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The Bare All Survey 2006 – big doesn’t mean best

August 14th, 2006

Dr Petra

Today you can expect the media to get very excited about the ‘biggest ever survey of young people on sex’. Predictably, coverage so far has manipulated the findings to promote ‘shock’ headlines. The ‘bare all’ survey was run online for two months between May and July this year and resulted in 26,623 responses (in the press this has been reported as 30,000).

Unfortunately the survey is no longer live so it’s not possible to access it. However it does appear there were some limitations to the study that didn’t prevent a person posting more than once (meaning we don’t know if the 2600+ respondents are all unique participants or someone answering several times). There was also no check on the age of participants – so respondents were asked to say they were over 16 but no checks of true age were made.

65% of respondents were aged between 16-24, the rest were older meaning 35% of the respondents didn’t belong in a ‘youth’ survey and affect the data accordingly. A youth radio station and a satellite music channel promoted the survey, with sponsorship from a condom manufacturer. The aim of the research wasn’t really to identify youth attitudes and behaviour, but was a PR vehicle to promote various partners, their programmes and their sexual health campaign. One has to question whether a campaign is successful if the results of research are used in press coverage that misrepresents flawed data and criticises young people.

The survey was designed by a number of journalists who, with respect, have no experience of writing or running a sex survey. No existing data on sexual activity and attitudes of teens was consulted in the design or reporting of this research (although there is plenty of quality information already available). Nor did the campaign set up by the media outlets fit with any existing campaigns or current evidence or approaches.

Which is why we have to be very careful about how we interpret these findings. Whilst a response rate of 26,000+ participants is very high, there’s no point in promoting a ‘biggest ever survey’ if the survey itself isn’t robust and the data generated are neither analysed nor particularly meaningful.

The survey focuses on a number of key areas in sexual experience and behaviour:
* Age at first intercourse
* Sexual orientation
* Number of sexual partners
* Contraception choices
* One night stands
* Condom use
* Discussing contraception with a partner
* Where do you get advice/information about sex
* Usefulness of sex education
* Pressure to have sex
* Alcohol or drug use before first time sex
* Knowledge of pregnancy and STIs
* Sex worries

What we already know
Whilst these are important issues, as mentioned there is a large body of evidence that already tells us that most people lose their virginity around 16, most teens haven’t had that many sexual partners (although across lifespan sexual partner numbers increase), most women still opt for the pill and condom use is often low (particularly when alcohol or drugs are involved). Most people use mates or the media for sex information but would like more sex education at school, and girls often feel pressured into early sexual experience. Young people do worry about sex and are often aware of STIs and pregnancy but lack the life skills to ensure they can avoid them.

Some of these findings were borne out in the ‘bare all’ survey, but in many cases it deviated from existing evidence – not because it was a particularly groundbreaking study – but because leading or confusing questions led to unreliable responses.

Where does the ‘bare all’ study fall down?


Number of sexual partners

If you ask participants ‘how many sexual partners have you had?’ (as this survey did) with no time limits it’s unclear how participants should answer – it would be better to ask them to specify how many partners they have ever had, or have had in previous month or year. It’s also worth being aware that males will always overestimate sexual activity and females downplay it – particularly when teens are being studied. None of these factors were addressed in the current study.

Defining sex

‘Sex’ is a difficult term within this survey since whilst we may assume we all know what it means, for these participants it could mean masturbation, petting or penetrative activities. It isn’t made clear within the survey what they mean by ‘sex’ (although we’re left assuming it’s intercourse) and also unclear what the participants definition of ‘sex’ was, which again makes interpretation unreliable.

Condom use

66% of those aged 16-24 stated they used condoms – higher than for those who used the pill or other methods. Additional data suggested girls preferred both pill and condom, whilst males favoured condoms. All dubious finding since the rates of STIs (particularly chlamydia) are at their highest in this age group. Most likely is this research captured what participants thought they wanted researchers to hear – rather than what they actually do during sex.

More leading questions came with ‘do you always use a condom with a new partner?’ where 59% said they did. Participants here will know it doesn’t make them look good to say they don’t use condoms. Yet this question doesn’t fully explore an issue – whilst people might use a condom the first time they have sex with someone, if they form a relationship with someone condom use may stop – but the risk of STIs remains. This survey didn’t tackle this issue. The use of the word ‘always’ is also confusing since many people may think because they usually use a condom that counts as ‘always’ – there’s no way of really knowing what people do in terms of condom use with the way this question is phrased.

