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Related Experiment Video

Updated: Jul 25, 2026

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
06:15

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Does measured behavior reflect STD risk? An analysis of data from a randomized controlled behavioral intervention

T A Peterman1, L S Lin, D R Newman

  • 1National Center for STD, HIV, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. tap1@cdc.gov

Sexually Transmitted Diseases
|September 15, 2000
PubMed
Summary

Measuring sexual behavior alone is insufficient to determine the effectiveness of STD/HIV prevention interventions. People often engage in risky behaviors with safe partners and safe behaviors with risky partners, complicating direct correlation.

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Area of Science:

  • Public Health
  • Epidemiology
  • Behavioral Science

Background:

  • Assessing the efficacy of sexually transmitted disease (STD)/HIV prevention interventions often relies on measuring sexual behavior.
  • A gap exists in understanding how well measured sexual behavior accurately reflects actual STD incidence.

Purpose of the Study:

  • To evaluate the correlation between measured sexual behaviors and the incidence of STDs.
  • To assess the utility of behavioral data in predicting STD prevention intervention efficacy.

Main Methods:

  • Analysis of data from Project RESPECT, a trial involving 2879 participants.
  • Comparison of self-reported sexual behaviors with laboratory-confirmed STD incidence (gonorrhea, chlamydia, syphilis, HIV) over two 6-month intervals.

Main Results:

  • 8.9% of participants acquired a new STD within a 6-month period.
  • Sexual behavior, including number of partners and unprotected sex acts, showed only a slight association with STD incidence.
  • Paradoxical associations were observed, with a limited STD incidence ratio (1.7) even when comparing highest and lowest risk behaviors.

Conclusions:

  • While behavioral interventions have contributed to STD prevention, measured behavior alone is a poor predictor of STD incidence.
  • Complex patterns of risk-taking, such as engaging in safe sex with high-risk partners and vice versa, complicate direct extrapolation of intervention efficacy.
  • Future STD/HIV prevention research should consider more comprehensive measures beyond self-reported sexual behavior.