects of courtship, marriage etc. This section will require careful pre-testing to establish whether or not respondents are able to understand the distinctions between these three domains and whether the pre-coded list of answers is appropriate. 2.1-2.2 Note that only one answer can be circled in each column. The same applies to 2.3-2.4 and 2.5-2.6. Sex Education in School Before fielding the survey, pilot work should be conducted to ascertain the existence and nature of 'sex education' in schools. In settings where active sex education does exist, it will be valuable to expand 2.7-2.8 to obtain more precise measures of exposure to this form of instruction. Knowledge of Reproductive Physiology Q 2.9-2.12 measure the accuracy of respondents' knowledge about basic sexual/reproductive physiology. Although answers to individual items are of interest, a summary score will be of most analytic use. Do not forget to take into account that the correct answer to 2.9 and 2.12 is 'true' but is 'false' to 2.10 and 2.11. Investigators should also consider whether these questions are suitable for the study population or whether more appropriate ones can be devised. Section 2: Sources of information on, and knowledge of reproductive health Young people learn about puberty - I mean the ways in which boys' and girls' bodies change during the teenage years - from many sources. They may learn from teachers at school, parents, brothers and sisters, from friends, from doctors or they may learn from books, films and magazines. What has been the most important source of information for you on this topic? And the second most important? CIRCLE MOST IMPORTANT IN COL 1 AND SECOND MOST IMPORTANT IN COL 2 From whom, or where, would you prefer to have received more information on this topic? CIRCLE ONE ANSWER IN COL. 3 School teacher Mother Father Brother Sister Other family members Friends Doctors Books/magazines Films/Videos Other (Specify)(1) Most Important 01 02 03 04 05 06 07 08 09 10 11 .....(2) Second most important 01 02 03 04 05 06 07 08 09 10 11 .....(3) Preferred 01 02 03 04 05 06 07 08 09 10 11 .....Now I want to ask you a similar question about sources of information on the sexual and reproductive systems of men and women - I mean where eggs and sperm are made and how pregnancy occurs. What has been the most important source of information on this topic? And the second most important? CIRCLE IN COLS. 1 AND 2. From whom or where, would you prefer to receive (or prefer to have received) more information on this topic? CIRCLE ONE ANSWER IN COL. 3 School teacher Mother Father Brother Sister Other family members Friends Doctors Books/magazines Films/Videos Other (Specify)(1) Most Important 01 02 03 04 05 06 07 08 09 10 11 .....(2) Second most important 01 02 03 04 05 06 07 08 09 10 11 .....(3) Preferred 01 02 03 04 05 06 07 08 09 10 11 ..... Now there is a third similar question about sources of information on relationships - I mean how boys should treat girls and vice versa. What has been the most important source of information on this topic? And the second most important? CIRCLE IN COLS 1 AND 2 From whom, or where, would you prefer to receive more information on this topic? CIRCLE ONE ANSWER IN COL. 3 School teacher Mother Father Brother Sister Other family members Friends Doctors Books/magazines Films/Videos Other (Specify)(1) Most Important 01 02 03 04 05 06 07 08 09 10 11 .....(2) Second most important 01 02 03 04 05 06 07 08 09 10 11 .....(3) Preferred 01 02 03 04 05 06 07 08 09 10 11 .....2.7 Some schools have classes on puberty, on sexual and reproductive systems and on relationships between boys and girls. Did you ever attend school classes on any of these topics?Yes 1 No 2 Not sure 3 Never been to school 4 2.92.8 Do you think that there should be (more) classes on these topics, fewer classes or were the number about right?More 1 Less 2 About right 32.9 Now I have some other questions on sex and reproduction. I will read you some statements. Please tell me whether you think the statement is true, or false, or whether you don't know.TrueFalseDon't Know/ Not Sure  A woman can get pregnant on the very first time that she has sexual intercourse.1232.10 A woman stops growing after she has had sexual intercourse for the first time.1232.11 Masturbation causes serious damage to health.1232.12 A woman is most likely to get pregnant if she has sexual intercourse half way between her periods.123 Section 3: Current/most recent heterosexual relationship The purpose of this section is to establish the types of relationships that young people form, their degree of sexual intimacy and communication, and the possible attendant risks of unwanted pregnancy or sexually transmitted