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Context: Sexually transmitted diseases (STDs) of bacterial origin such as gonorrhea and chlamydial infection can lead to pelvic inflammatory disease (PID) and infertility. Identifying behaviors and characteristics associated with infection may assist in preventing these often asymptomatic diseases and their sequelae., Methods: Data from 9,882 sexually active women who participated in the 1995 National Survey of Family Growth describe the characteristics of women who report a history of infection with a bacterial STD or of treatment for PID. Multivariate analysis is used to determine which demographic characteristics and sexual and health-related behaviors affect the likelihood of infection or the occurrence of complications., Results: Overall, 6% of sexually active women reported a history of a bacterial STD, and 8% reported a history of PID. Women who first had sexual intercourse before age 15 were nearly four times as likely to report a bacterial STD, and more than twice as likely to report PID, as were women who first had sex after age 18. Having more than five lifetime sexual partners also was associated with both having an STD and having PID. PID was more common among women reporting a history of a bacterial STD (23%) than among women who reported no such history (7%). In multivariate analyses, age, race, age at first intercourse and lifetime number of sexual partners had a significant effect on the risk of a bacterial STD. Education, age, a history of IUD use, douching and a history of a bacterial STD had a significant impact on the risk of PID, but early onset of intercourse did not, and lifetime number of partners had only a marginal effect., Conclusions: The pattern of characteristics and behaviors that place women at risk of infection with bacterial STDs is not uniform among groups of women. Further, the level of self-reported PID would suggest higher rates of gonorrhea and chlamydial infection than reported.

Surveys of risk behaviors have been hobbled by their reliance on respondents to report accurately about engaging in behaviors that are highly sensitive and may be illegal. An audio computer-assisted self-interviewing (audio-CASI) technology for measuring those behaviors was tested with 1690 respondents in the 1995 National Survey of Adolescent Males. The respondents were randomly assigned to answer questions using either audio-CASI or a more traditional self-administered questionnaire. Estimates of the prevalence of male-male sex, injection drug use, and sexual contact with intravenous drug users were higher by factors of 3 or more when audio-CASI was used. Increased reporting was also found for several other risk behaviors.

Background and Objectives: Arguments for population-based research on patterns of sexual behavior are reviewed, and survey data are used to illustrate the insights that can be gained from such research., Study Design: Reports of sexual behavior obtained in surveys of large probability samples of the U.S. population are analyzed and compared to make inferences about changes in the age of onset of sexual intercourse and the patterns of heterosexual and same-gender sexual behaviors of American men and women who entered adulthood during the period from 1930 to 1990., Results: Strong trends are documented for both a decline in the reported age at first heterosexual intercourse and an increase in the numbers of heterosexual partners reported during adulthood. Similar evidence on patterns of same-gender contact indicate a relatively stable prevalence of reported male-male contact for cohorts of men born from the 1930s through the 1960s. Preliminary analyses suggest, however, that there has been a substantial increase in the proportion of women reporting female-female sexual contact during adulthood. Although the analyses require refinement, it appears that the prevalence of reported female-female contact may have increased by a factor of 3 to 4 for cohorts of women born between the 1930s and the 1960s., Conclusions: Although the trends in reported behaviors are robust, inferences about behavior, pre se, rest on the assumption that reporting biases were equivalent across cohorts. Methodological challenges in the interpretation of such findings and new technologies for conducting such research are described.