Sexual Behavior Questions Research Articles

Perceived risk of HIV transmission by blood transfusion among gay, bisexual, and other men who have sex with men (gbMSM) in Australia.

In Australia, men who have sex with men (MSM) are deferred from blood donation for 3 months from last sexual contact. Internationally, deferral policies for MSM are evolving in the direction of expanded inclusivity in response to community expectations. To inform future policy options, we assessed perceptions of the risk of HIV transmission from blood transfusion among Australian MSM. Flux is an online prospective cohort of Australian gay and bisexual men (cis or trans, regardless of their sexual history) and other men who have had sex with men (gbMSM). We included questions on blood donation rules, window period (WP) duration, infectivity of blood from people with HIV on treatment and attitudes to more detailed questioning of sexual practices in the regular survey of Flux participants and conducted a descriptive analysis of responses. Of 716 Flux participants in 2019, 703 responded to the blood donation questions. The mean age was 43.7 years (SD 13.6 years). Overall, 74% were willing to confidentially respond to specific sexual behavior questions, such as the last time they had sex and the type of sex they had, in order to be considered eligible to donate blood. The majority (92%) of participants correctly assessed the duration of the WP as less than 1 month. When asked whether transfusion of blood from a donor with HIV and an undetectable viral load could transmit HIV, just under half (48%) correctly said yes. Our study suggests Australian gbMSM are generally comfortable with answering more detailed questions regarding sexual activity during the assessment to donate, indicating they would do so honestly. gbMSM are knowledgeable about the WP duration, important for their ability to correctly self-assess their HIV risk. However, half of participants incorrectly assessed the transmissibility by blood transfusion from an HIV positive person with an undetectable viral load, suggesting the need for a targeted education campaign.

Patient Attitudes on Collection of Sexual Orientation and Gender Identity Data in a Women's Health Clinic with an Embedded Transgender Medicine Program.

Purpose: We examined patient attitudes about the collection of sexual orientation and gender identity (SOGI) data in a mixed sample of sexual and gender minority (SGM) and cisgender heterosexual people. Methods: SOGI questions and an evaluation questionnaire were administered to a convenience sample of patients presenting at an academic women's health clinic with an embedded transgender medicine program. Clinic census is ∼10,000 patients, which includes some 1000 cisgender males and 800 transgender patients. Bivariate and multivariate analyses were performed. Our methods expand on prior study in this area through implementing an analysis which divides the sample into three groups; cisgender heterosexual, cisgender sexual minority, and transgender respondents, and includes an intersectional approach to the analysis by income and age range, race/ethnicity, and presence of a non-English language spoken at home. Results: Some 231 respondents participated out of 291 approached, including 149 cisgender heterosexual respondents, 26 cisgender sexual minority respondents, and 56 transgender people of any sexuality. Scores were high regarding ease and accuracy of the SOGI questionnaire, and willingness to answer SOGI questions. Among those identifying as cisgender/heterosexual, non-White respondents had an odds ratio of 5.48 of being offended by sexual behavior questions compared with White respondents. Respondents overwhelmingly preferred to complete questionnaires through confidential electronic or pen-and-paper means. Conclusion: Patients were overwhelmingly willing to complete SOGI data questionnaires in a clinic setting, and preferred to do so using confidential means rather than by live interview by staff or providers.

Comparison of the ACASI Mode to Other Survey Modes in Sexual Behavior Surveys in Asia and Sub-Saharan Africa: Systematic Literature Review.