infectious (STIs). This purpose is achieved by asking about current or most recent relationship. An ideal strategy would have been to ask about all such relationships in the last x years but the length of the interview could have become excessive for some respondents. Investigators need to think carefully about how to adapt the concept of 'boy/girlfriend' and 'dating' to local circumstances. The assumption behind the model questionnaire is that some young people will 'go out with' someone of the opposite sex to whom they are emotionally or sexually attracted and that this 'going out' or 'dating' will be unsupervised by adults and thus provide opportunity for sexual intimacy. In settings where this assumption in invalid, this section may have to be deleted or radically modified. Q 3.3 Interviewers should be instructed to stress that the full name is not needed so as to avoid suspicions of loss of confidentiality. Q 3.12 This phrasing of the question will need careful adaptation. Sexual Conduct Q 3.14-3.21 The appropriateness of this progressive sequence of sexual acts and the precise vocabulary need to be ascertained by qualitative research prior to the survey. Q 3.20 Positive answers to this question are classified as sexual intercourse and are used as a crucially important filter in Section 4. Whatever words are used, they must convey the meaning of penetrative intercourse without any ambiguity Q 3.22 The options here should be read out slowly and repeated if necessary. Q3.32 If more than one method has been used, interviewers should probe for the method more frequently used. Abortion should not be included here. Q3.33 The list of possible supply sources may need adaptation to local circumstances. Abortion If you anticipate frequent reporting of induced abortion, extra questions on circumstances, place, cost of abortion and post-abortion morbidity will be useful. Live-births If you anticipate frequent reporting of live-births extra questions in survival of the live-birth, care-taker of the infant/child will be useful. Q 3.40 This is a difficult question to administer because interviewers have to turn back and summarize answer to Q 3.14-3.19. Particular emphasis is needed in training. Section 3: Current/most recent heterosexual relationship 3.1 Have you ever had a girl/ boy friend? By girl/boy friend, I mean someone to whom you were sexually or emotionally attracted and whom you 'dated' (use local terms to specify going out together unaccompanied by other adults)Yes 1 No 2 Section 43.2 How many girl / boy friends have you had?NumberAsk the following sequence of questions about CURRENT (MOST RECENT) girl / boy friend3.3 What is her/his first name?Name:_________________________3.4 How old is NAME? Probe for current ageAge 3.5 When you started your relationship, was NAME single, married, divorced or separated?Single 1 Married 2 Divorce 3 Separated 43.6 When you started you relationship with NAME, was NAME a full time student, working or neither?Full time student 1 Working 2 Neither 33.7 How many months or years ago did you first 'date' NAME?Months or Years ago ago3.8 Has the relationship ended?Yes 1 No 2 3.113.9 How many days/weeks/months did it last? I mean from the first time you 'dated' to the last time?Days Or Weeks Or Months3.10 Who decided to end the relationship? You, NAME or both of you.Me 1 NAME 2 Both 3 Other 43.11 During the time you were/have been 'dating' NAME did you 'date'/have you dated anyone else?Yes 1 No 23.12 How would you describe your relationship with NAME? Was (is) it (a) a casual friendship; (b) a serious relationship but with no intention of marriage; or (c) an important relationship that might lead to marriage?(a) Casual 1 Serious 2 Important/might lead to marriage 3 Engaged to be married 4 3.14 3.13 And how do you think NAME would describe her /his relationship to you? (a) as a casual friendship; (b) a serious relationship but with no intention of marriage; (c) an important relationship that might lead to marriage?(a) Casual 1 (b) Serious 2 (c) Important/might lead to marriage 33.14 Did you and NAME have any physical contact, such as holding hands, hugging or kissing?Yes 1 No 23.15 Did you ever kiss NAME on the lips?Yes 1 No 23.16 Did you ever touch NAME'S vagina/penis with your hand?Yes 1 No 2 3.183.17 Did you ever stroke NAME'S vagina/penis so that she/he climaxed?Yes 1 No 23.18 Did NAME ever touch your penis/vagina with her /his hand?Yes 1 No 2 3.403.19 Did NAME ever stroke your penis/vagina so that you climaxed?Yes 1 No 2MALES: Did you ever put your penis inside NAME's vagina? FEMALES: Did NAME ever put his penis inside your vagina?Yes 1 No 2 3.40MALES: Did you ever reach climax inside NAME'S vagina? FEMALES: Did NAME