Health behavior research provides the basis for developing interventions to prevent high-risk sexual behaviors. Population-based surveys mentioned in Chapter 5 that collect information on STD-related health behaviors are critical for monitoring trends in health behaviors among the general population and in developing effective interventions. In addition to improving STD prevention efforts, research on sexual behavior has direct benefits in improving prevention programs for HIV and unintended pregnancy. To address the barriers to adoption of healthy sexual behaviors, there needs to be considerably more research regarding the psychological and sociocultural, including religious, factors responsible for the secrecy surrounding sexuality and additional evaluation of approaches (that are respectful of individual beliefs) to successfully overcome these barriers. There is limited information available regarding the origins of sociocultural strictures on open discussion of sexuality and STDs. Understanding this factor should be useful in developing strategies to overcome societal constraints on preventing STDs.
Population-based surveys and studies to assess STD-related health behaviors are not only justified but are necessary for the development of effective interventions to prevent high-risk behaviors. Such surveys, particularly those for adolescents, have been severely criticized by some policymakers and interest groups. This committee, while recognizing the sincere concerns expressed by some of these groups, strongly believes that collecting information on STD-related health behaviors, especially among adolescents, is critical to STD prevention, because sexual behaviors are usually initiated during adolescence. The committee found no evidence to support the belief that asking questions about sexual activity in any way promotes or increase sexual activity among survey respondents or changes attitudes of respondents regarding these activities (Halpern et al., 1994). Without data on sexual behaviors, it is more difficult to prevent the very behaviors that concern the critics of such surveys.
Federal legislation has been introduced that would require prior written parental consent for minors to participate in federally funded survey research if the survey or questionnaire contains questions in several specific areas, including sexual behavior.1 The committee strongly believes that such restrictions would seriously jeopardize both behavioral research and the ability to prevent high-risk behaviors among adolescents. Requiring parental consent or prior written consent for a minor's participation in survey research would make it practically impossible to conduct research in settings where minors obtain confidential health services, such as STD and family planning clinics, because parents could not be notified. Yet it is precisely in these types of settings that it is particularly important