BackgroundReliable data about sexual behaviors is fundamental in the prevention and control of HIV, hepatitis, and other sexually transmitted infections. Generally, sexual behaviors are regarded as a sociocultural taboo in Africa and Asia, and this results in biased sexual behavior survey data due to social desirability. Various modes of survey delivery, including audio computer-assisted self-interviews (ACASIs), have been investigated to improve data quality.ObjectiveThis study aimed to review studies that compared the ACASI mode to other survey modes in sexual behavior surveys in Asia and sub-Saharan Africa to ascertain the impact of survey mode on responses to sexual behavior questions.MethodsA systematic literature review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. The review protocol was registered at PROSPERO (International Prospective Register of Systematic Reviews). Six databases were searched.ResultsA total of 21 papers were included. The face-to-face interview (FTFI) mode was the survey mode most frequently compared to the ACASI mode. Among the most commonly reported outcome variable groups, ACASI participants were more likely to report sexual behaviors, such as “forced sex,” “multiple partners,” “transactional sex,” and “ever had sex,” as compared to FTFI participants. In addition to the survey mode effect, other factors were found to have had an impact on data quality, for example, participant characteristics, social norms, study design, and data collection setting.ConclusionsUse of ACASIs for administering sexual behavior surveys among populations in Asia and sub-Saharan Africa demonstrated higher reports for some sexual behaviors than the use of FTFIs. More studies that compare the ACASI mode to other survey modes would improve our understanding of the usefulness of ACASIs in sexual behavior surveys in these regions.

Sexual risk behavior questions: Understanding and mitigating donor discomfort.

BackgroundBlood operators are working to improve donor screening and eligibility for gay, bisexual and other men who have sex with men (gbMSM), and trans and nonbinary donors. Many consider screening all donors for specific sexual risk behaviors to be a more equitable approach that maintains the safety of the blood supply. Feasibility considerations with this change include ensuring donor understanding of additional sexual behavior questions and minimizing donor loss due to discomfort.Study design and methodsQualitative one‐on‐one interviews were conducted with Canadian whole blood and plasma donors (N = 40). A thematic analysis was conducted to assess participants' understandings of the questions, examine their comfort/discomfort, and identify strategies to mitigate donor discomfort.ResultsAll participants understood what the sexual behavior questions were asking and thought the questions were appropriate. Themes related to comfort/discomfort include: their expectations of donor screening, social norms that they bring to donation, whether their answer felt like personal disclosure, knowing the reasons for the question, trusting confidentiality, confidence in knowing their sexual partner's behavior, and potential for the question to be discriminatory. Strategies to mitigate discomfort include: providing an explanation for the questions, forewarning donors of these questions, reducing ambiguity, and using a self‐administered questionnaire.ConclusionWhile many blood operators and regulators view the move to sexual behavior–based screening for all donors as a significant paradigmatic shift, donors may not perceive additional sexual behavior questions as a significant change to their donation experience. Further research is needed to evaluate the effectiveness of strategies to mitigate donor discomfort.

Sexual Behavior In preschool, school and preadolescents children A Sample from Outpatient’s Clinic of Pediatric Hospital

Abstract Background Studies have suggested that Sexual behaviors are common in children. More than 50% of children will engage in some type of sexual behavior before their 13th birthday. Sexual behaviors in children range from normal and developmentally appropriate to abusive and violent. In retrospective study of 339 child welfare and mental health professionals in which participants were asked about their own experiences before 13 years of age, 73% recalled engaging in sexual behaviors with other children, 34% recalled showing their genitals to another child, 16% recalled simulating intercourse with another child, and 5% recalled inserting an object in the vagina or rectum of another child Aim of the Work To observe the developmental course of describe normative sexual behaviors in 2- to 12-years-old Egyptian children and to assess the relative frequencies of different types of sexual behaviors in general outpatient clinic of pediatric hospital of Ain Shams University hospitals. Patients and Methods This is a Cross sectional analytical started on October 2018. Study conducted in pediatric hospital Ain Shams University hospitals. This present study aimed at analyzing the data of 500 children aged from 2 to 12 years old. Thirsty four refused to participate on sexual behaviour questions. Results A total of 500 questionnaires were done by parents of child vising clinic of pediatric hospital of Ain Shams university, 35 refused to participate in sexual behaviour questionnaire. It was divided in three groups. Preschool aged children from 2-6 years 254 child (50.8%), school aged children from 6-9 years 106 child (18.82%) & preadolescents from 10 to 12 years 140 child (24.014%). The study Included both 252 males and 248 females. The most sexual behaviours detected among children “sometimes” were touching genitals at home 111(22.2%), child asks about sexual acts 86 child (17.2%) & saying sexual words 80 (16%) and mostly repeated children was flirt with strangers 11(2.2%) & asking about sex more than other children 10 (2%). Conclusion In general, sexual behaviors in children two to five years of age are of a greater variety and are more common compared with the behaviors in children older than five years. once the child becomes aware of social rules regarding sexual behaviors in public, those behaviors become more covert. There is a need for further national studies in different settings, to help create a better understanding of what constitutes both normative and deviant sexual behaviour in children.

