Skip to main content
SpringerLink
Log in
Book cover

Handbook of Behavioral Medicine pp 59–72Cite as

Assessment of Sexual Behavior

  • Chapter
  • First Online:

Abstract

Sexual behavior augments human experience, allowing people to express affection, develop intimate bonds and interpersonal relationships, and experience pleasure. Sexual behavior can also have unwanted consequences, such as sexually transmitted infections or unintended pregnancy. Researchers often assess sexual behavior to learn more about how it enhances the human experience and to understand conditions under which sexual behavior leads to unwanted consequences. Such assessments can be challenging because sexual behavior typically occurs in private, at the dyadic level, and it is often a stigmatized and culturally sensitive subject. Researcher often rely on self-reports, which are vulnerable to cognitive (e.g., memory) and social (e.g., self-presentation) biases. Research has investigated how best to assess sexual behavior to optimize accurate and reliable self-reports, which are critical to improving sexual functioning, reducing sexually transmitted infections, and informing public policy decisions. In this chapter, we discuss the importance of measuring sexual behaviors, review assessment modes and measures, and present challenges to sexual assessment. Although we focus primarily on retrospective methods of assessment, we also present contemporaneous assessments methods. Finally, we offer recommendations for improving sexual behavior assessment in future research.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   429.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   549.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Abraham, C., and Sheeran, P. (1994). Modelling and modifying young heterosexuals’ HIV-preventive behaviour; a review of theories, findings and educational implications. Patient Educ Couns, 23, 173–186.

    Article  PubMed  CAS  Google Scholar 

  • Al-Tayyib, A. A., Rogers, S. M., Gribble, J. N., Villarroel, M., and Turner, C. F. (2002). Effect of low medical literacy on health survey measurements. Am J Public Health, 92, 1478–1480.

    Article  PubMed  Google Scholar 

  • Baer, A., Saroiu, S., and Koutsky, L. A. (2002). Obtaining sensitive data through the Web: an example of design and methods. Epidemiology, 13, 640–645.

    Article  PubMed  Google Scholar 

  • Basile, K. C., Chen, J., Black, M. C., and Saltzman, L. E. (2007). Prevalence and characteristics of sexual violence victimization among U.S. adults, 2001–2003. Violence Vict, 22, 437–448.

    Article  PubMed  Google Scholar 

  • Biglan, A., Noell, J., Ochs, L., Smolkowski, K., and Metzler, C. (1995). Does sexual coercion play a role in the high-risk sexual behavior of adolescent and young adult women? J Behav Med, 18, 549–568.

    Article  PubMed  CAS  Google Scholar 

  • Boekeloo, B. O., Schiavo, L., Rabin, D. L., Conlon, R. T., Jordan, C. S. et al (1994). Self-reports of HIV risk factors by patients at a sexually transmitted disease clinic: audio vs. written questionnaires. Am J Public Health, 84, 754–760.

    Article  PubMed  CAS  Google Scholar 

  • Bogart, L. M., Walt, L. C., Pavlovic, J. D., Ober, A. J., Brown, N. et al (2007). Cognitive strategies affecting recall of sexual behavior among high-risk men and women. Health Psychol, 26, 787–793.

    Article  PubMed  Google Scholar 

  • Bolger, N., Davis, A., and Rafaeli, E. (2003). Diary methods: capturing life as it is lived. Annu Rev Psychol, 54, 579–616.

    Article  PubMed  Google Scholar 

  • Booth-Kewley, S., Larson, G. E., and Miyoshi, D. K. (2007). Social desirability effects on computerized and paper-and-pencil questionnaires. Comput Human Behav, 23, 463–477.

    Article  Google Scholar 

  • Bortz, W. M., 2nd, and Wallace, D. H. (1999). Physical fitness, aging, and sexuality. West J Med, 170, 167–169.

    PubMed  Google Scholar 

  • Brody, S. (2006). Blood pressure reactivity to stress is better for people who recently had penile-vaginal intercourse than for people who had other or no sexual activity. Biol Psychol, 71, 214–222.

    Article  PubMed  Google Scholar 

  • Burkholder, G. J., and Harlow, L. L. (1996). Using structural equation modeling techniques to evaluate HIV risk models. Struct Eq Model, 3, 348–368.

