An Analysis of Adolescence Sexual Activities

Adolescent Sex
Running Head: ADOLESCENT SEXUAL ACTIVITIES
An Analysis of Adolescent Sexual Activities
In the Transition from High School to University
Eun-Jin Kim Han, Sarah Blom, and Ronald G. Hanson
Michigan State University
CEP 822 Final Project
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Abstract
With the transition to college, high school students face many new situations and challenges.
One of these is the potential for increased sexual activity. This study will examine the
experiences of students as they transition from high school to college to determine if there is an
increase in sexual activity among students as they transition from high school to
college/university. A sexual activity survey questionnaire will be used at the start of the first
year of college and again at the conclusion of the first year of college to collect data from
students on their sexual experiences and attitudes. The sample will be comprised of one hundred
fifty senior high school students who have enrolled in Michigan State University in East Lansing
Michigan. It is hypothesized that students who are transitioning from their last year of high
school through their first year of college will experience an increase in heterosexual sexual
activity. This study will demonstrate the importance of understanding the change in sexual
behaviors that occur as high school students transition to college and the necessity to address
sexual issues as part of the curriculum during the freshman year of college.
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Problem Statement
As adolescents transition from the high school environment to the college or university
environment, they are faced with many choices and decisions. Some of these decision-makings
they have already experienced; other decisions will be first time decisions and choices. A major
area of their lives that they will have to face is that of sexual activities. Current statistics from
the Youth Risk Behavior Survey – United States, 2003, state that 46.7% of 9th to 12th graders in
America had experienced sexual intercourse during their life. For 12th graders, the group that
will be transitioning into college, 61.6% had had sexual intercourse, 20.3% had four or more sex
partners, and 48.9% of 12th graders were currently, during the survey, sexually active; 57.4%
used a condom at last intercourse. With the transition to the university, it is important to see if
adjusting to life in the university setting makes a difference in the attitudes and behaviors of
adolescents toward sexuality. If there is a marked increase in sexual behaviors, then it is
important that adolescents be provided with information during this time period to guide their
decision-makings and activities, so that they can make not only informed decisions, but also
decisions that will be crucial to their future health and well-being, such as the decisions of
avoiding an unwanted pregnancy, avoiding a sexually-transmitted disease or HIV/AIDS, or
learning how to best navigate the intimacies of a relationship.
The purpose of this proposal is to examine the sexual activities of adolescents as they
transition from high school to college or university settings: This research study includes two
parts: first getting a baseline survey of current and past sexual activities of the freshmen as they
begin their freshmen year in college or university, and then survey those freshmen again at the
conclusion of their freshmen year to determine if their year in college led to an increase in sexual
activity. If these two surveys demonstrate an increase in sexual activities, then the results
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obtained can then be used in developing and implementing an intervention program for all
freshmen students. It is expected that this intervention program will take into account the types
of experiences that they may encounter in the college or university setting.
The sexual activity questionnaire (see Appendix A) was developed to examine the
experiences of students as they transition from high school to college to find out whether or not
there is an increase in sexual activity during the transition from high to college. The
questionnaire was also designed to personalize the sexual risks and responsibilities of college
freshmen and to identify sexual behaviors and attitudes among this student population. The
survey is patterned after the Sexual Activity Survey conducted by Flannery and Ellingson
(2003). Content included sexual risk, students’ attitudes on sexual activity, and sexual selfefficacy items.
Literature Review
College freshmen represent a special population of interest as young adolescents move
from a protected parental atmosphere to a more open unrestricted environment with exposure to
influences and opportunities that they have not previously had, or not had to the same degree.
More access to alcohol and drugs, greater opportunities for sex and sexual experimentation and
risk-taking, are just a few of the situations that youth can be faced with, and the necessity to
make decisions with regard to them. A review of the literature found no studies that specifically
examined this transition period from high school to college and its effects on adolescent
sexuality.
