Table 2

Consensus statements (19 items)

Number	Statement	Grade
General principles that apply to design, implementation (including identifying and training interviewers), and dissemination
A sexual health survey instrument should do the following:
1.	Draw on a holistic view of sexual health, as described by the WHO’s working definition.	U
2.	Recognise the potentially sensitive nature of certain concepts and be informed about local and national norms and laws related to age of consent, same-sex relationships, abortion, sexual violence, gender issues and related macrolevel factors.	U
3.	Engage local multisectoral key stakeholders across all stages of the survey research project including design, implementation and dissemination. Key stakeholders might include potential research participants, government officials from across the socioeconomic and political spectrums, policy makers, members of civil society and others, depending on the context.	U
4.	Ensure the survey and its data are used in ways that promote, protect,and fulfil human rights, including sexual rights, per the WHO’s working definition (here).	U
5.	Be adaptable to the local population’s priorities, needs, norms and practices.	U
Design stage
6.	Capture information on one’s sexual and reproductive health, related choices and outcomes.	U
7.	Reflect the lived reality of the participant taking part in the survey in their local context.	A
8.	Acknowledge the broader determinants of sexual and reproductive health outcomes per the WHO’s working definition (here).	U
9.	Include young people under the age of 18 years if in line with local regulations, laws and ethical norms. This may benefit from discussions with the local ethical review committee whose approval would be required prior to starting research.	A
10.	Avoid language that is derogatory or discriminatory as informed by the local community; use people-centred language (eg, ‘people with disabilities’ instead of ‘disabled people’).	U
Implementation (dentify and train interviewers)
11.	Select interviewers who understand the local context. Special consideration should be given to including interviewers with knowledge of or experience with subgroups of participants identified as important by the research team (eg, older people, sexual minorities and people with physical or mental disabilities).	U
12.	Core topics of interviewer training include protecting participants, rapport building, the sociolegal environment, ethics training, gender dynamics (eg, women interviewing men or vice versa), age dynamics (eg, younger people interviewing older people), trauma-informed care and quality control.	U
13.	Core competencies of interviewers include obtaining participant consent/assent (for minors), asking sensitive questions, understanding behaviours considered illegal, managing participant responses to sensitive issues, avoiding biassing participant responses and demonstrating a non-judgemental demeanour.	U
14.	Training should focus on building mutual understanding between the participant and the interviewer, using participatory training methods where appropriate (eg, role-playing and/or implicit bias training). There should be regular ongoing supervision and support for interviewers in order to address issues that arise during data collection, particularly when asking about sensitive issues, such as sexual abuse or gender violence.	A
15.	Interviewers must be trained in their legal duties regarding reporting requirements (eg, with regard to sexual violence, consensual sexual activity among adolescents, even parental consent to access sexual and reproductive health referral services) and ethical duties. The research team should be aware that their actions or omissions may carry legal implications. If a conflict arises between a legal obligation and an ethical duty, the research team should obtain advice from their professional association on how best to proceed and, ultimately, to choose to always act in an ethical manner. When relevant issues are identified, the research team must provide information on appropriate services and assist in linking those affected to these services (eg, legal services, local hotlines, shelters, health and social services) and consider the safety of those affected when dealing with mandatory reporting requirements.*	U
16.	Ensure the confidentiality and privacy of participants.	U
Dissemination
17.	Create a summary of the research findings accessible to participants.	U
18.	Create a summary of research findings to be shared with policy makers, public audiences or others.	U
19.	Work in partnership with local communities to disseminate research findings to key stakeholders as defined previously.	U
U=100%, A=90%–99%

*Researchers may be legally required to report certain types of violence or sexual activity to relevant authorities, even though this reporting may conflict with the ethical obligation to protect participants" confidentiality and respect their autonomy. It is essential that researchers understand and plan appropriately for situations in which mandatory reporting requirements may apply, recognising that different standards apply across countries. They will need to explain the limits of confidentiality to research participants. In addition, it may be ethically appropriate to screen participants for immediate safety concerns and to refer them directly to additional support services for their own and their children’s safety and well-being.
A, agreement; U, unanimous.