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    Illustrative Questionnaire for interview-Surveys with Young People

     Introduction:

    This instrument is intended to be no more than a point of departure for investigators wishing

    to study the reproductive and sexual 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.

     Purposes

    The instrument is designed to document knowledge, beliefs, behaviour and outcomes in the

    domain of reproductive and sexual 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.

    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

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    • Sexual ideologyattitudes to gender 

    • !rotective, or risk, behaviour 

    • "ondoms #knowledge, attitudes, use$

    • "haracteristics of current #most recent$ boygirl friend

    • Sexual and reproductive health services #knowledge, use, evaluation$

    • Sexual and reproductive health outcomes

    • %ackground characteristics

    & detailed list of variables is shown below.

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    LIST OF VARIAL!S

    1. Sources of Information on Reproductive Health

     Source

    I"portant sour#es 'ost important source about puberty (.)

    Second most important source about puberty (.)

    'ost important source about reproductive systems (.*

    Second most important source about reproductive systems (.*

    'ost important source about relationships (.+

    Second most important source about relationships (.+

    Preferre$ sour#es !referred source about puberty (.(

    !referred source about reproductive systems (.

    !referred source about relationships (.-

    Parents requency of discussing sex with father ).(/

    requency of discussing sex with mother ).*)

    S#hool 0xposure to sex1education in school (./

    2pinion on amount of sex1education in school (.3

    %ealth fa#ilities&staff  Saw posters on contraception at last visit to health facility )).+

    4eceived brochures on contraception at last visit to health facility )).-

    &ttended talk on contraception at last visit to health facility ))./

    5octornurse talked about contraception at last visit to health facility )).6

    5octornurse talked about STIs at last visit to health facility )).6

    5octornurse talked about pregnancy at last visit to health facility )).6

    2. Sexual Reproductive Health Knowlede

     Source

    Repro$u#tive physiology %elief that a woman can get pregnant at first intercourse (.)7

    %elief that a woman stops growing after first intercourse (.))

    %elief that masturbation is a serious health threat (.)(

    %elief that pregnancy is most likely to occur in mid1cycle (.)*

    'ontra#eption Spontaneousprompted awareness of pill and supply source /.(

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    !. Sexual "onduct 

     Source

    )eneral %eterose*ual 0ver experienced sexual intercourse .)(, .)*

    &ge at first intercourse +.( 24 *.(+=ife1time number of sexual partners .)

     >umber of coercive sex partners .), .(

     >umber of casual sex partners .-, ./

     >umber of commercial sex partners .6, .)7

    4ecency of last intercourse .)+

    Sexual intercourse with current boygirl friend *.(7

    'hara#teristi#s of First

    Se* partner&Partnership  >ature of relationship

    I %2?@I4= 4I0>5A

    +.

    &ge of partner +.+ or *.

    'arital status of partner +.- or *.+

    Schoolemployment status of partner +./ or *.-

    Bhen relationship started +.3 or *./

    5uration of relationship +.6+.)7 or *.3*.6

    Bhether relationship has ended +.6 or *.3

    Bho ended the relationship +.)) or *.)7Bhether there were concurrent relationships +.)( or *.))

    4espondent

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    #. Sexual Ideoloy$%ender 

    To be added

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    &. Protective 'ehaviour 

     Source

    'ontra#eption with

    $ifferent types of

    partner 4egularity of contraception with coercive sex partners .*

    4egularity of contraception with casual sex partners .3

    4egularity of contraception with commercial sex partners .))

    'urrent&"ost re#ent

    #ontra#eptive status'ethod of contraception used at most recent act .)-, .)/

    'ontra#eption with first

    se* partner

    'ethod used at first sexual act +.)3+.)6 or  *.(/1*.(3

    4egularity of contraceptive use with first sexual partner +.(( or *.*)

    8sual method used +.(* or *.*(

    'ontra#eption with

    #urrent +oy&girl frien$

    'ethod used at first sexual act with current boygirl friend *.(/*.(3

    4egularity of contraceptive use with current boygirl friend *.*)*.*(

    !ver use of spe#ifi#

    #ontra#eptive "etho$s

    'ethods ever1used /.))

    Prote#tion against

    %IV&ST(s with first se*

    partner"oncern about infection +.(3 or *.*/

    !reventive steps taken +.(6*7 or  *.*3*6

    Prote#tion against

    %IV&ST(S with #urrent

    +oy&girl frien$"oncern about infection *.*/

    !reventive steps taken *.*3*6

    ST( Treat"ent Bhether most recent STI was treated 3.))