    Article  Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., and Weinhardt, L. S. (2001). Assessing sexual risk behaviour with the Timeline Followback (TLFB) approach: continued development and psychometric evaluation with psychiatric outpatients. Int J STD AIDS, 12, 365–375.

    Article  PubMed  CAS  Google Scholar 

  • Carey, M. P., Gordon, C. M., Morrison-Beedy, D., and McLean, D. A. (1997). Low-income women and HIV risk reduction: elaborations from qualitative research. AIDS Behav, 1, 163–168.

    Article  PubMed  Google Scholar 

  • Catania, J. A., Gibson, D. R., Chitwood, D. D., and Coates, T. J. (1990). Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull, 108, 339–362.

    Article  PubMed  CAS  Google Scholar 

  • Center for Disease Control and Prevention. (2009). Trends in reportable sexually transmitted diseases in the United States, 2007. http://www.cdc.gov/STD/stats07/trends.pdf.

  • Cecil, H., Pinkerton, S. D., Bogart, L. M., Pavlovic, J., and Kimball, A. M. (2005). An empirical study of ordinal condom use measures. J Sex Res, 42, 353–358.

    Article  PubMed  Google Scholar 

  • Cecil, H., and Zimet, G. D. (1998). Meanings assigned by undergraduates to frequency statements of condom use. Arch Sex Behav, 27, 493–505.

    Article  PubMed  CAS  Google Scholar 

  • Charnetski, C. J., and Brennan, F. X. (2004). Sexual frequency and salivary immunoglobulin A (IgA). Psychol Rep, 94, 839–844.

    Article  PubMed  Google Scholar 

  • Costa, R. M., and Brody, S. (2007). Women’s relationship quality is associated with specifically penile-vaginal intercourse orgasm and frequency. J Sex Marital Ther, 33, 319–327.

    Article  PubMed  Google Scholar 

  • Cutler, W. B., Preti, G., Huggins, G. R., Erickson, B., and Garcia, C. R. (1985). Sexual behavior frequency and biphasic ovulatory type menstrual cycles. Physiol Behav, 34, 805–810.

    Article  PubMed  CAS  Google Scholar 

  • Darke, S., Hall, W., Heather, N., Ward, J., and Wodak, A. (1991). The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug users. AIDS, 5, 181–185.

    Article  PubMed  CAS  Google Scholar 

  • Davey Smith, G., Frankel, S., and Yarnell, J. (1997). Sex and death: are they related? Findings from the Caerphilly Cohort Study. BMJ, 315, 1641–1644.

    Article  PubMed  CAS  Google Scholar 

  • Davis, C. M., Yarber, W. L., Bauserman, R., Schreer, G., and Davis, S. L. (Eds.). (1998). Handbook of Sexuality-Related Measures. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Durant, L. E., and Carey, M. P. (2000). Self-administered questionnaires versus face-to-face interviews in assessing sexual behavior in young women. Arch Sex Behav, 29, 309–322.

    Article  PubMed  CAS  Google Scholar 

  • Ebrahim, S., May, M., Ben Shlomo, Y., McCarron, P., Frankel, S. et al (2002). Sexual intercourse and risk of ischaemic stroke and coronary heart disease: the Caerphilly study. J Epidemiol Community Health, 56, 99–102.

    Article  PubMed  CAS  Google Scholar 

  • Fishbein, M., and Pequegnat, W. (2000). Evaluating AIDS prevention interventions using behavioral and biological outcome measures. Sex Transm Dis, 27, 101–110.

    Article  PubMed  CAS  Google Scholar 

  • Friedrich, W. N., Lysne, M., Sim, L., and Shamos, S. (2004). Assessing sexual behavior in high-risk adolescents with the adolescent clinical sexual behavior inventory (ACSBI). Child Maltreat, 9(3), 239–250.

    Article  PubMed  Google Scholar 

  • Gibson, D. R., Hudes, E. S., and Donovan, D. (1999). Estimating and correcting for response bias in self-reported HIV risk behavior. J Sex Res, 36, 96–101.

    Article  Google Scholar 

  • Godoy, C. G. (2007). Using Virtual Environments to Unobtrusively Measure Real-Life Risk-Taking: Findings and Implications for Health Communication Interventions. Unpublished Dissertation, University of Southern California.