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Environment
& Peers
Variables Affecting
Sexual Activity
Values &
Attitudes
Experimentation
Sexual
Activity
Education
Alcohol
& Drugs
Consent
Most studies focused on a particular aspect of teen sexuality, such as religiosity (Zaleski,
Schiaffino & Kathreen, 2000; Beckwith & Morrow, 2005), use of alcohol (Ramrakha et al.,
2000; Weinhardt & Carey, 2001; Goldman et al., 1999; Monahan, Murphy & Miller, 1999), use
of contraceptive devices (Siegel et al., 1999; McDonald, McDonald, et al., 2000), various sexual
risk behaviors and sexual activities (Ramrakha et al., 2000; Reinisch et al., 1995; Siegel et al.,
1999; Weinhartdt & Carey, 2001), influences on sexual activity (Maticka-Tyndale et al., 1998;
Dworkin, 2005; Kalmuss et al.), norms and attitudes of youth (Lance, 2004; McAnulty &
Burnette, 2003; Knox & Zusman, 2001), and a variety of other factors. It therefore seems then
that this research can provide an important new perspective on how college life affects
adolescent sexuality.
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Adolescents transitioning from high school to college experience great developmental
change. First-year college students navigate a newfound independence in relation to their
environment, as well as personal exploration opportunities involving values, education,
sexuality, and numerous risk behaviors associated with each.
For “emerging adults”, considered approximately ages 18 to 25, this developmental
period often involves the transition to a university (Lefkowitz, 2005). A university environment
provides an exposure to new relationships, differing opinions, and the opportunity to question
one’s own ideals. As described by Zalenski and Schiaffino, “the transition to college introduces
issues regarding identity and identity exploration, leading the adolescent to experiment with
possible adult roles, including sexual behavior,” (2000, pg. 226).
Navigating the many variables that impact sexual activity among college students is a rite
of passage for most emerging adults. To specifically investigate how these variables influence
adolescents transitioning from high school into college, it is necessary to first examine their
sexual behavior prior to the university experience.
According to Centers for Disease Control and Prevention, almost one-half of U.S. high
school students have had sexual intercourse in their lifetime (2002b). Regarding gender, several
studies have reported that men initiate intercourse at an earlier age than women (Ompad et al.,
2006). This statement is supported by the National Longitudinal Study of Youth, which reported
that the median age of first sex was younger for boys as compared to girls (15.9 and 16.1 years
respectively) (Mott et al., 1996). Thus, the average college freshman has experienced some level
of sexual activity upon entering their first year of school.
Given these statistics, how does an individual’s sexual activity change with the transition
to a college environment? Balancing values and relationships in a transforming environment
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filled with autonomy and risky behavior can be challenging for most first-year college students.
According to previously published literature, there are many variables that impact the sexual
behavior of college freshman.
Values
One of the primary foundations for an individual’s value system is religious belief. Prior
to reaching college, most emerging adult’s religious activity and beliefs are controlled by their
parent or guardian. Upon reaching college, a freshman must now attempt to remain steadfast in
their religious values in an environment that encourages new experiences and questioning
previous ideals. Religious beliefs have an impact on a college student’s sexual activity.
Sexually active students have lower levels of religiosity (Zalenski and Schiaffino, 2000).
Students who place great importance on adhering to the beliefs of their particular religion are
less likely to engage in sexual activity. Religion and values impact not only levels of sexual
activity, but also the behaviors associated with those activities.
Zalenski and Schiaffino further this discussion by noting that religiosity may be a
protective factor for sexual risk-taking, but also may be a contributing factor for unsafe sex
(2000). Because certain religions prohibit the use of contraception, unprotected sexual activity
increases pregnancy and sexually transmitted diseases. In fact, 22% of females and 33% of males
use no contraception for their first ever-sexual activity (Siegel et al., 1999). The value system is
important to not only sexual activity levels, but also the risk behaviors associated with sexual
activity.
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Environment
Another key variable in the sexual activity levels of first-year college students is the
environment itself. Students within a university find themselves without parental supervision as
they attempt to navigate surroundings littered with risk behavior and peer pressure.