Análise do perfil sexual de brasileiras: hábitos e práticas

Objetivo: Traçar o perfil de hábitos e de práticas sexuais de mulheres em todo o território brasileiro. Métodos: É um estudo transversal, ocorrido em dezembro de 2017 com mulheres entre 18 e 60 anos. A coleta foi mediante um questionário online, contendo 45 questões clínicas, sociodemográficas e decomportamento sexual. Resultados: Participaram 414 mulheres de todas as regiões brasileiras com média de idade 25 anos. A maioria é heterossexual, em um relacionamento estável, perdeu a virgindade entre 12 e 17 anos e sente-se à vontade para falar sobre sexo. Em relação à atividade sexual o envolvimento físico (76,6%), afetivo (72,5%) e o desejo (74,6%) estão sempre presentes. O que mais importa em um relacionamento sexual é o respeito (89,9%), a saúde sexual (88,4%), o afeto e o amor (83,1%). Essas mulheres temem engravidar (69,4%) e adquirir infecções sexualmente transmissíveis (84,1%), embora não usem frequentemente preservativo. Uma porcentagem das participantes (17,6%) apresentou depressão; dispareunia (27,5%) e vulvodínia (36,2%). Mesmo assim, 41,8% considera sua vida sexual boa. Conclusão: Observou-se que a mulher brasileira inicia cedo suas relações sexuais, e que estas estão vinculadas ao respeito, à saúde sexual, ao afeto, o carinho e o amor. Embora apresentem bastante medo de engravidar e adquirir infecções sexualmente transmissíveis. Além de apresentarem dor no ato sexual, vulvodínia.

An Approach to Reducing Problematic Data in an ACASI Sexual Behavior Assessment

ABSTRACT Minimizing error in self-reported sexual behavior could reduce investigators’ likelihood of rejecting truly successful interventions to decrease HIV and STI transmission risk. Sexual behavior assessments can elicit problematic data. This may manifest in the form of elevated levels of non-response, inaccurate point estimates, or misclassification errors resulting in inappropriately answering or, perhaps more importantly, skipping questions. We programed conversational interviewing elements into 20 sexual behavior questions in an exit survey of gay bathhouse patrons (N = 459) administered using ACASI. Those elements, called alternate pathways, included follow-up questions to responses to confirm that operational definitions were applied in the answer (with return to the initial question if confirmation failed), and assurances of confidentiality and requests for best guesses in reaction to non-response (including “don’t know”). These elements were invoked in nearly 10% of participants, and approximately 74% of all invocations resulted in a usable numeric response, or 87% if the data need only estimate prevalence. Almost two-thirds of the problematic data issues occurred in answers to sexual contact questions, with others related to follow-up questions about specific sexual behavior. It is at this level of important filtering questions where the benefits of the approach are likely to be maximized.

The association between interviewer gender and responses to sensitive survey questions in a sample of Haitian women

ABSTRACTBias may be introduced in survey data collection when participants answer questions differently depending on interviewer gender. This could affect the validity of collected data, especially sensitive data. Using sexual behavior data collected in a 2017–2018 cross-sectional survey of Haitian women (n = 304), we evaluated the associations between interviewer-gender and three different outcomes: (1) question-specific response rates, (2) total number of non-responses, and (3) differences in reported answers. We observed higher item response rates for sensitive sexual behavior questions when the interviewer was female and more item non-responses (Don’t know/Refuse) when the interviewer was male. Among those who did respond, participants were more likely to report some sensitive sexual behaviors to women and others to men. We conclude that researchers should consider the sociocultural norms of the study population and the potential for interviewer gender bias in the planning and analysis phase of studies using self-reported data.