    Google Scholar 

  • Graham, C. A., Catania, J. A., Brand, R., Duong, T., and Canchola, J. A. (2003). Recalling sexual behavior: a methodological analysis of memory recall bias via interview using the diary as the gold standard. J Sex Res, 40, 325–332.

    Article  PubMed  Google Scholar 

  • Graham, C. A., Crosby, R. A., Sanders, S. A., and Yarber, W. L. (2005). Assessment of condom use in men and women. Annu Rev Sex Res, 16, 20–52.

    PubMed  CAS  Google Scholar 

  • Green, A. S., Rafaeli, E., Bolger, N., Shrout, P. E., and Reis, H. T. (2006). Paper or plastic? Data equivalence in paper and electronic diaries. Psychol Methods, 11, 87–105.

    Article  PubMed  Google Scholar 

  • Hall, H. I., Song, R., Rhodes, P., Prejean, J., An, Q. et al (2008). Estimation of HIV incidence in the United States. JAMA, 300, 520–529.

    Article  PubMed  CAS  Google Scholar 

  • Jaccard, J., McDonald, R., Wan, C. K., Dittus, P. J., and Quinlan, S. (2002). The accuracy of self-reports of condom use and sexual behavior. J Appl Soc Psychol, 32, 1863–1905.

    Article  Google Scholar 

  • Kalichman, S. C., Benotsch, E., Suarez, T., Catz, S., Miller, J. et al (2000). Health literacy and health-related knowledge among persons living with HIV/AIDS. Am J Prev Med, 18, 325–331.

    Article  PubMed  CAS  Google Scholar 

  • Kauth, M. R., St Lawrence, J. S., and Kelly, J. A. (1991). Reliability of retrospective assessments of sexual HIV risk behavior: a comparison of biweekly, three-month, and twelve-month self-reports. AIDS Educ Prev, 3, 207–214.

    PubMed  CAS  Google Scholar 

  • Kenny, D. A., Kashy, D. A., and Cook, W. L. (2006). Dyadic Data Analysis. New York: Guilford Press.

    Google Scholar 

  • Kinsey, A. C., Pomeroy, W. R., and Martin, C. E. (2003). Sexual behavior in the human male. 1948. Am J Public Health, 93, 894–898.

    Article  PubMed  Google Scholar 

  • Kutner, M., Greenberg, E., Jin, Y., Boyle, B., Hsu, Y. et al (2007). Literacy in everyday life: results from the 2003 National Assessment of Adult Literacy (NCES 2007480) (Vol. U.S. Department of Education). Washington, DC: National Center for Education.

    Google Scholar 

  • Kutner, M., Greenberg, E., Jin, Y., and Paulsen, C. (2006). The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483) (Vol. U.S. Department of Education). Washington, DC: National Center for Education.

    Google Scholar 

  • Lau, J. T. F., Thomas, J., and Liu, J. L. Y. (2000). Mobile phone and interactive computer interviewing to measure HIV-related risk behaviours: the impacts of data collection methods on research results. AIDS, 14, 1277–1279.

    Article  PubMed  CAS  Google Scholar 

  • Laumann, E. O., Paik, A., Glasser, D. B., Kang, J. H., Wang, T. et al (2006). A cross-national study of subjective sexual well-being among older women and men: findings from the Global Study of Sexual Attitudes and Behaviors. Arch Sex Behav, 35, 145–161.

    Article  PubMed  Google Scholar 

  • Leitzmann, M. F., Platz, E. A., Stampfer, M. J., Willett, W. C., and Giovannucci, E. (2004). Ejaculation frequency and subsequent risk of prostate cancer. JAMA, 291, 1578–1586.

    Article  PubMed  CAS  Google Scholar 

  • McAuliffe, T. L., DiFranceisco, W., and Reed, B. R. (2007). Effects of question format and collection mode on the accuracy of retrospective surveys of health risk behavior: a comparison with daily sexual activity diaries. Health Psychol, 26, 60–67.