Eva Lefkowitz studied environment and the changes in college student attitude and
sexual behavior, based on their surroundings. She found that students who are concerned with
environmental changes tend to be more recent university students; students who are more
concerned with attitude and behavior changes are more likely to have been at the university
longer (Lefkowitz, 2005). Students new to college were most concerned with their new
environment, whereas students who have been in the college atmosphere longer became more
concerned with how attitudes and behaviors were changing as a result of the environment.
A seeming rite of passage for the college-aged student is the spring break vacation with
friends. This excursion creates a particularly risky and experimental environment for college
students with regard to sexual activity. In a survey of college students on spring break, it was
determined that sexual activities were guided by intentions and expectations, as well as peer
influences. In fact, peers provided a greater influence on women than men relative to sexual
activity on spring break (Maticka-Tyndale et al., 1998). Peer expectations and influence seem to
be a major factor in the sexual activities that occur among the college-aged students while on
spring break.
The university environment encourages students to reflect upon themselves, their
behavior, and examine the principles that will guide their lives. The environment is ripe for
experimentation, and it is a necessary passage for college students. According to Dworkin, the
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college atmosphere promotes experimentation, and in certain situations, how experimentation is
developmentally appropriate for students (2005).
Experimentation
Experimentation is related to decisions students make, and it gives them an opportunity to
test their limits and try new things and new experiences, or to question things such as religion or
personal ideals. The college environment provides a culture more conducive to experimentation
with its vast array of people, new ideas, and opportunities to experiment.
According to Dworkin, the period of college exploration is typified by Erickson’s
“moratorium” period – a time of transition as people seek their societal niche. These students
listed two major transitions as accounting for their high rate of experimenting; (1) the transition
from high school, and (2) the transition to having a greater level of independence (Dworkin,
2005). For these students, their period of “moratorium” is an important phase as they attempt to
figure out who they are, and doing this through experimentation. The transition period is a
necessary and important part of their development into adulthood, and experimentation is a key
part of that phase.
Sex Education
Institutions of higher education and of secondary education in the United States realize
that some sort of sex education must be present. According to the research conducted by Fields
(2002), typical educational efforts in sex education for students range from condom distribution
and information on birth control to the prevention of sexually transmitted diseases and
workshops on appropriate relationship behavior and protection against sexual assault. In order to
ensure the well being of entire campus community, the above services are essential. Most of all,
students who choose to be sexually active encounter the challenge of protecting themselves from
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unwanted pregnancy and sexually transmitted diseases (STD). As various researches on sexual
activities of university students have shown, differential socialization has lead to gender
differences in sexual attitudes, behaviors and information.
Despite differences between men and women in these areas, there needs to be a change in
the same direction for both genders: sexual responsibility (ibid). As Fields (2001) specifically
pointed out, teaching students appropriate sexual behavior is not an easy task and this kind of
work is best done early in a student's life by their parents. However, there are not many students
who have had the benefit of their parental guidance when it comes to sex education. Parental
guidance is one of the most influential factors in sex education: teenagers who perceive that their
mother disapproves of their having sex or who talked with their mother about condom use before
first intercourse are less likely than others to become sexually active or to fail to use condoms
(Kalmuss et al., 2003).
According to Kalmuss et al., sex education programs should begin earlier and target
younger adolescents to prevent sexual risks. Kalmuss et al. suggested that primary health care
providers should be screening and counseling youth regarding puberty, sex and sexual risk
behaviors at younger ages than they currently do because adolescents who experience early
puberty are at increased risk for early sexual activity (2003).
Alcohol and Drugs
Being that college is an environment of experimentation, increased alcohol and drugs use
become two significant risk behaviors students engage in. Substance abuse is a contributing
factor to risky behavior with adolescents as well as adults, and often, this behavior leads to
increased sexual activity. Adolescents with substance disorders were 2.1 times more likely to
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have initiated sexual intercourse before age 16 as compared to non-substance using adolescents
(Ramrakha et al., 2000).