One night stands

Participants were also asked ‘have you ever had a one night stand?’ (with 63% of people saying they’d had at least one, or more). This is another leading question. It doesn’t account for those who deliberately planned for a one night stand, enjoyed it, practiced safer sex and negotiated what was going on with those who didn’t practice safer sex or perhaps didn’t enjoy the experience, or those who thought they were embarking on a relationship that never got off the ground. The phrasing of the question (and answer choices that included ‘no, I would never’) portrayed one night stands as automatically bad – and yet we know for many young people they are common and it is unhelpful to judge such activity.

Sources of sex information

49% participants in this study claimed they got their sex advice from the Internet. Which is hardly a revelation since this was an online study. These figures are very high indicating a group of respondents who’re not representative of the wider population where Internet use for sex information is far lower. This outcome is being flagged up in media coverage with the concern of young people going to the Internet for sex advice (not parents or teachers) as though this is a worrying new trend – rather than just a reflection of those who took part in the survey. The research, because of its simplistic design also doesn’t explore answers so we’re unclear exactly what young people are using for sex ‘information’ on the net.

School sex education

Respondents were asked to comment on the ‘usefulness of sex information learnt at school’ with answer choices including ‘just the basics’, ‘we didn’t have any sex education’, ‘really informative’, ‘I didn’t really understand it’, ‘I didn’t go to school’. This automatically sets up sex education as negative, difficult or non-existent. And predictably the results show people didn’t like or get much sex education – which have been spun into headlines about lack of sex education (and justification for the media campaigns this survey’s promoting).

Coercion

More confusion comes from the question ‘did you feel pressure to have sex for the first time?’ It’s unclear if this question is asking has a person ever felt pressured into having sex, or whether the first time they had sex they felt pressured into it. Which means the answers aren’t reliable since participants won’t have all responded to the question in the same way. Moreover the outcomes claim no gender differences on pressure to have sex, which is unusual given that it’s usually far more likely that girls feel pressured to have sex. You would have thought that such a discrepancy with existing evidence would have been explored (which in a reliable study it would have been).

Getting pregnant (or not)

The most bewildering questions are those that ask about ‘activities that can result in pregnancy’ where participants are asked to choose between ‘sex without a condom’, ‘first time sex’, ‘sex during your period’, ‘sex on the pill’, ‘sex with a condom’, ‘anal sex’. The results have been presented to the media as startling that 43% didn’t know you could get pregnant from sex using a condom and 35% didn’t know you could get pregnant from sex using the pill. However the participants weren’t given the proper question to respond to. If the pill or condom aren’t used correctly then there is a risk of pregnancy and in the latter case STIs also. So were participants in this study answering as though they thought condoms/the pill were being used incorrectly or correctly? Whatever they thought their answers aren’t reliable since either they’re mostly right that if used incorrectly the pill or condom may not work – or they’re worryingly confused that the pill or condom used correctly aren’t a safe method of contraception. Rather than picking up on these outcomes are being promoted to the press as deficits in young people’s knowledge – rather than deficits in survey questioning.

The problem with this study is that it wasn’t designed to truly uncover youth attitudes, behaviours and activities. It was a vehicle to get publicity for a wider campaign that’s been run independently of other existing sexual health programmes.

Unfortunately because it’s being promoted as the ‘biggest ever survey’ journalists aren’t going to question whether the survey itself is any good. Nor will they be aware of wider ethical issues of not using existing evidence and not fitting with existing health campaigns. There is good evidence that the range and variety of sex advice schemes being run within the UK at the moment is causing more problems than offering help as it leads to greater confusion amongst young people – and competition from different groups with diverse sexual health/education agendas.

Another clue about this survey not being as good as it could be is that there’s no purpose or interpretation of the results. They’re simply listed as percentages (with no analysis or cross-comparison). There’s no discussion or application of findings. We’re simply told the results (at the most basic level). A reliable survey would have identified outcomes and points for action.

Sex within this survey isn’t presented as pleasurable, joyous or exploratory. It’s not discussed in terms of choice or negotiation. It’s limited to negative areas of STIs, drugs, alcohol, contraception knowledge (or the lack of), and coercion.

There’s a further problem that the press is selectively reporting poor data. Overall the ‘bare all’ survey didn’t reveal high levels of sexual activity in young people and indicated most were using condoms. Although those outcomes are questionable, the press coverage has instead presented the study as shocking – and the angle that today’s youth are promiscuous, reckless substance abusers who don’t practice safer sex.

The problem of a limited survey is further compounded by inaccurate press coverage.

Many young people and parents may be worried on hearing these findings that imply young people are having sex, not always using condoms, didn’t get sex education and would rather go online than talk to a parent about advice.

Unfortunately we can be sure that this will become one of those surveys that journalists will cite for years to come because it sounds big and impressive, will be easily accessible, and saves the bother of having to work with existing evidence and public health messages.

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