    Source of treatment 3.)(

    Bhether partner was treated 3.)*

    se of Servi#es  >umber of visit to 4: health facility in last )( months )).), )).(

    Type of facility most recently visited )).*

    4eason for most recent visit )).

    Bhether contraception was requested at most recent visit )).3

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    Reasons for virginity 'ain reason for virginity

    'ain reason for future

    Sexual debut

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    (. "ondoms

     Source

    Awareness& .nowle$ge  Spontaneousprompted awareness of condoms /.

    &wareness of source /.0ver seen a condom 6.+

    &gree that condoms effectively protect against pregnancy 6.-

    &gree that condoms effectively protect against :I9 6.)7

    &gree that condoms effectively protect against STIs 6.)3

    &gree that condoms can disappear inside a woman

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    4espondent

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    -. Sexual and Reproductive Health Services

     Source

    .nowle$ge of servi#es ;nowledge of supply sources for specific contraceptive methods /.(1/.+, "ol. *

    ;nowledge of places of STI treatment 3./

    se of servi#es 0ver used 4: services )).)

     >umber of visits in last )( months )).(

    'hara#teristi#s of "ost

    re#ent visit

    Type of facility )).*

    4eason for visit )).

    0xposure to information about contraception )).+1))./

    Bhether contraceptive services were requested )).3

    Bhether staff spoke about contraception, STIs, pregnancy )).6

    Bhether respondent felt able to ask questions )).)7

    Bhether questions were answered adequately )).))

    Bhether there was sufficient privacy )).)(

    Sour#e of #ontra#eptive

    "etho$s

    Source of method used with first partner +.( or *.**

    Source of method used with current boygirl friend *.**

    Sour#e of STI treat"ent Source of treatment for most recent STI episode 3.)(

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    . Sexual Reproductive Health /utcomes

     Source

    Pregnan#y =ifetime number of pregnancies .)3

    Bhether last pregnancy was wanted .)6Bhether last pregnancy was aborted .(7

    !regnancy by first partner +.(- or *.*+

    2utcome of pregnancy by first partner +.(/ or *.*-

    !regnancy by current boygirl friend *.*+

    2utcome of pregnancy by current boygirl friend *.*+

    STIs =ifetime number of STIs 3.)7

    Bhether treatment was sought for last episode 3.))

    Bhether partner obtained treatment 3.)*

    'oer#iveo""er#ial se* =ifetime number of coercive sex partners .(

    =ifetime number of commercial sex partners .)7

    requency of physical sexual harassment ., .+

    "oercion at first intercourse +.)+ or *.((

    "oercion at first intercourse with current boygirl friend *.((

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    S!'TIO/ 0 SO'IO!'O/O1I' A/( FA1ILY '%ARA'T!RISTI'S

    @2 T2

    020 S!3 OF R!SPO/(!/T 1AL! 0

    F!1AL! 4

    ).( Bhat day, month and year were you bornC 5ay 'onth ?ear

    ).* :ow old were you at your last birthdayC ?ears old

    "42SS1":0"; BIT: 5&T0 2 %I4T: &>5

    40"2>"I=0

    ). "an you read, for example, a newspaperC ?es )

     >o (

    ).+ :ave you ever1attended schoolC ?es )

     >o ( ).)

    ).- Bhat is the highest level of schooling youcompletedC

    #"I4"=0 :I@:0ST S":22= =090=

    !rimary 7)

    Secondary 7(

    Stu$ies without Se#on$ary S#hool5

    Technical 7*

    "ommercial or Secretarial 7

    !reparatory 7+

    Stu$ies with se#on$ary S#hool5

    Technical 7-

    "ommercial or Secretarial 7/

    Teacher Training "ollege #TT"$ 73

    8niversity 76

    TT" with !reparatory )7

    !ostgraduate ))

    )./ Bhat classformgradeyear did you complete at thisschoolDDD..C

    "lassorm etc

    ).3 &re you currently attending regular school, college

    or universityC ull1time or part1timeC

    ?es, full1time )

    ?es, part1time )

     >o ( ).)7

    ).6 :ow many more years of education do you expect ?ears ).))

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    to receiveC

    ).)7 :ow old were you when you left school, college oruniversityC

    &ge

    ).)) Is the school, college or university that youattend#ed$ a government or private institutionC

    @overnment )

    !rivate (

    ).)( Is it run by a particular religion or religious groupC ?es )

     >o (

    ).)* Is the school or university that you attend#ed$ forD40&5 28T

    %oys and girlsC )

    2nly boys #only girls$C (

    ).) >ow I have some questions about work.

