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{{Short description|Factors affecting the validity and accuracy of self-reported sexual health behaviors}}
Self-Report Sexual Risk Behaviors
{{Tone|date=December 2023}}
 
'''Self-report sexual risk behaviors''' are a cornerstone of [[reproductive health]]–related research, particularly when related to assessing risk-related outcomes such as pregnancy or acquisition of [[sexually transmitted disease]]s (STDs) such as [[HIV]]. Despite their frequency of use, the utility of self-report measures to provide an accurate account of actual behavior are questioned,<ref name=Brody>{{cite journal|author=Brody, S.|year=1995|title=Patients misrepresenting their risk factors for AIDS|journal=Journal of STD and AIDS|volume=6|issue=6|pages=392&ndash;398|doi=10.1177/095646249500600603|pmid=8845395|s2cid=8989124|doi-access=free}}</ref> and methods of enhancing their accuracy should be a critical focus when administering such measures.<ref name=Anals1>{{cite journal|author1=K. E. E. Schroder |author2=A. D. Forsyth |author3=M. P. Carey |author4=P.A. Vanable |name-list-style=amp |year=2003|title=Methodological Challenges in Research on Sexual Risk Behavior: II. Accuracy of Self-Reports|journal=Annals of Behavioral Medicine|volume=26|issue=2|pages=104&ndash;123|pmc=2441938|doi=10.1207/S15324796ABM2602_03|pmid=14534028}}</ref><ref name=Archives1>{{cite journal|author1=L. S. Weinhard |author2=A. D. Forsyth |author3=M. P. Carey |author4=B. C. Jaworski |author5=L. E. Durant |name-list-style=amp |year=1998|title=Reliability and Validity of Self-Report Measures of HIV-Related Sexual Behavior: Progress Since 1990 and Recommendations for Research and Practice|journal=Archives of Sexual Behavior|volume=27|issue=2|pages=155&ndash;180|pmc=2452986|doi=10.1023/A:1018682530519|pmid=9562899}}.</ref> Self-reported assessments of sexual behavior are prone to a number of measurement concerns which may affect the reliability and validity of a measure, ranging from a participant's literacy level and comprehension of behavioral terminology to recall biases and self-presentation (or confidentiality concerns resulting from stigmatization of the behavior in question).<ref name=Anals1 /><ref name=Archives1 /><ref name=JAH1>{{cite journal|author1=N. D. Brenner |author2=J. O. G. Billy |author3=W. R. Grad |name-list-style=amp |year=2003|title=Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: Evidence from the scientific literature|journal=Journal of Adolescent Health|volume=33|pages=436&ndash;457|doi=10.1016/S1054-139X(03)00052-1|pmid=14642706 |issue=6|url=https://zenodo.org/record/1260192 }}</ref>
Self-report sexual risk behavior is a cornerstone of sexual health-related research, particularly when related to assessing risk-related outcomes such as pregnancy or acquisition of sexually transmitted infections (STIs) such as HIV. Despite their frequency of use, the utility of self-report measures to provide an accurate account of actual behavior are questioned (1) and ways to enhance their accuracy should be a critical focus when administering such measures (2-3).
 
Self-reported assessments of sexual behavior are prone to a number of measurement concerns that could affect the reliability and validity of a measure ranging from participants literacy level and comprehension of behavioral terminology to recall biases and self-presentation or confidentiality concerns resulting form stigmatization of the behavior in question (2-4).
ThusTherefore, the decision to incorporate a self-report measure of sexual risk behaviors is often one of practicality. Self-report measures are both inexpensive and more feasible than behavioral observation given the private nature of most sexual risk behaviors. To this end, the validity of self-reported sexual risk measures can be strengthened by the level of concordant answers obtained from sexual partners or obtained from sexual partners or through more objective measures of risk (such as the incidence of pregnancy, HIV or other STIs (2-3)STDs.<ref name=Anals1 /><ref name=Archives1 />
 
It is important to consider the way in which measures of self-reported sexual risk behaviors will be collected during the research development phase. Frequently self-report measures are self -administered, but canmay also be elicited from an interviewer, either face-to-face or overby the phonetelephone; such modalities help to address literacy and comprehension confounds but may increase the potential for self-presentation bias (2-3). The delivery of risk behavior assessments via the internet or computer can increase a sense of privacy, and may reduce self-presentation biases.<ref>{{cite journal|author1=D. Morrison-Breedly |author2=M. P. Carey |author3=X. Tu |name-list-style=amp |year=2006|title=Accuracy of Audio Computer-Assisted Self-Interviewing (5ACASI) and Self-Administered Questionnaires for the Assessment of Sexual Behavior|journal=AIDS and Behavior|volume=10|pages=541&ndash;552|pmc=2430922|doi=10.1007/s10461-006-9081-y|pmid=16721506|issue=5}}</ref>
 
