Can We Talk? Adolescent Perception of Privacy and Self-Reported Sexual Risk Behavior in the Phone-Based California Health Interview Survey

Background:  Population-based behavioral surveys of adolescent sexual risk behavior enable assessment of sexual activity, safe sex practices, and susceptibility to sexually transmitted diseases.  The validity of adolescent self-reported sensitive behaviors may be compromised if parents listen during the interview. We compared the prevalence of self-reported sexual risk behaviors and less sensitive behaviors among adolescent behavioral survey respondents whose parents may or may not have been perceived as listening during phone-based behavioral surveys.

Methods:  We analyzed the 2009 California Health Interview random-digit dialed household-based phone survey of adolescents aged 12-17 whose parents granted permission for interview.  Questions included whether the adolescent ever had sex (oral and vaginal/penile) and whether a parent was listening on the phone or in the room during interview.  The proportion of respondents answering affirmatively to sexual risk behavior, ever smoking, and recent park use questions was compared by whether adolescents perceived parents listening to the interview, and stratified by gender, age (12-14, 15-17 years), and race.  All proportions were weighted to 2009 California Department of Finance population projections.

Results:  Among 3379 adolescent respondents surveyed, 10% reported parents listening during the interview (males 11% versus females 9%).  A higher proportion of younger adolescents (15%) reported parents listening compared with older adolescents (6%).  Adolescents whose parents listened reported sexual activity less frequently than those whose parents did not listen: oral sex: males 11% versus 17%, females 3% versus 13%; vaginal/penile sex: males 8% versus 16%, females 4% versus 12%.  Lower proportions of adolescents reported ever smoking when parents listened (5 %) versus when parents did not listen (15%).  There was no difference in reporting recent use of parks by parent listening.

Conclusions:  Perceived parental eavesdropping regarding sexual risk behavior disclosure dramatically impacts the reporting of sensitive behaviors and may lead to inaccurate assessment of risk behaviors requiring intervention.