ever reach climax inside your vagina?Yes 1 No 2QUESTION 3.22 - 3.39 ARE ONLY FOR THOSE WHO HAVE EXPERIENCED PENETRATIVE SEXThink back to the first time you had sex with NAME - I mean the first time that the penis was in the vagina. Would you say. READ OUT I forced NAME to have intercourse against her/his will I persuaded NAME to have intercourse NAME persuaded me to have intercourse NAME forced me to have intercourse We were both equally willing (a) I forced 1 (b) I persuaded 2 (c) NAME persuaded 3 (d) NAME forced 4 (e) Both willing 5 3.23 And would you say it was planned or unexpected?Planned 1 Unexpected 2 3.24 Was this the first time that you had full sexual intercourse in your life?Yes 1 No 2 3.263.25 How old were you at the time you first had sex with NAME?AGE3.26 Did you regret having intercourse with NAME on that first time?Yes, regretted 1 No, not regretted 23.27 On that first time did you or NAME do anything to avoid a pregnancy?Yes 1 No 2 3.293.28 What method did you use?Condom 1 Pill 2 Injection 3 Withdrawal 4 Safe period 5 Other.. 63.29 Did you ever discuss contraception with NAME? IF YES Did you discuss contraception before or after you first had intercourse?Before first intercourse 1 After first intercourse 2 Never 33.30 How many times did you and NAME have full intercourse? (estimate)No. Once only 1 3.353.31 Apart from the first time, did you and NAME ever use a method to avoid pregnancy? IF YES Always or sometimes?Always 1 Sometimes 2 Never 3 3.343.32 What method did you and NAME mostly use? (MULTIPE RESPONSES PERMITTED)Condom 1 Pill 2 Injection 3 Withdrawal 4 Safe period 5 Other.. 6 3.343.33 Where did you or NAME get this method? (CIRCLE ONLY ONE)Shop 1 Pharmacy 2 Govt. Clinic/Health Centre/Hospital 3 Private Doctor/Nurse/Clinic 4 Friend 5 Other.. 6 Don't know 9 SEE Q. 3.31 Whose decision was it to use a method always/sometimes/never? Was it mainly your decision, NAME'S decision or a joint decision?My decision 1 NAME'S decision 2 Joint decision 3MALES: Did NAME ever become pregnant by you? FEMALES: Did you ever become pregnant by NAME?Yes 1 No 2 3.373.36 What happened to the pregnancy? Currently pregnant 1 Abortion 2 Miscarriage 3 Live-birth 4 No sure 53.37 Were you ever concerned that you might catch AIDS or another sexually transmitted disease from NAME? IF YES Very or somewhat?Very concerned 1 Somewhat concerned 2 Not concerned 3 SECTION 43.38 Were you able to do anything to reduce the risk of infectionYes 1 No 2 SECTION 43.39 What did you do? ProbeUse condoms 1 Take medicines 2 Other (..) 3 SECTION 4 REVIEW QUESTIONS 3.14-3.19 AND SUMMARIZE DEGREE OF PHYSICAL INTIMACY. THEN ASK ONLY IF RELEVANT. You had no physical contact/kissed/touched etc. with NAME . Think carefully and tell me which of these statements is true. READ OUT I wanted (more) physical contact but NAME refused NAME wanted (more) physical contact but I refused Neither of us wanted more physical contact (a) Respondent wanted 1 (b) NAME wanted 2 (c) Neither wanted 3 Section 4: Types of heterosexual contact Sexual intercourse does not necessarily occur with a girl/boyfriend. It may happen in coercive circumstances, it may be financial in motive, or may occur voluntarily but outside of any 'relationship', as in a 'one-night stand'. This section starts by enquiring about sexual intercourse under each of these circumstances; details about life-time number of sexual partners and most recent act of intercourse are then obtained. Q 4.4 This question seeks information about frequency of sexual harassment. Q 4.6 The concept of 'one-night stands' will require careful translation and should be distinguished from commercial sex. Q 4.9 Interviewers should stress the phrase "in exchange for". The intention here is to identify sexual encounters where the main motive is money or gifts. Filter 4.12 is an important filter, requiring the interview to review Q 3.20 as well as earlier answers in Section 4. Q 4.20 See comment on page 11/12. Reasons for Virginity Questions on this page are asked only of respondents who have not experienced sexual intercourse. The objective here is to obtain information on the reasons, future expectations and the possibility of pressure from others to have intercourse. Section 4: Types of heterosexual contact INTERVIEWER SEE Q. 3.1-3.3 ON PAGE 7 ANSWER TO 3.1 IS "NO": You told me that you have had no girl/boy friends. I now want to ask you about any sexual contacts that you may have experienced. ANSWER TO 3.1 IS "YES": You have told me about your relationship with NAME. Apart from her/him and any earlier girl /boy friends, I now want to ask you about other types of sexual partners that you may have experienced.4.1 Some young people are forced to have sexual