    :ave you ever worked for payC

    ?es )

     >o ( ).(7

    ).)+ :ow old were you when you started working for payC

    &ge in years

    ).)- &re you currently working for payC ?es )

     >o ( ).(7

    ).)/ &bout how many hours a week do you workC :ours

    ).)3 Bhat type of work do #did$ you doC !42%0 DDDDDDDDDDDDDDDDDDDD

    DDDDDDDDDDDDDDDDDDDD

    ).)6 :ow much do #did$ you earn in a weekC Beekly wage 0nter 8nitDDD. ).()

    ).(7 &re you looking for workC ?es )

     >o (

    ).() Bhat is your religionC >one 7)

    "atholic 7(

    !rotestant 7*

    'uslim 7

    :indu 7+

    Eudaism 7-

    2therDDDDDDDDDDDDDD..

    DDDDDDDDDDDDDDDDD 7/

      ).(

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    #S!0"I?$

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    ).(( :ow often do you usually attend religious servicesC 0very day )

    &t least once a week (

    &t least once a month *

    &t least one a year

    =ess than once a year +

     >ever -

    ).(* :ow important is religion in your lifeC 9ery important )

    Important (

     >ot important *

    ).( >ow I have some questions about your family. Isyour father aliveC

    ?es )

     >o (  ).(3

    ).(+ 5oes he live in the same household as youC ?es )

     >o (

    ).(- 5o you find it difficult or easy to talk with yourfather about things that are important to youC

    9ery easy )

    0asy (

    &verage *

    5ifficult

    9ery difficult +

    5o not see him -   ).*3

    ).(/ :ave you ever discussed sex1related matters withyour fatherC If ?0S 2ften or occasionallyC

    2ften )

    2ccasionally (

     >ever *

    ).(3 Is your mother aliveC ?es )

     >o ( ).*(

    ).(6 5oes she live in the same household as youC ?es )

     >o (

    ).*7 5o you find it difficult or easy to talk with yourmother about things that are important to youC

    9ery easy )

    0asy (

    &verage *

    5ifficult

    9ery difficult +

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    5o not see her -

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    ).*) :ave you ever discussed sex1related matters withyour motherC If ?0S 2ften or occasionallyC

    2ften )

    2ccasionally (

     >ever *

    ).*( 5o you have any older brothersC ?es )

     >o ( ).*

    ).** 5o any live in the same householdC ?es )

     >o (

    ).* 5o you have any older sistersC ?es )

     >o ( ).*-

    ).*+ 5o any live in the householdC ?es )

     >o (

    ).*- &nd now I have some questions about your socialactivities. 5o you ever go to clubs or parties whereyoung people danceC I ?0S. :ow many times in

    the last monthC >umber of times >ever 33

    ).*/ 5o you ever go to the moviesC I ?0S. :ow manytimes in the last monthC

     >umber of times >ever 33

    ).*3 5o you ever drink alcoholC I ?0S. 2n how manydays in the last month have you drunk alcoholC

     >umber of days >ever 33

    ).*6 5o you ever smoke cigarettesC I ?0S. :ow manyhave you smoked in the last / daysC

     >umber of >ever 33"igarettes

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    S!'TIO/ 4 SOR'!S OF I/FOR1ATIO/ O/6 A/( ./O7L!()! OF R!PRO('TIV!

    %!ALT%

    (.) ?oung people learn about pu+erty 1 I mean theways in which boys< and girls< bodies change duringthe teenage years 1 from many sources. They maylearn from teachers at school, parents, brothers andsisters, from friends, from doctors or they may learn

    from books, films and magaFines. Bhat has beenthe most important source of information for you onthis topicC &nd the second most importantC"I4"=0 '2ST I'!24T&>T I> "2= ) &>5S0"2>5 '2ST I'!24T&>T I> "2= (

    (.( rom whom, or where, would you prefer to receivedmore information on this topicC

    "I4"=0 2>0 &>SB04 I> "2=. *

    School

    'other 

    ather

    %rother 

    Sister 

    2ther family

    members

    riends

    5octors

    %ooksmagaFines

    ilms

    2ther#SpecifyDDDDDDDDDDD$

    #)$

    'ostImportant

    7)

    7(

    7*

    7

    7+

    7-

    7/

    73

    76

    )7

    ))

    DDD...DDDD

    D..

    #($

     Second mostimportant

    7)

    7(

    7*

    7

    7+

    7-

    7/

    73

    76

    )7

    ))

    DDD...DDDDD..

    #*$

    !referred

    7)

    7(

    7*

    7

    7+

    7-

    7/

    73

    76

    )7

    ))

    DDD...

    DDDDD..