“A large number of global association studies suggest a direct correlation between
patterns of alcohol use and risky sexual behavior; that is, individuals who report heavier and
more frequent alcohol use tend to report more unsafe sex,” (Weinhardt & Carey, 2001, as cited
in Maisto et al., 2004, pg. 571). Alcohol dims some of the inhibitions individuals place on
themselves due to value systems, and thus, contributes to an increased frequency of unprotected
sex.
Not only does alcohol contribute to increased sexual activity in emerging adults, but also
it facilitates the belief that alcohol will create better sexual experiences. Beliefs (expectancies)
that alcohol enhances sexual experiences may lead to the initiation or continuation of alcohol use
in contexts where a sexual encounter is anticipated (Goldman et al., 1999). Similarly, in a study
where young adult men were given either alcohol or a placebo, the individuals who believed they
drank alcohol reported more confidence than individuals who believed they had not consumed
alcohol (Monahan, Murphy, & Miller, 1999). In college-aged students, alcohol is not only used
to elevate sexual activity, but also to provide a perceived boost of confidence.
Alcohol abuse and increased sexual activity leads to an increased possibility of having
unprotected sex. In addition to risky sexual activity, alcohol impairs one’s ability to negotiate
sexual encounters with prospective partners. “Alcohol intoxication is positively associated with
perceived likelihood of having sex without a condom and impairs condom use negation skills,”
(McDonald, McDonald, et al., 2000; Gordon et al., 1997, as cited in Maisto et al., 2004). The
administration of alcohol caused greater intentions to engage in unprotected sex and impairment
of skills in negotiating safer sex.
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Consent
Impairing negotiation skills within a sexual context leads to mixed signals regarding sex
and consent between partners. Communication problems in our society are prevalent, with men
and women interpreting behavior differently and coming to alternate conclusions about the same
behaviors.
A highly publicized Antioch University policy on sexual behavior states that “consent’
shall be defined as follows: the act of willingly and verbally agreeing to engage in specific
sexual contact or conduct,” (Hall, 1998). There is a stereotype that exists that indicates that
women say “no” to sex when they really mean “yes” (token resistance). In an attempt to
investigate whether token resistance behavior actually happens, Muehlenhard and Hollabaugh
(1988) studied college women. Of 610 participants, 39.3% reported they had said no to sexual
intercourse when they meant yes, at least once. The results from this experiment indicate that
much of the sexual activity of college students proceeds without much verbal permission
granting, and there is a high reliance on nonverbal permission. Muehlenhard further summarizes
studies that show men are more likely than women to interpret specific behaviors as indicators of
interest in sex.
All of these factors, given the highly charged sexual atmosphere for college-aged
students, can lead to misinterpretations of consent and intent, and create unhealthy and unsafe
sexual environments for emerging adults.
Attitudes and Behaviors related to Sexual Activity
A variety of studies have been conducted to indicate the differences in the sexual
attitudes and behaviors of female and male university students. Of those, Lance (2004) examined
the contemporary sexual attitudes and perceived sexuality information of university students,
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focusing on the attitudes of college students toward contraceptive in consideration of gender
differences. According to him, there is a “contraceptive gap” among young people: there is a
time lapse between the onset of sexual activity and the use of contraceptives while a large
majority of young males and females become sexually active. As a result of this lack of sexual
responsibility among teenagers, there have been over a million teenage pregnancies each year in
the U.S.
As Lance pointed out, university men's and women's attitudes towards sex seem to have
coincided over the years; nevertheless, differences still exist. In the past men generally held more
positive attitudes towards sex than women, feeling less guilt for sexual behavior, feeling that sex
is a natural social evolution of relationships, resulting in a more open attitude regarding sex.
Therefore, men participated in wider sexual behaviors than women as a result of positive
attitudes about sex. Gender role socialization and expectation seems to be key factors in gender
differences in sexual attitudes and behaviors of university students as well.