intercourse against their will by a stranger, a relative or an older person. Has this ever happened to you?Yes 1 No 2 4.34.2 How many different strangers, relatives or older perons have forced you to have sex against your will?No.  4.3 Did you or the sexual partner do anything to avoid a pregnancy on these occasions? IF YES Always or sometimes?Always 1 Sometimes 2 Never 34.4 Some young people/females are touched on the breast or some other part of the body when they do not want to be, by a stranger, a relative or an older person. Has this ever happened to you?Yes 1 No 2 4.64.5 Would you say this has happened often, sometimes, or rarely?Often 1 Sometimes 2 Rarely 34.6 Some young people have 'one night stands' (use local terms), perhaps after a party or after drinking? Has this ever happened to you?Yes 1 No 2 4.84.7 How many 'one night stands' have you had?No. 4.8 Did you or the sexual partner do anything to avoid a pregnancy on these occasions? IF YES Always or sometimes?Always 1 Sometimes 2 Never 34.9a Some young people pay money or gifts in exchange for sexual intercourse. Has this ever happened to you? 4.9b Some you people receive money or gifts in exchange for sexual intercourse. Has this ever happened to you?Yes 1 No 2 Yes 1 No 2 4.11 4.114.10 How many women/men have you had sex with for money or gifts?No.  4.11 Did you or the sexual partner de anything to avoid a pregancy on these occasions? IF YES Always or sometimes?Always 1 Sometimes 2 Never 3 REVIEW 3.20 AND 4.1, 4.5, 4.8 AND TICK APPROPRIATE BOXRespondent has not Respondent has reported sexual reported Intercourse sexual intercourse 4.144.13 I want to make certain that I have the correct information. Have you ever had sexual intercourse in your whole life?Yes 1 No 2 4.214.14 In your whole life how many people have you had sexual intercourse with?No.How long ago did you last have intercourse with a woman/man? IF LESS THAN ONE WEEK, ENTER 00 WEEKSWeeks ago Or Months ago4.16 On that last occasion did you or your partner do anything to avoid pregnancy?Yes 1 No 2 4.184.17 What method was used?Condom 1 Pill 2 Injection 3 Withdrawal 4 Safer Period 5 Other .. 6MALES: Have you ever made a girl or woman pregnant? IF YES How many times? FEMALES: Have you ever been pregnant? IF YES How many times?No. Never 0 Not Sure 9 4.194.19 Thinking of the most recent pregnancy, did you want the pregnancy at that time or not want it?Want 1 Not want 24.20 What happened to the (last) pregnancy?Currently pregnant 1 Abortion 2 Miscarriage 3 Live-birth 4 Not sure 5  Section 5 THIS PAGE I ONLY FOR THOSE WHO HAVE NEVER EXPERIENCED SEXUAL INTERCOURSE People may have mixed reasons for not having intercourse. I will read out some reasons. Please tell me for each reason whether it applies to you or not.AppliesNot appliesDon't Know/ Not Sure 4.21 I don't feel ready to have sex.1234.22 I have not had the opportunity.1234.23 I think that sex before marriage is wrong1234.24 I am afraid of getting pregnant1234.25 I am afraid of getting HIV/AIDS or another sexually transmitted infection.123And now I have a question about your future plans about sexual intercourse. Which of these statement best describes your plans. READ OUT I plan to wait until marriage I plan to wait until I am engaged to be married I plan to wait until I find someone I love I plan to have sexual intercourse when an opportunity comes along Marriage 1 Engagement 2 Love 3 Opportunity 4Do you feel any pressure from others to have sexual intercourse? IF YES A great deal or a little?A great deal 1 A little 2 None 3 Section 6From whom do you feel pressure? PROBE CIRCLE ALL THAT APPLYFriends 1 Relatives 2 Work colleagues 3 Partner/special friend 4 Other 5 . Section 5: First sexual relationship Evidence suggests that the nature of the first partner and the circumstances of sexual initiation may have a lasting influence on subsequent sexual conduct. Hence this section deals exclusively with this topic. Filter 5.1 This is an important filter. Some respondents first experienced intercourse with their current or most recent girl/boyfriend and this entire section is therefore redundant Section 5: First sexual relationship SEE 3.24 ALL OTHERS CURRENT (MOST RECENT) GIRL/BOY FRIEND WAS FIRST SEXUAL PARTNER SECTION 65.2 Now I have some question about the first time that you had sexual intercourse. How old were you at that time?AGE5.3 What is her/his first name?Name:_________________________ D.K 9In the following questions, use "that person" instead of NAME if name of first partner is not known 5.4 How would describe your relationship to NAME (that person)? PROBE Boy/girl friend 1 Stranger/relative/other person who forced me 2 One night stand 3 Commercial sex partner 4 5.16  