    Article  PubMed  Google Scholar 

  • Miner, M. H., Robinson, B. E., Hoffman, L., Albright, C. L., and Bockting, W. O. (2002a). Improving safer sex measures through the inclusion of relationship and partner characteristics. AIDS Care, 14, 827–837.

    Article  PubMed  CAS  Google Scholar 

  • Miner, M. H., Robinson, B. E., Hoffman, L., Albright, C. L., and Bockting, W. O. (2002b). Improving safer sex measures through the inclusion of relationship and partner characteristics. AIDS Care, 14, 827–837.

    Article  PubMed  CAS  Google Scholar 

  • Needle, R., Fisher, D. G., Weatherby, N., Chitwood, D., Brown, B. et al (1995). Reliability of self-reported HIV risk behaviors of drug users. Psychol Addict Behav, 9, 242–250.

    Article  Google Scholar 

  • Noar, S. M., Cole, C., and Carlyle, K. (2006). Condom Use Measurement in 56 studies of sexual risk behavior: review and recommendations. Arch Sex Behav, 35, 327–345.

    Article  PubMed  Google Scholar 

  • Ostrow, D. G., DiFranceisco, W. J., Chmiel, J. S., Wagstaff, D. A., and Wesch, J. (1995). A case-control study of human immunodeficiency virus type 1 seroconversion and risk-related behaviors in the Chicago MACS/CCS Cohort, 1984–1992. Multicenter AIDS Cohort Study. Coping and Change Study. Am J Epidemiol, 142, 875–883.

    PubMed  CAS  Google Scholar 

  • Parish, W. L., Luo, Y., Stolzenberg, R., Laumann, E. O., Farrer, G. et al (2007). Sexual practices and sexual satisfaction: a population based study of Chinese urban adults. Arch Sex Behav, 36, 5–20.

    Article  PubMed  Google Scholar 

  • Patterson, T. L., and Strathdee, S. A. (2005). From Don Giovanni to Magic Johnson: methodological conundrums in the measurement of sexual risk behavior. Ann Behav Med, 29, 83–85.

    Article  PubMed  Google Scholar 

  • Pequegnat, W., Rosser, B. R., Bowen, A. M., Bull, S. S., DiClemente, R. J. et al (2007). Conducting Internet-based HIV/STD prevention survey research: considerations in design and evaluation. AIDS Behav, 11, 505–521.

    Article  PubMed  Google Scholar 

  • Reik, T. (1983). Listening with the Third Ear. New York: Farrar, Straus, and Giroux.

    Google Scholar 

  • Renaud, P., Rouleau, J. L., Granger, L., Barsetti, I., and Bouchard, S. (2002). Measuring sexual preferences in virtual reality: a pilot study. Cyberpsychol Behav, 5, 1–9.

    Article  PubMed  Google Scholar 

  • Rhodes, S. D., Bowie, D. A., and Hergenrather, K. C. (2003). Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health, 57, 68–73.

    Article  PubMed  CAS  Google Scholar 

  • Robinson, B. B., Bockting, W. O., Rosser, B. R., Miner, M., and Coleman, E. (2002). The Sexual Health Model: application of a sexological approach to HIV prevention. Health Educ Res, 17, 43–57.

    Article  PubMed  Google Scholar 

  • Robinson, R., and West, R. (1992). A comparison of computer and questionnaire methods of history-taking in a genito-urinary clinic. Psychol Health, 6, 77–84.

    Article  Google Scholar 

  • Sangi-Haghpeykar, H., Ambani, D. S., and Carson, S. A. (2009). Stress, workload, sexual well-being and quality of life among physician residents in training. Int J Clin Pract, 63(3), 462–467.

    Article  PubMed  CAS  Google Scholar 

  • Schroder, K. E., Carey, M. P., and Vanable, P. A. (2003a). Methodological challenges in research on sexual risk behavior: I. Item content, scaling, and data analytical options. Ann Behav Med, 26, 76–103.

    Article  PubMed  Google Scholar 

  • Schroder, K. E., Carey, M. P., and Vanable, P. A. (2003b). Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Ann Behav Med, 26, 104–123.

    Article  PubMed  Google Scholar 

  • Sheeran, P., and Abraham, C. (1994). Measurement of condom use in 72 studies of HIV-preventive behaviour: a critical review. Patient Educ Couns, 24, 199–216.