    (.* >ow I want to ask you a similar question aboutsources of information on the se*ual an$

    repro$u#tive syste"s of "en an$ wo"en 1 I mean

    where eggs and sperm are made and how pregnancyoccurs. Bhat has been the most important source of information on this topicC &nd the second mostimportantC "I4"=0 I> "2=S. ) &>5 (.

    (. rom whom or where, would you prefer to receive

    more information on this topicC

    "I4"=0 2>0 &>SB04 I> "2=. *

    School

    'other 

    ather

    %rother 

    Sister 

    2ther family

    members

    riends

    5octors

    %ooksmagaFines

    ilms

    2ther

    #SpecifyDDDDDDDDDDD$

    #)$

    'ostImportant

    7)

    7(

    7*

    7

    7+

    7-

    7/

    73

    76

    )7

    ))

    DDD...DDDD

    D..

    #($

     Second mostimportant

    7)

    7(

    7*

    7

    7+

    7-

    7/

    73

    76

    )7

    ))

    DDD...DDDDD..

    #*$

    !referred

    7)

    7(

    7*

    7

    7+

    7-

    7/

    73

    76

    )7

    ))

    DDD...DDDDD

    ..

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    *.)( &t that time how would you describe yourrelationship with >&'0C Bas #is$ it #a$ a casualfriendshipH #b$ a serious relationship but with nointention of marriageH or #c$ an importantrelationship that might lead to marriageC

    #a$ "asual )

    #b$ Serious (

    #c$ Importantmight lead to marriage *

    #d$ 0ngaged to be married *.)

    *.)* &nd how do you think >&'0 would describe

    her his relationship to youC #a$ as a casualfriendshipH #b$ a serious relationship but with nointention of marriageH #c$ an important relationshipthat might lead to marriageC

    #a$ "asual )

    #b$ Serious (

    #c$ Importantmight lead to marriage *

    *.) 5id you and >&'0 have any physical contact, such

    as holding hads, hugging or kissingC

    ?es )

     >o (

    *.)+ 5id you ever kiss >&'0 on the lipsC ?es )

     >o (

    *.)- 5id you ever touch >&'0o ( *.)3

    *.)/ 5id you ever stroke >&'0o (

    *.)3 5id >&'0 ever touch your penisvagina withher his handC

    ?es )

     >o ( *.7

    *.)6 5id >&'0 ever stroke your penisvagina so thatyou climaxedC

    ?es )

     >o (

    *.(7 '&=0SA 5id you ever put your penis inside >&'0o ( *.7

    *.() '&=0SA 5id you ever reach climax inside >&'0o (

    34S5I/6 !.22 7 !.! 8R4 /69 ;/R 5H/S4 P4RI46"4? P4645R85I=4 S4> 

    *.(( Think back to the first time you had sex with >&'0 1 I mean the first time that the penis was inthe vagina. Bould you say. 40&5 28T

    #a$ I forced >&'0 to have intercourse againstherhis will #a$ I forced )

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    #b$ I persuaded >&'0 to have intercourse

    #c$ >&'0 persuaded me to have intercourse

    #d$ >&'0 forced me to have intercourse

    #e$ Be were both equally willing

    #b$ I persuaded (

    #c$ >&'0 persuaded *

    #d$ >&'0 forced

    #e$ %oth willing +

    *.(* &nd would you say it was planned or unexpectedC !lanned )

    8nexpected (

    *.( Bas this the first time that you had full sexualintercourse in your lifeC

    ?es )

     >o ( *.(-

    *.(+ :ow old were you at that timeC &@0

    *.(- 5id you regret having intercourse with >&'0 onthat first timeC

    ?es )

     >o (

    *.(/ 2n that first time did you or >&'0 do anything toavoid a pregnancyC

    ?es )

     >o ( *.(6

    *.(3 Bhat method did you useC "ondom )

    !ill (

    Injection *

    Bithdrawal

    Safe period +

    2therDDDDDDDDDD.. -

    *.(6 5id you ever dicuss contraception with >&'0C I

    ?0S 5id you discuss contraception before or afteryou first had intercourseC

    %efore first intercourse )

    &fter first intercourse (

     >ever *

    *.*7 :ow many times did you and >&'0 have fullintercourseC #estimate$

     >o.