Syphilis Screening Practices of Family Care Providers

Background The incidence of syphilis has doubled since 2000 and continues to increase. Improving syphilis screening practices is an important factor in controlling the spread. The major predictors of syphilis screening among family care providers were investigated. Methods A cross-sectional pilot survey consisting of 27 questions was administered electronically to 3 major health systems located in central Pennsylvania. The target population consisted of primary care physicians, nurse practitioners, and physician assistants. Statistical tests were performed to measure the associations between the predictors and the primary outcome variable of syphilis screening rate. Results Fifty-two surveys were completed and included. There was no significant association between provider type or provider-patient contact time with syphilis screening rate (P > 0.05). A positive relationship between providers who reported having a standard spoken phrase for sexual health queries and syphilis screening rate trended toward significance (P = 0.07). Qualitative data indicated some provider bias in screening patients only when they are symptomatic or during well woman visits. Conclusions Family care providers who have a standard spoken phrase when addressing sexual health are more likely to ask sexual behavior questions and are more likely to screen for syphilis. Biased screening practices are aimed at women, despite higher syphilis prevalence in men, demonstrating a need for increased efforts to educate providers about syphilis, and provide training programs to encourage the assessment of patient risk for exposure to sexually transmitted diseases.

Daily Vaginal Swabs and Mobile Phone Sex Report for Assessing HIV Virion Exposure Prospectively Among a Cohort of Young Sexually Active Women in South Africa (HVTN 915).

Measurements of HIV exposure could help identify subpopulations at highest risk of acquisition and improve the design of HIV prevention efficacy trials and public health interventions. The HVTN 915 study evaluated the feasibility of self-administered vaginal swabs for detection of HIV virions to assess exposure. Fifty 18- to 25-year-old sexually active HIV-seronegative women using contraception were enrolled in Soweto, South Africa. Participants self-administered daily vaginal swabs and answered sexual behavior questions through mobile phone for 90 days. Clinician-administered vaginal swabs, behavioral questionnaires, HIV diagnostic testing, and counseling were performed at 8 clinic visits. Glycogen concentrations assessed adherence to swabbing. Y-chromosome DNA (Yc-DNA) assessed the accuracy of reported condom use. HIV exposure was measured by virion polymerase chain reaction in swabs from 41 women who reported unprotected vaginal sex during follow-up. Glycogen was detected in 315/336 (93.8%) participant-collected and in all clinician-collected swabs. Approximately 20/39 daily swabs (51.3%) linked to mobile reports of unprotected sex tested positive for Yc-DNA, whereas 10/187 swabs collected after 3 days of abstinence or protected sex (5.3%) had detectable Yc-DNA. No participant became HIV infected during the study; yet, exposure to HIV was detected by nucleic acids in 2 vaginal swabs from 1 participant, collected less than 1 hour after coitus. There was high adherence to daily vaginal swabbing. Daily mobile surveys had accurate reporting of unprotected sex. Detection of HIV in self-collected vaginal swabs from an uninfected participant demonstrated it was possible to measure HIV exposure, but the detection rate was lower than expected.

The influence of interviewers on survey responses among female sex workers in Zambia

BackgroundInterviewers can substantially affect self-reported data. This may be due to random variation in interviewers’ ability to put respondents at ease or in how they frame questions. It may also be due to systematic differences such as social distance between interviewer and respondent (e.g., by age, gender, ethnicity) or different perceptions of what interviewers consider socially desirable responses. Exploration of such variation is limited, especially in stigmatized populations.MethodsWe analyzed data from a randomized controlled trial of HIV self-testing amongst 965 female sex workers (FSWs) in Zambian towns. In the trial, 16 interviewers were randomly assigned to respondents. We used hierarchical regression models to examine how interviewers may both affect responses on more and less sensitive topics, and confound associations between key risk factors and HIV self-test use.ResultsModel variance (ICC) at the interviewer level was over 15% for most topics. ICC was lower for socio-demographic and cognitively simple questions, and highest for sexual behaviour, substance use, violence and psychosocial wellbeing questions. Respondents reported significantly lower socioeconomic status and more sex-work related violence to female interviewers. Not accounting for interviewer identity in regressions predicting HIV self-test behaviour led to coefficients moving from non-significant to significant.ConclusionsWe found substantial interviewer-level effects for prevalence and associational outcomes among Zambian FSWs, particularly for sensitive questions. Our findings highlight the importance of careful training and response monitoring to minimize inter-interviewer variation, of considering social distance when selecting interviewers and of evaluating whether interviewers are driving key findings in self-reported data.Trial registrationclinicaltrials.gov NCT02827240. Registered 11 July 2016.