    Article  PubMed  CAS  Google Scholar 

  • Sobell, L. C., and Sobell, M. B. (1996). Timeline Followback Users Guide. Toronto, Canada: Alcohol Research Foundation.

    Google Scholar 

  • Stone, A. A., and Shiffman, S. (2002). Capturing momentary, self-report data: a proposal for reporting guidelines. Ann Behav Med, 24, 236–243.

    Article  PubMed  Google Scholar 

  • Tourangeau, R., and Smith, T. W. (1996). Asking sensitive questions: the impact of data collection mode, question format, and question context. Public Opinion Quarterly, 60, 275–304.

    Article  Google Scholar 

  • Turner, C. F., Ku, L., Rogers, S. M., Lindberg, L. D., Pleck, J. H. et al (1998). Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science, 280, 867–873.

    Article  PubMed  CAS  Google Scholar 

  • Weinhardt, L. S., Carey, M. P., Maisto, S. A., Carey, K. B., Cohen, M. M. et al (1998a). Reliability of the timeline follow-back sexual behavior interview. Ann Behav Med, 20, 25–30.

    Article  PubMed  CAS  Google Scholar 

  • Weinhardt, L. S., Forsyth, A. D., Carey, M. P., Jaworski, B. C., and Durant, L. E. (1998b). Reliability and validity of self-report measures of HIV-related sexual behavior: progress since 1990 and recommendations for research and practice. Arch Sex Behav, 27, 155–180.

    Article  PubMed  CAS  Google Scholar 

  • Whipple, B. (2006). The health benefits of sexual expression. In M. S. Tepper & A. F. Owens (Eds.), Sexual Health, Vol. 1 (pp. 17–42). Westport, CT: Greenwood.

    Google Scholar 

  • White, J. R., Case, D. A., McWhirter, D., and Mattison, A. M. (1990). Enhanced sexual behavior in exercising men. Arch Sex Behav, 19, 193–209.

    Article  PubMed  CAS  Google Scholar 

  • Whittier, D. K., Lawrence, J. S., and Seeley, S. (2005). Sexual risk behavior of men who have sex with men: comparison of behavior at home and at a gay resort. Arch Sex Behav, 34, 95–102.

    Article  PubMed  Google Scholar 

  • World Health Organization (WHO). (2006). Defining sexual health: report of a technical consultation on sexual health. http://www.who.int/reproductive-health/publications/sexualhealth/index.html.

  • Wilcox, A. J., Weinberg, C. R., and Baird, D. D. (1995). Timing of sexual intercourse in relation to ovulation. Effects on the probability of conception, survival of the pregnancy, and sex of the baby. N Engl J Med, 333, 1517–1521.

    Article  PubMed  CAS  Google Scholar 

  • Wincze, J. P., and Carey, M. P. (2001). Sexual Dysfunction: A Guide for Assessment and Treatment, 2nd Ed. New York, NY: Guilford Press.

    Google Scholar 

Download references

Acknowledgments

Funding: The preparation of this chapter was supported by National Institute of Mental Health grants to Seth C. Kalichman (R01-MH71164) and Michael P. Carey (R01-MH068171).

Author information

Authors and Affiliations

  1. Center for Health and Behavior, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244-2340, USA

    Lori A.J. Scott-Sheldon

  2. Department of Psychology, Center for Health, Intervention, and Prevention, University of Connecticut, 406 Babbidge Road, Storrs, CT, 06269, USA

    Seth C. Kalichman (Professor of Psychology)

  3. Center for Health and Behavior, Syracuse University, 415-B Huntington Hall, Syracuse, NY, 13244-2340, USA

    Michael P. Carey (Director)

Authors
  1. Lori A.J. Scott-Sheldon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seth C. Kalichman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael P. Carey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lori A.J. Scott-Sheldon .

Editor information

Editors and Affiliations

  1. St Georges Hospital Medical School, Dept. Psychology, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom

    A. Steptoe

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Scott-Sheldon, L.A., Kalichman, S.C., Carey, M.P. (2010). Assessment of Sexual Behavior. In: Steptoe, A. (eds) Handbook of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09488-5_5

Download citation

Publish with us

Policies and ethics

Search

Navigation