    2nce only ) *.*+

    *.*) &part from the first time, did you and >&'0 everuse a method to avoid pregnancyC I ?0S &lwaysor sometimesC

    &lways )

    Sometimes (

     >ever * *.*

    *.*( Bhat method did you and >&'0 mostly useC "ondom )

    !ill (

    Injection *

    Bithdrawal

    Safe period +2therDDDDDDDDDDD.. -

      *.*

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    *.** Bhere did you or >&'0 get this methodC#"I4"=0 2>=? 2>0$

    Shop )

    !harmacy (

    @ovt. "linic:ealth "entre:ospital *

    !rivate 5octor>urse"linic

    riend +

    2therDDDDDDDDDDD.. -

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    *.* S00 . *.*) Bhose decision was it to use a methodalwayssometimesneverC Bas it mainly yourdecision, >&'0o ( *.*/

    *.*- Bhat happened to the pregnancyC "urrently pregnant )

    &bortion (

    'iscarriage *

    =ive1birth

    *.*/ Bere you ever concerned that you might catch&I5S or another sexually transmitted disease from >&'0C I ?0S 9ery or somewhatC

    9ery concerned )

    Somewhat concerned (

     >ot concerned * S0"TI2>

    *.*3 Bere you able to do anything to reduce the risk ofinfection

    ?es )

     >o ( S0"TI2>

    *.*6 Bhat did you doC  Probe 8se condoms )

    Take medicines (

    2ther #DDDDDDDDDD..$ *  S0"TI2>

    *.7 409I0B 80STI2>S *.)1*.)6 &>5S8''&4IJ0 50@400 2 !:?SI"&=I>TI'&"?. ?ou had no physical

    contactkissedtouched etc. with >&'0 . Thinkcarefully and tell me which of these statements istrue. 40&5 28T

    #a$ I wanted #more$ physical contact but >&'0refused

    #b$ >&'0 wanted #more$ physical contact but Irefused

    #c$ >either of us wanted more physical contact

    #a$ 4espondent wanted )

    #b$ >&'0 wanted (

    #c$ >either wanted *

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    sometimesCSometimes (

     >ever *

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    409I0B *.(7 &>5 .), .+, .3 &>5 TI"; &!!42!4I&T0 %2L

    .)( 4espondent has not  4espondent has

    reporte$ sexual reported

    Intercourse sexual intercourse

      .)

    .)* I want to make certain that I have the correctinformation. :ave you ever had sexual intercourse

    in your whole lifeC

    ?es )

     >o ( .()

    .) In your whole life how many people have you hadsexual intercourse withC

     >o.

    .)+ :ow long ago did you last have intercourse with awomanmanC

    I =0SS T:&> 2>0 B00;, 0>T04 77 B00;S

    Beeks ago

    2r 

    'onths ago

    .)- 2n that last occasion did you or your partner doanything to avoid pregnancyC

    ?es )

     >o ( .)3

    .)/ Bhat method was usedC "ondom )

    !ill (

    Injection *

    Bithdrawal

    Safer !eriod +

    2ther DDDDD.DDDDDDD. -

    .)3 '&=0SA :ave you ever made a girl or woman pregnantC I ?0S :ow many timesC

    0'&=0SA :ave you ever been pregnantC I ?0S:ow many timesC

     >o.

     >ever 7

     >ot Sure 6

     Section +

    .)6 Thinking of the most recent pregnancy, did youwant the pregnancy at that time or not want itC

    Bant ) >ot want (

    .(7 Bhat happened to the #last$ pregnancyC "urrently pregnant )

    &bortion (

    'iscarriage *

    =ive1birth

     >ot sure +

    Section +

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    S!'TIO/ : FIRST S!3AL R!LATIO/S%IP

    +.) S00 *.( &== 2T:04S "8440>T #'2ST 40"0>T$@I4=%2? 4I0>5 B&SI4ST S0L8&= !&4T>04 

      S0"TI2> -

    +.( >ow I have some question about the first time thatyou had sexual intercourse. :ow old were you atthat timeC

    &@0

    +.* Bhat is herhis first nameC >ameAGGGGGGGGGGGGGGGGGGGGGGGGG  

    5.;DDDDDDDDDDDDD 6

     In the followin AuestionsB use Cthat personC instead of 

     68D4 if name of first partner is not nown

    +. :ow would describe your relationship to >&'0

    #that person$C !42%0%oygirl friend )

    Strangerrelativeother personwho forced me (

    2ne night stand *

    "ommercial sex partner

      +.)-

     

    +.)+

    +.+ :ow old is >&'0C Probe for current age &ge

    +.- Bhen you started your relationship, was >&'0single, married, divorced or separatedC Single )'arried (

    5ivorce *

    Separated

    +./ Bhen you started you relationship with >&'0 was >&'0 a full time student, working or neitherC

    ull time student )

    Borking (

     >either *

    +.3 :ow many months or years ago did you first &'0C

    'onths or ?ears

    ago ago

    +.6 :as the relationship endedC ?es )

     >o ( +.)(

    +.)7 :ow many daysweeksmonths did it lastC I meanfrom the first time you

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    +.)) Bho decided to end the relationshipC ?ou, >&'0or both of you.