Chlamydia trachomatis Pgp3 Antibody Population Seroprevalence before and during an Era of Widespread Opportunistic Chlamydia Screening in England (1994-2012).

BackgroundOpportunistic chlamydia screening of <25 year-olds was nationally-implemented in England in 2008 but its impact on chlamydia transmission is poorly understood. We undertook a population-based seroprevalence study to explore the impact of screening on cumulative incidence of chlamydia, as measured by C.trachomatis-specific antibody.MethodsAnonymised sera from participants in the nationally-representative Health Surveys for England (HSE) were tested for C.trachomatis antibodies using two novel Pgp3 enzyme-linked immunosorbent assays (ELISAs) as a marker of past infection. Determinants of being seropositive were explored using logistic regression among 16–44 year-old women and men in 2010 and 2012 (years when sexual behaviour questions were included in the survey) (n = 1,402 women; 1,119 men). Seroprevalence trends among 16–24 year-old women (n = 3,361) were investigated over ten time points from 1994–2012.ResultsIn HSE2010/2012, Pgp3 seroprevalence among 16–44 year-olds was 24.4% (95%CI 22.0–27.1) in women and 13.9% (11.8–16.2) in men. Seroprevalence increased with age (up to 33.5% [27.5–40.2] in 30–34 year-old women, 18.7% [13.4–25.6] in 35–39 year-old men); years since first sex; number of lifetime sexual partners; and younger age at first sex. 76.7% of seropositive 16–24 year-olds had never been diagnosed with chlamydia. Among 16–24 year-old women, a non-significant decline in seroprevalence was observed from 2008–2012 (prevalence ratio per year: 0.94 [0.84–1.05]).ConclusionOur application of Pgp3 ELISAs demonstrates a high lifetime risk of chlamydia infection among women and a large proportion of undiagnosed infections. A decrease in age-specific cumulative incidence following national implementation of opportunistic chlamydia screening has not yet been demonstrated. We propose these assays be used to assess impact of chlamydia control programmes.

Exploring Adolescent Sexual Behaviour: A Pilot Study of Questions for Inclusion in the Health Behaviour in School Aged Children (HBSC) Study

Objective: The Health Behaviour in School-aged Children (HBSC) study is a World Health Organization collaborative cross-national research project which aims to improve understanding of young people’s health and wellbeing, including sexual behaviours. Data are collected on a four year cycle from schoolchildren in 43 countries in Europe and North America. Requests for detailed information about adolescent sexual behaviours have prompted the development of new sexual behaviour questions for use in the HBSC study. The aim of this pilot study was to provide guidance on the utility and appropriateness of new sexual health items for inclusion in future HBSC studies. Design and Method: A pilot involving 233 Irish students aged 15-19 years used questionnaires and classroom discussion groups to test the utility and appropriateness of new sexual health items. Twenty-one sexual behaviour questions were developed based on previously validated questionnaires. Questions measured sexual behaviour, romantic experiences and the circumstances surrounding first intercourse. Results: The findings provide feedback on the following dimensions of the proposed items; cultural acceptability, understandability, answerability, skews, translatability, relevance and contextual understanding. A test-retest provides further details on the validity and consistency of the questions. Analysis highlights questions which not only have conceptual cohesion within the study and the potential to inform policy but which are understandable, acceptable and of a high priority to the target population. Conclusions: The findings have provided guidance for the mandatory and optional sexual behaviour questions for further HBSC studies. They have informed a standardized protocol which will enable the collection of internationally comparable adolescent sexual behaviour data.

Religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: Findings from the National Alcohol Survey

ObjectiveDespite research documenting disparities in risk for alcohol-related problems among sexual minority women, few studies explore potential protective factors within this population. This study examines how religiosity may function as a protective or risk factor for alcohol-problems or other substance use among sexual minorities compared to heterosexuals. MethodData from 11,169 women who responded to sexual identity and sexual behavior questions from three population-based National Alcohol Survey waves (2000, 2005, 2010) were utilized for analyses of religiosity in relation to lifetime drinking, past year hazardous drinking, and past year drug use. ResultsReligiosity was significantly greater among exclusively heterosexual women compared to all sexual minority groups (lesbian, bisexual and heterosexual women who report same sex partners). Lesbians reported the lowest rates of affiliation with religions/denominations discouraging alcohol use. Past year hazardous drinking and use of any illicit drugs were significantly lower among exclusively heterosexual women compared to all sexual minority groups. High religiosity was associated with lifetime alcohol abstention and was found to be protective against hazardous drinking and drug use among both sexual minority and heterosexual women. Reporting religious norms unfavorable to drinking was protective against hazardous drinking among exclusively heterosexual women but not sexual minority women. ConclusionsFindings reveal the importance of considering sexual minority status in evaluation of religion or spirituality as protective among women. Future studies should explore religiosity in the context of other individual and environmental factors, such as positive identity development and community-level acceptance, which may be salient to resiliency among sexual minorities.

P08.12 Insights intochlamydia trachomatiscumulative incidence in the context of widespread opportunistic chlamydia screening in england: seroprevalence study using sera from a nationally-representative household survey

Introduction The National Chlamydia Screening Programme (NCSP) was nationally implemented in England in 2008. The programme recommends that sexually-active under-25 year-olds are tested for chlamydia annually and on change of partner with the aim of interrupting transmission and preventing complications. We undertook a seroprevalence study to explore the impact of chlamydia screening on the cumulative incidence of infection up to 2012. Methods Anonymised sera from participants in the Health Survey for England (HSE), a series of nationally-representative household surveys, were tested for anti-chlamydia antibodies using an ELISA based on the Chlamydia trachomatis -specific antigen Pgp3. Factors associated with seropositivity among 16–44 year-olds in 2010 and 2012 (years when sexual behaviour questions were included) were investigated using logistic regression. Seroprevalence trends were investigated for 1994–2012. Results In 2010/2012, Pgp3 seroprevalence was 24% (95% CI: 22%–27%) in women and 14% (12%–16%) in men. Seroprevalence increased with age to 34% (28%–40%) in 30–34 year-old women and 20% (15%–27%) in 35–39 year-old men, and with numbers of lifetime sexual partners (17% with 1–4 partners versus 43% in those with ≥10 in women; 6% vs. 27% in men). 78% of seropositive 16–24 year-old women did not report a previous chlamydia diagnosis. Among 16–24 year-old women, there was no significant trend in seroprevalence over time and no difference in age-specific seroprevalence between birth cohorts exposed to different levels of chlamydia screening. Conclusion In 2010–12, at least one third of women had been exposed to chlamydia by age 30–34. Most of those with evidence of previous infection did not report a previous diagnosis, presenting consequent risks of transmission and complications. A decrease in cumulative incidence among young adults following the implementation of the NCSP has not yet been demonstrated. Additional years of screening may be needed to have a measurable effect on cumulative incidence. Continued monitoring of seroprevalence is required. Disclosure of interest statement The study was funded by the Health Protection Agency (now part of Public Health England). No pharmaceutical or diagnostic company grants were received in the development of this study.