It is generally assumed that men are more sexual than women; that men have stronger
and more readily stimulated sexual appetites and that they find sex more pleasurable than women
in modern American culture (ibid). According to McAunlty and Burnette (2003), different
factors play a part in the involvement in sexual intercourse. In addition, perceived peer norms are
involved in the timing of sexual intercourse as well. That means if teens have friends who are
involved in sexual activities, they tend to be more inclined to start sexual activities themselves.
The research regarding the impacts of religiosity and spirituality on the sexual attitudes of
college students conducted by Beckwith and Morrow (2005) has shown that religiosity and
spirituality were significantly negatively correlated with conservative attitudes about sex.
Religiosity and spirituality were significantly positively related. Beckwith and Morrow
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hypothesized that religiosity would be related with more conservative sexual attitudes and that
students who possessed qualities that defined them as spiritual would also demonstrate more
conservative attitudes about sex. As assumed, the result of the study showed that religiosity was
significantly related to permissiveness, sexual practices, and the instrumentality sexual attitude
factor; religiosity was not related to communion in the relationship. Therefore, according to the
research, the more religious a person tends to be, the more likely he or she will also hold
conservative attitudes about sex.
Knox and Zusman (2001) also attempt to identify the social correlates of sexual values
among a sample of university students. In their study, six hundred and twenty never-married
undergraduates at a large southeast university identified the sexual values that guide their
behaviors in sexual decision making. Each student completed a questionnaire that evaluated his
or her sexual value system as one of absolutism, relativism, or hedonism. Analysis was run by
sex, race, age, relationship status, and a series of Likert-scored questions related to students’
attitudes on sexual value. Both men and women were more relativistic than absolutist or
hedonistic. However, male students were six times more hedonistic than were female students.
Other factors significantly associated with hedonism included being over age 20, uninvolved in a
relationship, being open to living together, and a belief that divorce was justifiable. Overall, this
research has shown that university students today are predominantly relativistic in their sexual
beliefs. Whether or not they have intercourse is a decision that can only be made in reference to
the context of the relationship with the partner.
According to Knox, Cooper, and Zusman (2001), traditionally, women have been
socialized to be more concerned about relationship context--commitment and security--as a
condition for sexual expression than men. They also claimed that men have traditionally been
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more sexually aggressive and pleasure focused independent of the relationship context than
women.
Association of Sexual Activity with Academic Achievement
Schvaneveldt, Miller, Berry and Lee (2001) found that there is a negative correlation
between the age of one’s first sexual intercourse and one’s academic performance based on their
longitudinal study. They tried to address two main questions in their research: First, do
adolescents' previously measured academic values and achievement predict their age at first
sexual intercourse? Second, does the onset of sexual activity predict later measured academic
values and achievement? They hypothesized that people who are sexually active will perform
differently academically than those who are not sexually active. It was further hypothesized that
students who are sexually active and in relationships will perform differently than students who
are sexually active and not in relationships. Research has been done on the age at which one has
sexual activity as well. The younger the age at which one has sexual intercourse is negatively
correlated with lowered academic performance and goals (Schvaneveldt et al., 2001).
Quatman et al. (2001) also found a negative correlation between dating frequency and
academic achievement in high school students. Furthermore, Quatman et al. also pointed out that
dating frequency and academic motivation to be negatively correlated as well. Therefore, based
on the study conducted by Quatman et al., we can see that there is an interaction between dating
and grade point average.
According to various studies on the relationship between academic achievement and
sexual activity, adolescents with higher educational achievement and goals are more likely to
delay sexual activity than those with lower educational achievement and goals since having
sexual intercourse at an early age could lower educational interest, goals, and achievement.
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Method
Participants
The subjects of this study are 150 (75 males and 75 females) 17-19 year-old freshman
students of Michigan State University in East Lansing, Michigan. Students are of varied
ethnicities and socioeconomic status and will be full-time university students. All subjects will
have graduated from public high schools in the spring of 2006, and entered university in the fall
of 2006.
