Table 1 Definitions and measures of sexual wellbeing outcome variables
| Variable by domain | Survey question(s) and response options | Measurement in analysis |
|---|---|---|
| Sexual literacy and communication | ||
| Knowledge about pregnancy |
∙ A girl can get pregnant the first time that she has sexual intercourse ∙ A girl can get pregnant after kissing or hugging ∙ A girl can swallow a pill every day to protect against pregnancy ∙ Using a condom can protect against pregnancy ∙ A girl can have a shot or injection that will protect against pregnancy ∙ A girl can use herbs to prevent a pregnancy (yes, no, don’t know) | Continuous, mean score of correct answers (0–6) |
| Knowledge about HIV |
∙ A boy/girl can get HIV the first time that he/she has sexual intercourse ∙ Using a condom can protect against HIV ∙ You can get HIV through kissing ∙ A girl or boy can swallow a pill before having sex that will protect against HIV (yes, no, don’t know) | Continuous, mean score of correct answers (0–4) |
| SRHR knowledge | Combining questions about pregnancy and HIV |
Continuous, mean total score (0–10) Dichotomized into: Low ≤ 50% correct High > 50% correct |
| SRHR communication |
∙ Have you talked with anyone about the body changes that happen as boys and girls grow up? ∙ Have you ever discussed the following topics with anyone? Sexual relationships Pregnancy and how it happens Contraception (yes, no, don’t know) |
Categorical 1 = talked about SRHR (puberty, sexual relationships, pregnancy, contraception) with someone 0 = did not talk 2 = don’t know |
| SRHR topics ever discussed (only among those who reported ever talking about SRHR) |
∙ Body changes/puberty ∙ Sexual relations ∙ Pregnancy ∙ Contraceptives |
Categorical 1 = talked about this topic with someone 0 = did not talk 2 = don’t know |
| Gender attitudes | ||
| Sexual double standard (SDS) |
∙ Boys have girlfriends to show off to their friends ∙ Adolescent boys fool girls into having sex ∙ Boys tell girls that they love them when they don’t ∙ Adolescent boys loose interest in a girl after they have sex with her ∙ Adolescent girls should avoid boys because they trick them into having sex ∙ Girls are the victims of rumors if they have boyfriends (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree) |
Continuous, 6-item scale with composite score (mean) 1–5; higher scores = higher agreement Cronbach’s alpha = 0.8 Dichotomized at the median into agree vs disagree |
| Gender stereotypical traits (GST) |
∙ Boys should always defend themselves even if it means fighting ∙ It’s important for boys to show they are tough even if they are nervous inside ∙ Boys who behave like girls are considered weak ∙ Boys should be able to show their feelings without fear of being teased ∙ Boys should be raised to be tough so can overcome any difficulties in life ∙ A boy should always have the final say about decision with his girlfriend ∙ Girls are expected to be humble ∙ Girls should avoid raising their voice to be lady like ∙ Girls need their parents’ protection more than boys (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree) |
Continuous, 7-item scale with composite score (mean) 1–5 Cronbach’s alpha = 0.72 Dichotomized at the median into agree vs disagree |
| Gender stereotypical roles (GSR) |
∙ A woman’s role is taking care of her home and family. (GN39) ∙ A man should have the final word about decisions in the home. (GN40) ∙ Boys and girls should be equally responsible for household chores. (GN38) ∙ A woman should obey her husband in all matters. (GN41) ∙ Men should be the ones who bring money home for the family, not women. (GN44) (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree) |
Continuous, 5-item scale with composite score (mean) 1–5 Cronbach’s alpha = 0.77 Dichotomized at the median into agree vs disagree |
| Attitudes towards gender-related teasing |
∙ It is okay to tease a girl who acts like a boy ∙ It is okay to tease a boy who acts like a girl (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree) |
Dichotomous 0 = disagree/neutral 1 = agree |
| Comfort with body and emerging sexuality | ||
| Body satisfaction |
∙ On the whole, I am satisfied with my body ∙ I like the way I look ∙ I like looking at my body ∙ I feel like I am beautiful/handsome (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree) |
Continuous, 4-item scale with composite score (mean) 1–5 Cronbach’s alpha = 0.72 Dichotomous 0 = neg/neutral (≤ 3) 1 = positive (> 3) |
| Comfort with pubertal development |
∙ I like the fact that I am becoming a man (boys) ∙ I like the fact that I am becoming a woman (girls) (1 = strongly agree, 2 = agree, 3 = neither agree nor disagree, 4 = disagree, 5 = strongly disagree) |
Categorical 0 = disagree 1 = neutral/neither 2 = agree |
| Feelings of guilt about sexuality |
∙ Looking at myself naked when I am alone I would feel… ∙ If I were romantically attracted to someone else I would feel… ∙ If I were to touch the private parts of my body I would feel… ∙ If I had sexual feelings I would feel… (1 = not guilty at all, 2 = not very guilty, 3 = a little guilty, 4 = somewhat guilty, 5 = very guilty) |
Continuous, 4-item scale with composite score (mean) ranging from 1–5 Cronbach’s alpha = 0.65 Dichotomous 0 = low (< 3) 1 = high (≥ 3) |
| Normal to be curious about love/sexuality |
∙ It is normal for adolescents to be curious about love and sexuality (1 = not true at all, 2 = not very true, 3 = somewhat true, 4 = very true, don’t know) |
Categorical 0 = no (1–2) 1 = yes (3–4) 2 = don’t know |
| Perceived relational self-efficacy | ||
| Communicate romantic feelings |
How confident do you think you would be… ∙ Telling a boy or girl that you like them (1 = not at all confident, 2 = not very confident, 3 = a little confident, 4 = somewhat confident, 5 = very confident) |
Dichotomous 0 = low (1–2) 1 = high (3–5) |
| Say “no” to unwanted interaction |
How confident do you think you would be… ∙ Telling a boy or girl no if they were doing something that you don’t want (1 = not at all confident, 2 = not very confident, 3 = a little confident, 4 = somewhat confident, 5 = very confident) |
Dichotomous 0 = low (1–2) 1 = high (3–5) |
| Prevent pregnancy |
How confident do you think you would be… ∙ Talking to a boyfriend or girlfriend about contraception ∙ Obtaining information on prevention of pregnancy ∙ Getting contraception if you need it (1 = not at all confident, 2 = not very confident, 3 = a little confident, 4 = somewhat confident, 5 = very confident) |
Continuous, 3-item scale with composite score (mean) ranging from 1–5 Cronbach’s alpha = 0.81 Categorical 0 = low (1–2) 1 = high (3–5) |
| Freedom from peer bullying and violence | ||
| Bullied by peers during last 6 months |
∙ During the last six months, have you been teased or called names by someone? (yes, by a girl; yes, by a boy; yes, by both boys and girls, don’t know) |
Categorical based on sex of perpetrator 0 = no 1 = yes, both boys and girls 2 = yes, opposite sex only |
| Bullying due to gender last 6 months (only among those bullied) |
∙ If you were teased or called names, do you think this was because… You are a girl You are a boy The person thought you were acting like a girl The person thought you were acting like a boy (yes, no, don’t know) |
Combined bullying due to being boy/girl with acting like opposite sex into “gender-related reason” 0 = other reason 1 = due to gender |
| Physical violence victimization by peers during last 6 months |
∙ During the last 6 months, have you ever been slapped, hit or otherwise physically hurt by a boy or girl in a way that you did not want? (yes, by a girl; yes, by a boy; yes, by both boys and girls, don’t know) |
Categorical based on perpetrator sex 0 = no 1 = yes, both boys and girls 2 = yes, opposite sex only |