    'e )

     >&'0 (

    %oth *

    2ther

    +.)( 5uring the time you were &'0 did youo (

    +.)* &t that time how would you describe yourrelationship with >&'0C Bas #is$ it #a$ a casualfriendshipH #b$ a serious relationship but with nointention of marriageH or #c$ an important

    relationship that might lead to marriageC

    #a$ "asual )

    #b$ Serious (

    #c$ Importantmight lead to marriage *

    #d$ 0ngaged to be married

     

    +.(-

    +.) &nd how do you think >&'0 would describe her

    #his$ relationship to youC #a$ as a casual friendshipH#b$ a serious relationship but with no intention ofmarriageH #c$ an important relationship that mightlead to marriageC

    #a$ "asual )

    #b$ Serious (

    #c$ Importantmight lead to marriage *

    +.)+ Think back to the first time you had sex with >&'0 1 I mean the first time that the penis was inthe vagina. Bould you say.

    #a$ I forced >&'0 to have intercourse againstherhis will

    #b$ I persuaded >&'0 to have intercourse

    #c$ >&'0 persuaded me to have intercourse

    #d$ >&'0 forced me to have intercourse

    #e$ Be were both equally willing

    #a$ I forced )

    #b$ I persuaded (

    #c$ >&'0 persuaded *

    #d$ >&'0 forced

    #e$ %oth willing +

    +.)- &nd would you say it was planned or unexpectedC !lanned )

    8nexpected (

    +.)/ 5id you regret having intercourse with >&'0 onthat first timeC

    ?es )

     >o (

    +.)3 2n that first time did you or >&'0 do anything to

    avoid a pregnancyC

    ?es )

     >o ( +.(7

    +.)6 Bhat method did you useC "ondom )

    !ill (

    Injection *

    Bithdrawal

    Safe period +

    2therDDDDDDDDDD.. -

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    +.(7 5id you ever dicuss contraception with >&'0C I?0S 5id you discuss contraception before or afteryou first had intercourseC

    %efore first intercourse )

    &fter first intercourse (

     >ever *

    +.() :ow many times did you and >&'0 have fullintercourseC #estimate$

     >o.

    2nce only ) +.(-

    +.(( &part from the first time, did you and >&'0 everuse a method to avoid pregnancyC I ?0S &lways

    or sometimesC

    &lways )

    Sometimes (

     >ever * +.(+

    +.(* Bhat method did you and >&'0 mostly useC "ondom )

    !ill (

    Injection *

    Bithdrawal

    Safe period +

    2therDDDDDDDDDDD.. -

    +.( Bhere did you or >&'0 get this methodC#"I4"=0 2>=? 2>0$

    Shop )

    !harmacy (

    "linic:ealth "entre:ospital *

    !rivate 5octor>urse"linic

    riend +

    2therDDDDDDDDDDD.. -

    #Specify$

    +.(+ S00 . +.(( Bhose decision was it to use a methodalwayssometimesneverC Bas it mainly youdecision, >&'0o ( +.(3

    +.(/ Bhat happened to the pregnancyC "urrently pregnant )

    &bortion (

    'iscarriage *

    =ive1birth

    +.(3 Bere you ever concerned that you might catch&I5S or another sexually transmitted disease from

    9ery concerned )

    Somewhat concerned (

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     >&'0C I ?0S 9ery or somewhatC >ot concerned * S0"TI2> -

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    +.(6 Bere you able to do anything to reduce the risk ofinfectionC

    ?es )

     >o (

    +.*7 Bhat did you doC  Probe 8se condoms )

    Take medicines (

    2ther #DDDDDDDDDD..$ *

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    S!'TIO/ ; %O1OS!3AL !3P!RI!/'!S

    -.) Some young people are sexually attracted to peopleof the same sex. :ave you ever been sexuallyattracted to a boygirlC

    ?es )

     >o (

    -.( :ave you ever had any sexual contact, such ashugging or touching, with a boygirlC

    ?es )

     >o ( -.)7

    -.* :as a boy girl ever stroked your penisvagina sothat you climaxedC

    ?es )

     >o (

    -. :ave you ever stroked a boygirl in this wayC ?es )

     >o (

    -.+ 40S!2>50>T IS '&=0 40S!2>50>T IS 0'&=0 -.)7

    -.- :as a boy or man ever had sexual intercourse withyouC I mean inserted his penis into youC

    ?es )

     >o ( -.3

    -./ :ow many boys or men have ever had sexual

    intercourse with youC

     >o.