In addition, a study was conducted by Durant, Carey and Schroeder in which 358 college students were examined to see effects of anonymity and confidentiality on responses. The confidentiality group, the members were asked to provide their personal information however were assured that they would be kept confidential. Whereas, in the anonymity group the members were simply not asked to provide their personal information. The results indicated that members of the confidentiality group answered much lower frequencies for questions about their health risk behaviors, and also had many more non-responses. In conclusion, this study demonstrated the vital value of collecting sexual behavior self-reports through a process of anonymity.<ref>Schroder K, Carey MP and Vanable PA. 2003. "Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports". ''Annals of Behavioral Medicine''. 26:2. 104–123.</ref>
Similarly, it is important to select a self-report sexual risk measure that meets the studies assessment needs. Dichotomous (yes/no) evaluation of engagement in risk behaviors (Risk Screening), assessing the level of risk via frequency of engagement in risk behaviors (Risk Assessments), and detailed event-level data related to the co-occurrence of other factors (e.g., alcohol use or primary vs. secondary partners) that may facilitate engaging in risk behaviors (Risk-event Data) are non-equivocal serving very distinct functions in evaluating self-reported risk behavior (3). ▼
 
▲Similarly, it is important to select a self-report sexual risk measure thatwhich meets the studiesstudy's assessment needs. Dichotomous (yes/no) evaluation of engagement in risk behaviors (Riskrisk Screeningscreening), assessing the level of risk via frequency of engagement in risk behaviors (Riskrisk Assessmentsassessments), and detailed event-level data related to the co-occurrence of other factors (e.g.,&nbsp;[[alcohol (drug)|alcohol]] use or primary vs.versus secondary partners) that may facilitate engaging in risk behaviors (Riskrisk-event Datadata) are non-equivocalunequivocal, serving very distinct functions in evaluating self-reported risk behavior (3).<ref name=Archives1 />
Attention should also be paid to the period of time in which self-reported risk measures ask individuals to recall the occurrence/frequency of engaging in risk behavior, generally recalling frequency of risk behaviors over a period of approximately 3 months supports recall accuracy (2). ▼
 
▲Attention should also be paid to the period of time inover which self-reported risk measures ask individuals to recall the occurrence/ and frequency of engaging in risk behavior,; generally, recalling frequency of risk behaviors over a period of approximately 3three months supports recall accuracy (2).<ref name=Anals1 />
References▼
 
==The interrelationship of self-reported sexual risk behavior and STI status==
1. Brody, S. (1995). Patients misrepresenting their risk factors for AIDS. Journal of STD and AIDS, 6, 392-398.
The self-reported STI-like symptoms and unsafe sexual behavior taken together as a [[prediction|predictor]] of confirmed&nbsp;STIs improve the sensitivity to a significantly greater degree (χ&nbsp;2&nbsp;=&nbsp;2.83, p&nbsp;<&nbsp;0.05) as compared to the sensitivity of self-reported STI-like symptoms or unsafe sexual behavior alone as a predictor of confirmed&nbsp;STIs. In addition, the consistency of self-report was found to vary among socio-demographic and behaviorally defined sub-groups. These results provide preliminary support for the importance of population-based surveys, which collect all the three types of data such as reported behavior, symptoms and laboratory confirmed&nbsp;STIs for a full understanding of sexual risk and STIs and for identification of sub-groups within communities that vary in their ability to identify STI symptoms.<ref>Niranjan Saggurtia, Stephen L. Schensulb, Ravi K. Vermac, [http://www.tandfonline.com/doi/abs/10.1080/09540121.2010.487087 "The interrelationship of men's self-reports of sexual risk behavior and symptoms and laboratory-confirmed STI-status in India"], ''AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV'' '''23'''(2): 163–170, 22 Jan 2011</ref>
 
==See also==
2. Schroder, K. E. E.; Forsyth, A. D.; Carey, M. P.; Vanable, P.A. (2003). Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports. Anals of Behavioral Medicine, 26(2), 104-123.
* [[Safe sex]]
 
▲==References==
3. Weinhard, L. S.; Forsyth, A. D.; Carey, M. P.; Jaworski, B. C. and Durant , L. E. (1998). Reliability and validity of self-report measures of HIV-related sexual behavior: Progress since 1990 and recommendations for research and practice. Archives of Sexual Behvior, 27(2), 155-180.
<references />
 
{{Reproductive health}}
4. Brenner, N. D.; Billy, J. O. G.; and Grad, W. R. (2003). Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: Evidence from the scientific literature. Journal of Adolescent Health, 33, 436-457.
 
[[Category:Epidemiology]]
5. Morrison-Breedly, D.; Carey, M. P.; and Tu, X. (2006) Accuracy of Audio Computer-Assisted Self-Interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS and Behavior, 10, 541-552.
[[Category:Sexual health]]
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