5.155.5 How old is NAME? Probe for current ageAge 5.6 When you started your relationship, was NAME single, married, divorced or separated?Single 1 Married 2 Divorce 3 Separated 45.7 When you started you relationship with NAME was NAME a full time student, working or neither?Full time student 1 Working 2 Neither 35.8 How many months or years ago did you first 'date' NAME? How many months or years were there between the time you started your relationship and the time you first had sex with NAME?Months or Years Ago ago Months or Years Ago ago 5.9 Has the relationship ended?Yes 1 No 2 5.125.10 How many days/weeks/months did it last? I mean from the first time you 'dated' to the last time?Days Or Weeks Or Months 5.11 Who decided to end the relationship? You, NAME or both of you.Me 1 NAME 2 Both 3 Other 45.12 During the time you were 'dating' NAME did you 'date' anyone else?Yes 1 No 25.13 At that time how would you describe your relationship with NAME? Was (is) it (a) a casual friendship; (b) a serious relationship but with no intention of marriage; or (c) an important relationship that might lead to marriage?(a) Casual 1 (b) Serious 2 (c) Important/might lead to marriage 3 (d) Engaged to be married 4 5.265.14 And how do you think NAME would describe her (his) relationship to you? (a) as a casual friendship; (b) a serious relationship but with no intention of marriage; (c) an important relationship that might lead to marriage?(a) Casual 1 (b) Serious 2 (c) Important/might lead to marriage 35.15 Think back to the first time you had sex with NAME - I mean the first time that the penis was in the vagina. Would you say. I forced NAME to have intercourse against her/his will I persuaded NAME to have intercourse NAME persuaded me to have intercourse NAME forced me to have intercourse We were both equally willing (a) I forced 1 (b) I persuaded 2 (c) NAME persuaded 3 (d) NAME forced 4 (e) Both willing 55.16 And would you say it was planned or unexpected?Planned 1 Unexpected 25.17 Did you regret having intercourse with NAME on that first time?Yes 1 No 2 If yes, WHY .. 5.18 On that first time did you or NAME do anything to avoid a pregnancy?Yes 1 No 2 5.205.19 What method did you use?Condom 1 Pill 2 Injection 3 Withdrawal 4 Safe period 5 Other.. 6 5.20 Did you ever dicuss contraception with NAME? IF YES Did you discuss contraception before or after you first had intercourse?Before first intercourse 1 After first intercourse 2 Never 35.21 How many times did you and NAME have full intercourse? (estimate)No. Once only 1 5.265.22 Apart from the first time, did you and NAME ever use a method to avoid pregnancy? IF YES Always or sometimes?Always 1 Sometimes 2 Never 3 5.255.23 What method did you and NAME mostly use?Condom 1 Pill 2 Injection 3 Withdrawal 4 Safe period 5 Other.. 65.24 Where did you or NAME get this method? (CIRCLE ONLY ONE)Shop 1 Pharmacy 2 Clinic/Health Centre/Hospital 3 Private Doctor/Nurse/Clinic 4 Friend 5 Other.. 6 (Specify)5.25 SEE Q. 5.22 Whose decision was it to use a method always/sometimes/never? Was it mainly you decision, NAME'S decision or a joint decision?My decision 1 NAME decision 2 Joint decision 35.26 MALES: Did NAME ever become pregnant by you? FEMALES: Did you ever become pregnant by NAME?Yes 1 No 2 5.285.27 What happened to the pregnancy? Currently pregnant 1 Abortion 2 Miscarriage 3 Live-birth 45.28 Were you ever concerned that you might catch AIDS or another sexually transmitted disease from NAME? IF YES Very or somewhat?Very concerned 1 Somewhat concerned 2 Not concerned 3 SECTION 6 5.29 Did you do anything to reduce the risk of infection?Yes 1 No 25.30 What did you do? ProbeUse condoms 1 Take medicines 2 Other (..) 3 Section 6: Homosexual experiences Depending on local circumstances this short section on homosexual experiences may be expanded or removed. The recommended questions reflect the fact that male-to-male sex carries a much greater disease-risk than woman-to-woman sex. Q 6.1-6.4 Need to remind interviewers that these questions relate to homosexual experiences and questions to boys must ask about relationships with other boys, and questions to girls must ask about relationships with other girls. Section 6: Homosexual experiences 6.1 Some young people are sexually attracted to people of the same sex. Have you ever been sexually attracted to a boy/girl?Yes 1 No 26.2 Have you ever had any sexual contact, such as hugging or touching, with a boy/girl?Yes 1 No 2 6.106.3 Has a boy / girl ever stroked your penis/vagina so that you climaxed?Yes 1 No 26.4 Have you ever stroked a boy/girl in this way?Yes 1 No 26.5 RESPONDENT IS MALERESPONDENT IS FEMALE 6.106.6 Has a boy or man ever had sexual intercourse with you? I mean inserted his