    -.3 :ave you ever had sexual intercourse with a boy ormanC I mean inserted your penis into a boy or manC

    ?es )

     >o ( -.)7

    -.6 :ow many boys or men have you had sexual

    intercourse withC

     >o.

    -.)7 Bould you say that you are mostly attracted to people of the opposite sex, more attracted to peopleof the same sex, or attracted to both sexes equallyC

    2pposite sex )

    Same sex (

    %oth equally *

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    S!'TIO/ < ./O7L!()! A/( !V!R-S! OF 'O/TRA'!PTIV! 1!T%O(S

    /.) I now have some questions about contraception 1 I mean ways in which men and women can avoidgetting pregnant. Bhich methods have you heard ofC Bhat othersC

    "I4"=0 "250 ) I> "2=. ( 24 0&": '0T:25 '0>TI2>05.

    24 0&": '0T:25 I> T:0 T&%=0 >2T &=40&5? '0>TI2>05, 40&5 T:0 50S"4I!TI2>I> "2=.) &>5 40"245 &>SB04 I> "2=.(

    24 0&": '0T:25 ;>2B> &S; 80STI2> I> "2=.*

    'OL 02 'OL2 42 'OL2 82

    /.( !ill

    Bomen can take a pill every day

    ;nowledge of 'ethod

    ?es #spont.$ )

    ?es #prompted$ (

     >o *

    ;nowledge of Source

    K5o you know any place or

     person where young people couldobtain this methodC

    ?es )

     >o (

    /.* Injection

    Bomen can have any injectionevery ( or every * months

    ?es #spont.$ )

    ?es #prompted$ (

     >o *

    K5o you know any place or person where young people could

    obtain this methodC

    ?es )

     >o (

    /. "ondom

    & man can put a rubber deviceon his penis before intercourse

    ?es #spont.$ )

    ?es #prompted$ (

     >o *

    K5o you know any place or person where young people could

    obtain this methodC

    ?es )

     >o (

    /.+ 0mergency "ontraceptive !ills

    & woman can take pills soon

    after intercourse

    ?es #spont.$ )

    ?es #prompted$ (

     >o *

    K5o you know any place or

     person where young people couldobtain this methodC

    ?es )

     >o (

    /.- Bithdrawal

    & man can pull out of a woman before climax

    ?es #spont.$ )

    ?es #prompted$ (

     >o *

    /./ !eriodic &bstinence4hythm

    & couple can avoid sex on days

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    when pregnancy is most likely tooccurr.

    ?es #spont.$ )

    ?es #prompted$ (

     >o *

    /.3 There are other methods of contraception that I havenot mentioned. Bhat other methods have you heardofC "I4"=0 0&": '0T:25 '0>TI2>05.

    I85 )Implant (

    Eellyfoam *

    emale SteriliFation

    'ale SteriliFation +

    2ther #S!0"I?$DDDDDD.. -

    /.6 Bhich method do you think is most suitable for

    young peopleC

    "I4"=0 2>0 &>SB04 

    !ill )

    injection (

    "ondom *0merg. !ills

    Bithdrawal +

    !eriodic. &b. -

    2ther DDDDDDDDDDD.. /

    5.;. 3

    /.)7 S00 .)( and .)* 2> !&@0 )(

    4espondent has 4espondent has not

    experienced sexual experienced sexualintercourse intercourse

      S0"TI2> -

    /.)) Bhich methods of contraception have you or a

    sexual partner ever usedC

    !42%0 which othersC

    "I4"=0 &== T:&T &!!=?

    !ill )

    injection (

    "ondom *

    0merg. !ills

    Bithdrawal +

    !eriodic. &b. -

    2ther DDDDDDDDDDD.. /

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    S!'TIO/ =

    ./O7L!()! OF %IV&AI(S A/( S!3ALLY TRA/S1ITT!( (IS!AS!S

    3.) :ave you heard of :I9 or &I5S #use local terms$C ?es )

     >o ( 3.+

    3.( I am now going to read you some statements about:I9&I5S. !lease tell me whether you think thestatement is true, or false, or whether you donTI2>05

    Shop )

    !harmacy (

    @ovt. hospitalhealth centreclinic *

    !rivate doctornurseclinic

    2ther #S!0"I?$DDDDDDDD +

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    3.6 S00 .)( and .)* 2> !&@0 )(

    4espondent has experiencedSexual intercourse

    4espondent has not experiencedSexual intercourse S0"TI2> 6

    3.)7 :ave you ever had a sexually transmitted diseaseC

    I ?0S 2nce or more than onceC

    2nce )

    'ore than once (

     >ever * S0"TI2> 6

    3.)) #2n the last occasion$ did you seek treatmentC ?es )