S09.2 The prevalence of chlamydia among 16 to 29 year olds in australia

The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) is a cluster randomised controlled trial that aims to measure the effectiveness of a chlamydia testing intervention in general practice. Over 140 general practice clinics are participating in ACCEPt in 54 geographical areas across four Australian states (Victoria, New South Wales, Queensland and South Australia). The primary outcome of ACCEPt is change in chlamydia prevalence among 16 to 29 year old men and women attending general practice. This will be assessed as the difference in chlamydia prevalence between a survey conducted prior to randomisation in all participating clinics (survey 1) and a survey conducted at the conclusion of the trial (survey 2). Both surveys have identical methodology. A research assistant employed by the research team is based in each of the participating clinics and invites consecutive patients to participate as they arrive for a consultation with a doctor. Men and women are eligible if they are 16–29 years old and have ever had vaginal and/or anal sex. Participants provide a self-collected urine specimen or vaginal swab for chlamydia testing and complete a questionnaire. The questionnaire includes items about demographic characteristics, sexual behaviour, reasons for attending and genital symptoms. Sexual behaviour questions includes number of partners in the last 12 months, concurrency (two or more overlapping partnerships), duration of most recent partnership and condom use (inconsistent or consistent use with most recent partner). The first survey was conducted between 2010 and 2012 with over 4000 men and women tested and an overall chlamydia prevalence of 4.6% (95% CI: 3.9%, 5.3%). The second survey commenced in July 2014 and will be completed in August 2015. Over 3,400 men and women had been recruited as of the end of June 2015. The results of the second survey will be presented and its findings compared with survey 1.

Using computer-assisted survey instruments instead of paper and pencil increased completeness of self-administered sexual behavior questionnaires

ObjectivesTo compare the data quality, logistics, and cost of a self-administered sexual behavior questionnaire administered either using a computer-assisted survey instrument (CASI) or by paper and pencil in a primary care clinic. Study Design and SettingA self-administered sexual behavior questionnaire was administered to 16–29 year olds attending general practice. Questionnaires were administered by either paper and pencil (paper) or CASI. A personal digital assistant was used to self-administer the CASI. ResultsA total of 4,491 people completed the questionnaire, with 46.9% responses via CASI and 53.2% by paper. Completion of questions was greater for CASI than for paper for sexual behavior questions: number of sexual partners [odds ratio (OR), 6.85; 95% confidence interval (CI): 3.32, 14.11] and ever having had sex with a person of the same gender (OR, 2.89; 95% CI: 1.52, 5.49). The median number of questions answered was higher for CASI than for paper (17.6 vs. 17.2; P < 0.01). CASI was cheaper to run at $8.18 per questionnaire compared with $11.83 for paper. ConclusionElectronic devices using CASI are a tool that can increase participants' questionnaire responses and deliver more complete data for a sexual behavior questionnaire in primary care clinics.

Sexual experience and HIV-related knowledge among Belgian university students: a questionnaire study.

BackgroundAdolescents are a risk group for acquiring sexually transmitted diseases, including HIV. Correct knowledge about transmission mechanisms is a prerequisite to taking appropriate precautions to avoid infection. This study aimed at assessing the level of HIV-related knowledge among university students as a first step in developing targeted interventions. We used a self-developed HIV knowledge questionnaire, supplemented with socio-demographic and sexual behaviour questions. The questionnaire was composed of 59 items from different existing questionnaires. It included general statements and statements about prevention, transmission and treatment of HIV.ResultsThere were 357 (79.7%) female and 93 (20.3%) male participants and their median age was 20 (IQR 19–21). On average 42/59 (71.2%) questions were answered correctly, 5/59 (8.5%) were answered incorrectly and 12/59 (20.3%) were unknown . The best and worse scores were seen on the prevention questions and the treatment questions, respectively. HIV-related knowledge is higher in older students and in students with a health-related education. Students with sexual experience, with five or more partners and students who have been tested on STDs have a higher HIV-related knowledge.ConclusionsKnowledge on prevention and transmission of HIV is fairly good among university students and knowledge is higher among students with more sexual experience. They still have some misconceptions (e.g. HIV is spread by mosquitoes) and they are ignorant of a substantial number of statements (e.g. risk for infection through oral sex).

Sexual orientation differences in the relationship between victimization and hazardous drinking among women in the National Alcohol Survey.

This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n = 3,880), 2005 (n = 3,464), and 2010 (n = 3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms, and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared with three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3%). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (ORadj = 2.0, CI = 1.1-3.9, p < .01; bisexual (ORadj = 1.8, CI = 1.0-3.3, p < .05; heterosexual with same-sex partners (ORadj = 2.7; CI = 1.7-4.3, p < .001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women.

Improving the Validity of Self-Reported Sexual Behavior

Improving the Validity of Self-Reported Sexual Behavior