the advent of the HIV epidemic. The Behavioral Risk Factors Surveillance Survey supported by the CDC was originally developed to ascertain health behaviors related to chronic diseases such as heart disease, but has been modified to include questions regarding HIV/STD-related risk behaviors. A similar survey, the Youth Risk Behavior Surveillance System, designed to determine risk behaviors of teenagers, including sexual activity and alcohol and other drug use, has been developed by the CDC and implemented by schools nationwide. This survey is perhaps the best currently available source of information on the scope and frequency of STD-related behaviors among teenagers and is commonly used to develop effective prevention programs for adolescents (CDC, 1995d).

The National Center for Health Statistics, CDC, also sponsors health interviews with women regarding reproductive health issues. The National Survey of Family Growth provides important information regarding the self-reported prevalence of STDs and STD-related health behaviors among the general U.S. population. The National Survey of Adolescent Males is another federally funded survey that collects data on sexual behavior and contraceptive use from a nationally representative cohort of male adolescents 15-19 years old (Ku et al., 1992). Other health behavior surveys and studies that are not periodically administered have also produced important data regarding sexual behavior. For example, the National Health and Social Life Survey collected information from a probability sample of 3,432 American adults between 18 and 59 years of age in 1992 and produced the most comprehensive nationally representative data on sexual behavior among adults in the United States in many years (Laumann et al., 1994). In addition, a multiyear study, the National Adolescent Health Survey, jointly sponsored by several agencies, recently has completed data collection to examine the influence of family, peers, schools, and the community on adolescent health.

There is no evidence that participating in surveys of sexual behavior has a detrimental effect on sexual behavior. Halpern and others (1994) analyzed multiple study groups from three longitudinal studies of the effect of repeated administration of questionnaires regarding sexual behavior on male adolescents. They found no evidence that such questionnaires had an effect on sexual behavior.

Measuring and Evaluating Program Effectiveness

Data regarding federally supported projects collected by the CDC through state and local health departments consist primarily of output indicators that relate to laboratory reporting, community screening, case investigation, preventive and other clinical services, and gonorrhea, chlamydial, and HIV case detection. Other federal agencies, such as the Health Resources and Services Administration and the Health Care Financing Administration, collect information primarily related to the provision of direct health care services they support.

The committee is not aware of any nongovernmental organizations or associations that routinely collect data regarding STDs. However, the National Committee



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