penis into you?Yes 1 No 2 6.86.7 How many boys or men have ever had sexual intercourse with you? On these occasion, would you say that your partner(s) have never used a condom, used a condom sometimes, or always?No. Never 1 Sometimes 2 Always 36.8 Have you ever had sexual intercourse with a boy or man? I mean inserted your penis into a boy or man?Yes 1 No 2 6.106.9 How many boys or men have you had sexual intercourse with? On these occasion, have you never used a condom, used a condom sometimes, or always?No. Never 1 Sometimes 2 Always 36.10 Would you say that you are mostly attracted to people of the opposite sex, more attracted to people of the same sex, or attracted to both sexes equally?Opposite sex 1 Same sex 2 Both equally 3 Section 7: Knowledge and ever-use of contraceptive methods Knowledge of contraception and supply sources is a precondition for adoption of pregnancy-protection means. In Q 7.2-7.7 detailed information is elicited about each of the main methods that young people might use. Less appropriate methods (sterilization, IUD, implant) and uncommon methods, such as jellies/foams, are addressed in a more summary way (see 7.8). While knowledge of individual methods (and sources) is of interest, these data can also be summarized at the analysis stage i.e. number of methods known. More detailed questions on condoms may be found in Section 9 but investigators may wish to measure knowledge of how oral contraceptive should be used (e.g. what to do if one pill is forgotten) in settings where this method is common. Q 7.5 Note that this method may be unknown (unavailable) in some countries) Q 7.7 Note that Q2.12 provides at least a partial measure of the respondent's understanding of this method. Section 7: Knowledge and ever-use of contraceptive methods I now have some questions about contraception - I mean ways in which men and women can avoid getting pregnant. Which methods have you heard of? What others? CIRCLE CODE 1 IN COL. 2 FOR EACH METHOD MENTIONED. FOR EACH METHOD IN THE TABLE NOT ALREADY MENTIONED, READ THE DESCRIPTION IN COL.1 AND RECORD ANSWER IN COL.2 FOR EACH METHOD KNOWN ASK QUESTION IN COL.3COL 1.COL. 2.COL. 3.Pill Women can take a pill every dayKnowledge of Method Yes (spont.) 1 Yes (prompted) 2 No 3 Knowledge of Source "Do you know any place or person where young people could obtain this method? Yes 1 No 27.3 Injection Women can have an injection every 2 or every 3 months Yes (spont.) 1 Yes (prompted) 2 No 3 "Do you know any place or person where young people could obtain this method? Yes 1 No 27.4 Condom A man can put a rubber device on his penis before intercourse Yes (spont.) 1 Yes (prompted) 2 No 3 "Do you know any place or person where young people could obtain this method? Yes 1 No 27.5 Emergency Contraceptive Pills A woman can take pills soon after intercourse  Yes (spont.) 1 Yes (prompted) 2 No 3 "Do you know any place or person where young people could obtain this method? Yes 1 No 27.6 Withdrawal A man can pull out of a woman before climax Yes (spont.) 1 Yes (prompted) 2 No 3 7.7 Periodic Abstinence/Rhythm A couple can avoid sex on days when pregnancy is most likely to occur. Yes (spont.) 1 Yes (prompted) 2 No 3  7.8 There are other methods of contraception that I have not mentioned. What other methods have you heard of? CIRCLE EACH METHOD MENTIONED.IUD 1 Implant 2 Jelly/foam 3 Female Sterilization 4 Male Sterilization 5 Other (SPECIFY).. 6Which method do you think is most suitable for young people? CIRCLE ONE ANSWERPill 1 injection 2 Condom 3 Emerg. Pills 4 Withdrawal 5 Periodic. Ab. 6 Other .. 7 D.K. 8SEE Q4.12 and 4.13 ON PAGE 12 Respondent has Respondent has not experienced sexual experienced sexual intercourse intercourse SECTION 8Which methods of contraception have you or a sexual partner ever used? PROBE which others? CIRCLE ALL THAT APPLYPill 1 injection 2 Condom 3 Emerg. Pills 4 Withdrawal 5 Periodic. Ab. 6 Other .. 7 Section 8: Knowledge of HIV/AIDS and sexually transmitted diseases Indication of knowledge of HIV/AIDS and other sexually transmitted infections are measured in this section. In settings where HIV is common, investigators should consider the addition of extra questions, such as knowledge of HIV infected relatives/friends, and attitudes to voluntary testing. Beliefs about HIV/AIDS Q 8.2-8.4 This three-item list can be expanded and many model questionnaires contain examples of questions. Q 8.5 To overcome reluctance to report knowledge, investigators might consider giving examples. Local terms should be used. Q 8.7 The pre-coded responses should be adapted to local circumstances. If preliminary investigations suggest that reporting of sexually transmitted infections will be reasonably common, additional information may be collected on (a) delay between noticing symptoms and treatment (b) cost of treatment (c) quality of treatment (e.g. examination, advice about condoms, partner notification) (d) sexual behaviour during treatment. Section 8: Knowledge of HIV/AIDS and sexually transmitted diseases 8.1 Have you heard of HIV or AIDS (use local terms)?Yes 1 No 2 8.5I am now going to read you some statements about HIV/AIDS. Please tell me whether you think the statement is true, or false, or whether you don't know.  