Instrumentation
The instrumentation for this research is a survey questionnaire. Participants will be
informed that they will be completing two pencil and paper surveys during their freshman year,
once within the first four weeks of school (T1), and the second (T2) in the final four weeks of the
freshman year. Participants will be paid $15 to complete the first survey and $25 to complete the
second survey. The increased incentive is offered as a means of avoiding mortality during the
year.
The instrument that will be used will be a modified version of the Sexual Activity Survey
by Diana Flannery and Lyndall Ellingson. The questionnaire was designed to look at sexual
behaviors and attitudes of college freshmen in regards to sexual risk factors and risk prevention
measures, sexual practices, sexual orientation, sex drive and body image.
A sample questionnaire is provided in Attachment A.
Piloting
University professors familiar with the survey questionnaire process will review the
questionnaires and the process in order to reveal any potential problems or weaknesses either in
instrument design or in the procedures employed. . Additionally, a group of twenty-five students
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will pilot the process to make sure that the process works smoothly and that the results can be
appropriately tabulated.
Procedure
Data will be collected via the questionnaire that is completed at the beginning of the
freshman year and again at the completion of the freshman year. The participants will be
randomly selected from a pool of applicants who will have responded to an invitation to
participate as part of their freshmen orientation packet. All incoming freshmen will be invited by
means of a letter along with a coded card in their orientation packet. Students will be informed
that the survey has to do with sexuality, but not of the specific purpose in order to prevent any
possible bias. Those who choose to participate will turn in one-half of the card and retain the
other half, both of which will be coded, with an M or an F for male or female, followed by a
unique identifier number. From those cards an equal number of males and females will be
selected, and those who are chosen to participate will respond with their card to participate and
to receive their incentive. Among those who volunteer, 150 students will be randomly selected
to participate. All students volunteering will be categorized by gender only, and an equal
number of subjects will be randomly selected for each gender, 75 males and 75 females.
Participants will also sign a university participation form. The results of this study will only
generalize to the population of students who might typically attend this university having come
from public high schools.
Research staff will oversee the administering of the survey, and will also assist by
answering any questions. The surveys will be administered in a large classroom configured so
that students are not able to see the answers of other students.
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Completed surveys will be placed in an individual envelope that each student has and
then collected from the students. Each survey will have a bar coded identifier number on it. It is
estimated that each survey will take approximately 30 minutes to complete.
Analysis
Responses to individual questions by each student will be recorded by a trained coder and
entered into a computer database. Questionable markings on the survey response form will be
discussed with the principal researcher. Computer generated reports, bar graphs, pie graphs, and
other formats will be used to display the resultant data. Observed trends will be communicated
via a report that will summarize the findings of the surveys. Nonparametric techniques would be
most appropriate for this study in that few if any assumptions are made about the sample. ChiSquare would be the inferential statistical technique most appropriate for this study. Logistic
regression would also be used in the analysis of the data.
Data obtained from the survey will be separated into categories by gender and sexual
experience. Data analysis involves using the parametric techniques T-test to compare the two
sets of data. For the survey from the beginning of the freshman year in college, we can obtain
the mean and standard deviation for sexual activities of the participating students. We would do
the same thing for the survey taken at the completion of the freshman year. By using the t-test
we can discover if there are statistically significant differences between the two data sets. We
will be able to demonstrate that there was an increase in sexual activity if the mean from the
second survey is higher than the first.
The questionnaire that is being used has face validity. Additionally, the validity of the
instrument would be determined through content-related evidences of validity. To accomplish
this, a minimum of three qualified university researchers in the human sciences field (sociology,
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ethnology, human ecology, psychology) would be selected to review and critique the instrument.
They will provide their responses based on whether or not they feel the instrument measures
what it is intended to measure based on the characteristics of the sample.
