Methods to increase reporting of childhood sexual abuse in surveys: the sensitivity and specificity of face-to-face interviews versus a sealed envelope method in Ugandan primary school children

BMC International Health and Human Rights

Research Article

Karen M. Devries¹  Louise Knight¹  Anna Louise Barr²  Elizabeth Allen³  Dipak Naker⁴  Ivan Franҫa-Junior⁵ 

[1] Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK;Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK;Department of Medicine, University of Cambridge, Cambridge, UK;Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;Raising Voices, P.O. Box 6770, 16 Tufnell Drive, Kamwokya, Kampala, Uganda;School of Public Health, University of São Paulo, State of São Paulo, Brazil;

关键词: Child sexual abuse;    Violence;    Methodology;    Reporting;    Disclosure;    Uganda;    Face-to-face interviews;    Africa;    Sexual violence;    Confidential methods;   

DOI  :  10.1186/s12914-016-0110-2

 received in 2016-05-26, accepted in 2016-12-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUnderreporting of childhood sexual abuse is a major barrier to obtaining reliable prevalence estimates. We tested the sensitivity and specificity of the face-to-face-interview (FTFI) method by comparing the number of disclosures of forced sex against a more confidential mode of data collection, the sealed-envelope method (SEM). We also report on characteristics of individuals associated with non-disclosure in FTFIs.MethodsSecondary analysis of data from a cross-sectional survey conducted in 2014, with n = 3843 children attending primary school in Luwero District, Uganda. Sensitivity and specificity were calculated, and mixed effects logistic regression models tested factors associated with disclosure in one or both modes.ResultsIn the FTFI, 1.1% (n = 42) of children reported ever experiencing forced sex, compared to 7.0% (n = 268) in the SEM. The FTFI method demonstrated low sensitivity (13.1%, 95%CI 9.3–17.7%) and high specificity (99.8%, 95%CI 99.6–99.9%) in detecting cases of forced sex, when compared to the SEM. Boys were less likely than girls to disclose in the FTFI, however there was no difference in prevalence by sex using the SEM (aOR = 0.91, 95%CI 0.7–1.2; P = 0.532). Disclosing experience of other forms of sexual violence was associated with experience of forced sex for both modes of disclosure.ConclusionsThe SEM method was superior to FTFIs in identifying cases of forced sex amongst primary school children, particularly for boys. Reporting of other forms of sexual violence in FTFIs may indicate experience of forced sex. Future survey research, and efforts to estimate prevalence of sexual violence, should make use of more confidential disclosure methods to detect childhood sexual abuse.

【 授权许可】

CC BY   
© The Author(s). 2017