True False Don't know8.2 It is possible to cure AIDS1238.3 A person with HIV always looks emaciated or unhealthy in some way1238.4 People can take a simple test to find out whether they have HIV1238.5 Apart from HIV/AIDS, there are other diseases that men and women can catch by having sexual intercourse. Have you heard of any of these diseases?Yes 1 No 2 SECTION 9 What are the signs and symptoms of a sexually transmitted disease in a man? PROBE CIRCLE EACH MENTIONEDDischarge from penis 1 Pain during urination 2 Ulcers/sores in genital area 3 Other Other D.K. any signs 88.7 And what are the signs or symptoms when a woman is infected?Vaginal discharge 1 Pain during urination 2 Ulcers/sores in genital area 3 Other Other D.K. any signs 88.8 If a friend of yours needed treatment for a sexually transmitted disease, where could he or she obtain such treatment? PROBE Any other places? CIRCLE EACH MENTIONEDShop 1 Pharmacy 2 Govt. hospital/health centre/clinic 3 Private doctor/nurse/clinic 4 Other (SPECIFY) 5 SEE Q 4.12 and 4.13 ON PAGE 12 Respondent has experienced Sexual intercourse  Respondent has not experienced Sexual intercourse SECTION 9Have you ever had a sexually transmitted disease? IF YES Once or more than once?Once 1 More than once 2 Never 3 SECTION 98.11 (On the last occasion) did you seek treatment?Yes 1 No 2 8.138.12 Where did you seek treatment?Shop 1 Pharmacy 2 Govt. hospital/health centre/clinic 3 Private doctor/nurse/clinic 4 Other 58.13 Did your sexual partner (any of your partners) also obtain treatment?Yes 1 No 2 Don't know 3 Section 9: Condom knowledge and attitudes An entire section is devoted to condoms because of the unique importance of this method in offering a degree of dual protection against pregnancy and against infection. Q 9.6-9.18 measure both beliefs about condoms and attitudes to their use. Q. 9.6, 9.7, 9.10, 9.16 and 9.18 measure knowledge about the properties of condoms and answers could be combined to form a summary score. But note that the correct answer for some questions (9.6, 9.10, 9.18) is AGREE, and for the others (9.7, 9.16) is DISAGREE. Therefore, before combining the responses to produce an overall knowledge score, the codings for 9.7 and 9.16 should be reversed. Section 9: Condom knowledge and attitudes SEE Q.7.4 ON PAGE 18 CONDOMS KNOWN CONDOMS NOT KNOWN SECTION 10SEE Q4.12 AND 4.13 ON PAGE 12 Respondent has experienced sexual intercourse  Respondent has not experienced sexual intercourse 9.5Have you or a partner ever used a condom?Yes 1 No 2 9.6Have you ever experienced a condom that split or broke during intercourse?Yes 1 No 2 9.6Have you ever seen a condom?Yes 1 No 2People have different opinions about condoms. I will read out some opinions. For each one, I want you to tell me whether you agree or disagree, or whether you don't knowAgree Don't know/not sure Disagree Condoms are an effective method of preventing pregnancy123Condoms can be used more than once123A girl can suggest to her boyfriend that he use a condom123A boy can suggest to his girlfriend that he use a condom123Condoms are an effective way of protecting against HIV/AIDS 123Condoms are suitable for casual relationships123Condoms are suitable for steady, loving relationships123It would be too embarrassing for someone like me to buy or obtain condoms123If a girl suggested using condoms to her partner, it would mean that she didn't trust him123 Condoms reduce sexual pleasure123Condoms can slip off the man and disappear inside the woman's body123If unmarried couples want to have sexual intercourse before marriage, they should use condoms123Condoms are an effective way of protecting against sexually transmitted diseases123 Section 10: Sexuality, gender and norms This section explores gender-related norms towards pre-marital sex, coercion/violence, and protection mechanisms. Much of the analytic interest will lie in simple comparisons of responses by sex and age of respondent. For better educated study populations, investigators should consider using 5-point or even 7-point scales instead of the simple 3-point scale in the illustrative questionnaire. This modification will offer more scope for the application of statistical techniques