Reliability of the instrument will be determined using the split-half reliability SpearmanBrown Prophecy Formula. Definitions of specific terms are provided to make sure respondents
understand what they are replying to.
Potential limitations
The sample was restricted to adolescents who were public high school students and who
participated in the freshmen orientation. Students from parochial or private high schools were
not included thus the sample is not reflective of the general population of freshmen college
students. Students who decided to participate may have done so for monetary reasons only, and
thus students who had no need for financial remuneration would not have participated, thus the
participants may be reflective of a certain socioeconomic status.
Due to the fact that participants in this survey are not totally random, we are forced to
include in the survey only those who have elected to participate. In so doing we run the potential
for subject bias from the standpoint that those who participate in the survey may be sexually
experienced versus those who are not sexually experienced and may not choose to participate in
the survey.
Definitions
Sexual intercourse is defined as the penis in the vagina.
Anal intercourse is defined as the penis in the rectum.
One night stand is defined as a one-time sexual encounter with a member of the opposite
sex with no intention of forming a relationship.
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Oral-genital sexual play is described as mouth-penis or mouth-vagina play.
21
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24
APPENDIX A
SEXUAL ACTIVITY SURVEY
PLEASE DO NOT PUT YOUR NAME ON THE QUESTIONNAIRE. Your honesty in responding to
the statements is very important. Be sure to answer every question, even if it does not apply.
1. What is your sex?
A. Female
B. Male
2. What is your age? ___________________
3. Have you ever had sexual intercourse?
A. Yes
B. No
4. How old were you when you had sexual intercourse for the first time?
A. I have never had sexual intercourse
B. ___________________years of age
5. During your life, with how many people have you had sexual intercourse?
A. I have never had sexual intercourse
B. ___________________number of partners
6. During the past 9 months, with how many people did you have sexual intercourse?
A. I have never had sexual intercourse
B. I have had sexual intercourse, but not during the past 9 months
C. 1 person
D. 2 people
E. 3 people
F. 4 people
G. 5 people
H. 6 or more people
7. Did
A.
B.
C.
you drink alcohol or use drugs before you had sexual intercourse the last time?
I have never had sexual intercourse
Yes
No
8. The last time you had sexual intercourse did you or your partner use a condom?
A. I have never had sexual intercourse
B. Yes
C. No
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9. The last time you had sexual intercourse, what one method did you or your partner use to
prevent pregnancy? (Select only one response.)
A. I have never had sexual intercourse
B. No method was used to prevent pregnancy
C. Birth control pills
D. Condoms
E. Depo-Provera (injectable birth control)
F. Withdrawal
G. Some other method
H. Not sure
10. How many times have you been pregnant or gotten someone pregnant?
A. 0 times
B. 1 time
C. 2 or more times
D. Not sure
11. Regarding your sexual orientation, you are primarily?
A. Heterosexual
B. Gay/lesbian
C. Bisexual
D. Don’t know
12. Have you ever engaged in sexual play with someone of the same sex?
A. Yes
B. No
13. Which of the following best describes your oral-genital sexual play?
A. Does not apply
B. Received and given equally
C. I usually give more than I receive
D. I usually receive more than I give
14. How often have you had sexual intercourse on a "one night stand" over the last 9 months?
A. Never
B. Once
C. Two to Three times
D. Four or more times
15. Have you ever engaged in anal intercourse?
A. Yes
B. No
16. If you answered yes to anal intercourse was a condom used?
A. I have never engaged in anal intercourse
B. Always
C. Sometimes
D. Never
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17. How would you describe your sex drive?
A. Very strong
B. Somewhat strong
C. Not very strong
D. No sex drive
18. Are you happy with the way your body looks?
A. All of the time
B. Most of the time
C. Sometimes
D. Rarely
E. Never
19. Have you ever experienced forced sexual intercourse?
A. Yes
B. No
20. Have you ever forced someone to engage in sexual intercourse with you?
A. Yes
B. No
Footnote: Permission to use Sexual Activity Survey was received from Diana Flannery.