     >o ( 3.)*

    3.)( Bhere did you seek treatmentC Shop )

    !harmacy (

    @ovt. hospitalhealth centreclinic *

    !rivate doctornurseclinic

    2ther DDDDDDDDDDDD +

    3.)* 5id your sexual partner #any of your partners$ alsoobtain treatmentC

    ?es )

     >o (

    5on

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    S!'TIO/ >

    'O/(O1 ./O7L!()! A/( ATTIT(!S

    6.) S00 ./. 2> !&@0 )3

    "2>52'S ;>2B> "2>52'S >2T ;>2B> S0"TI2> )7

    6.( S00 .)( &>5 .)* 2> !&@0 )(

    4espondent has experiencedsexual intercourse

    4espondent has not0xperienced sexual

    Intercourse  6.+

    6.* :ave you or a partner ever used a condomC ?es )

     >o (   6.-

    6. :ave you ever experienced a condom that split or broke during intercourseC ?es ) >o (   6.-

    6.+ :ave you ever seen a condomC ?es )

     >o (

    6.- !eople have different opinions about condoms. Iwill read out some opinions. or each one, I wantyou to tell me whether you agree or disagree, or

    whether you don

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    would mean that she didn

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    S!'TIO/ 0?

    S!3ALITY6 )!/(!R A/( /OR1S

    ?oung people have various views about relationships. Iwill read you out some views. or each one, please tell

    me whether you agree or disagreeC

    )7.) I believe itMs all right for unmarried boys and girlsto have dates #8S0=2"&= T04'$

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.( I believe itMs all right for boys and girls to kiss, hugand touch each other.

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.* I believe there is nothing wrong with unmarried boys and girls having sexual intercourse if theylove each other.

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7. I think that sometimes a boy has to force a girl to

    have sex if he loves her.

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.+ & boy will not respect a girl who agrees to havesex with him

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.- 'ost girls who have sex before marriage regret itafterwards

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7./ 'ost boys who have sex before marriage regret it

    afterwards

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.3 & boy and a girl should have sex before they become engaged #8S0 =2"&= T04'$ to seewhether they are suited to each other 

    &gree5onMt knownot sure

    5isagree

    )(

    *

    )7.6 I believe that girls should remain virgins untilthey marry

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.)7 I believe that boys should remain virgins untilthey marry

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

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    )7.)) It is sometimes justifiable for a boy to hit hisgirlfriend.

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.)( 'ost of my friends think that one1night stands are2; 

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.)* ItMs all right for boys and girls to have sex witheach other provided that they use methods to stop pregnancy.

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.) 'ost of my friends who have sex with someoneuse condoms regularly

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.)+ I am confident that I can insist on condom useevery time I have sex

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.)- I would never contemplate having an abortion

    myself or for my partner 

    &gree

    5onMt knownot sure

    5isagree

    )

    (

    *

    )7.)/ It is mainly the woman

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    S!'TIO/ 00

    S! A/( P!R'!PTIO/S OF %!ALT% S!RVI'!S

    )).) :ave you ever visited a health facility or doctor ofany kind to receive services or information on

    contraception, pregnancy, abortion or sexuallytransmitted dieasesC

    ?es )

     >o ( 0>5

    )).( :ow many times have you sought services orinformation from a doctor or a nurse for these

    services in the last twelve months

     >umber of times

    5id not seek care in last )( months 7 0>5

    )).* Thinking about your last visit, did you go to agovernment clinic, health centre or hospital or a private doctor or clinicC

    @overnment )

    !rivate (

    2therDDDDDDDDDDDDD. *

    )). Bhen you last saw a doctor or a nurse, what wasyour reason for goingC

    "ontraception )

    ST5 (

    @ynaecological exam *

    !regnancy test

    !regnancy termination +

    '": -

    2therDDDDDDDDDDDD /

    )).+ &t this facility

    5id you see any posters on contraceptionC

    ?0S

    )

     >2

    (

    )).- Bere you given brochures on contraceptionC ) (

    ))./ 5id you attend a talk on contraceptionC ) (

    )).3 5id you request contraception services during theconsultationC

    ) (

    )).6 5id the doctor or nurse talk to you aboutA

    #a$ "ontraceptionC

    #b$ Sexually transmitted diseasesC

    #c$ !regnancyC

    ?0S

    )

    )

    )

     >2

    (

    (

    (

    )).)7 5id you feel comfortable enough to ask questionsC ) ( )).(

    )).)) Bere the questions you asked during theconsultation answered adequatelyC

    ) (

    )).)( Bas there enough confidentialityC ) (

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