such as principal component analysis. Whether or not this modification is made, careful adaptation of the individual questions, and their phrasing, is essential. Section 10: Sexuality, gender and norms Young people have various views about relationships. I will read you out some views. For each one, please tell me whether you agree or disagree?10.1 I believe it's all right for unmarried boys and girls to have dates (USE LOCAL TERM)Agree 1 Dont know/not sure 2 Disagree 310.2 I believe it's all right for boys and girls to kiss, hug and touch each other.Agree 1 Dont know/not sure 2 Disagree 310.3 I believe there is nothing wrong with unmarried boys and girls having sexual intercourse if they love each other.Agree 1 Dont know/not sure 2 Disagree 310.4 I think that sometimes a boy has to force a girl to have sex if he loves her.Agree 1 Dont know/not sure 2 Disagree 310.5 A boy will not respect a girl who agrees to have sex with him.Agree 1 Dont know/not sure 2 Disagree 310.6 Most girls who have sex before marriage regret it afterwards.Agree 1 Dont know/not sure 2 Disagree 310.7 Most boys who have sex before marriage regret it afterwards. Agree 1 Dont know/not sure 2 Disagree 310.8 A boy and a girl should have sex before they become engaged (USE LOCAL TERM) to see whether they are suited to each other.Agree 1 Dont know/not sure 2 Disagree 310.9 I believe that girls should remain virgins until they marry.Agree 1 Dont know/not sure 2 Disagree 310.10 I believe that boys should remain virgins until they marry.Agree 1 Dont know/not sure 2 Disagree 310.11 It is sometimes justifiable for a boy to hit his girlfriend.Agree 1 Dont know/not sure 2 Disagree 3 10.12 Most of my friends think that one-night stands are OK.Agree 1 Dont know/not sure 2 Disagree 310.13 It's all right for boys and girls to have sex with each other provided that they use methods to stop pregnancy.Agree 1 Dont know/not sure 2 Disagree 310.14 Moat of my friends who have sex with someone use condoms regularly.Agree 1 Dont know/not sure 2 Disagree 310.15 I am confident that I can insist on condom use every time I have sex.Agree 1 Dont know/not sure 2 Disagree 310.16 I would never contemplate having an abortion my self or for my partner.Agree 1 Dont know/not sure 2 Disagree 310.17 It is mainly the woman's responsibility to ensure that contraception is used regularly.Agree 1 Dont know/not sure 2 Disagree 310.18 I think that you should be in love with someone before having sex with them.Agree 1 Dont know/not sure 2 Disagree 310.19 I feel that I know how to use a condom properly.Agree 1 Dont know/not sure 2 Disagree 310.20 Most of my friends would never contemplate having an abortion for themselves or their partner.Agree 1 Dont know/not sure 2 Disagree 310.21 Men need sex more frequently than do womenAgree 1 Dont know/not sure 2 Disagree 310.22 Most of my friends believe that you should be in love before you have sex with someone.Agree 1 Dont know/not sure 2 Disagree 310.23 I would refuse to have sex with someone who is not prepared to use a condom.Agree 1 Dont know/not sure 2 Disagree 3 10.24 One night stands are OKAgree 1 Dont know/not sure 2 Disagree 310.25 How many of your friends have had sexual intercourse? Would you say many, some, a few, or none?Many 1 Some 2 A few 3 None 4 Not sure 8 Section 11: Use and perceptions of health services This section on use of health facilities will require thorough review and adaptation to the local service environment. In settings where special services exist for young people (e.g. drop-in clinics, school clinics), additional questions will be needed to measure use of such services. Section 11: Use and perceptions of health services Have you ever visited a health facility or doctor of any kind to receive services or information on contraception, pregnancy, abortion or sexually transmitted dieases?Yes 1 No 2 ENDHow many times have you sought services or information from a doctor or a nurse for these services in the last twelve months?Number of times Did not seek care in last 12 months 0 ENDThinking about your last visit, did you go to a government clinic, health centre or hospital or a private doctor or clinic?Government 1 Private 2 Other. 3When you last saw a doctor or a nurse, what was your reason for going?Contraception 1 STD 2 Gynaecological exam 3 Pregnancy test 4 Pregnancy termination 5 MCH 6 Other 7At this facility Did you see any posters on contraception?YES 1NO 2Were you given brochures on contraception?12Did you attend a talk on contraception?12Did you request contraceptive services during the consultation?12Did the doctor or nurse talk to you about: Contraception? Sexually transmitted diseases? 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