Misclassification bias: diversity in conceptualisations about having 'had sex'

Abstract

These findings highlight the need to use behaviour-specific terminology in sexual history taking, sex research, sexual health promotion and sex education. Researchers, educators and medical practitioners should exercise caution and not assume that their own definitions of having 'had sex' are shared by their research participants or patients.

The Behavioral Definitions of “Having Sex With a Man” and “Having Sex With a Woman” Identified by Women Who Have Engaged in Sexual Activity With Both Men and Women

“…Consistent with previous research with predominantly heterosexual and mostly college samples (Byers et al, 2009;Carpenter, 2001;Gute et al, 2008;Pitts & Rahman, 2001;Randall & Byers, 2003;Richters & Song, 1999;Sanders & Reinisch, 1999;Sanders et al, 2010), penile-vaginal intercourse was the most frequently included item within the behavioral definition of having sex with a man in this sample of WSWM. In contrast to penile-vaginal intercourse, the percentage of participants who indicated that they would have indicated that they had sex if they engaged in fellatio in the present study was considerably higher than the percentage of participants who reported that fellatio was "having sex" in previous research with primarily heterosexual participants (Byers et al, 2009;Carpenter, 2001;Gute et al, 2008;Pitts & Rahman, 2001;Randall & Byers, 2003;Richters & Song, 1999;Sanders & Reinisch, 1999;Sanders et al, 2010). However, the diversity in their definitions is consistent with the few other studies that have examined sexual orientation as a factor in behavioral definitions of having sex Horowitz & Spicer, 2013;Richters & Song, 1999).…”

“…In comparison, fewer than 40% of the participants indicated that they would say they had sex with a partner if they engaged in oral-genital contact, and fewer than 20% of the participants indicated that they would include kissing, breast stimulation, or digital-vaginal stimulation within their behavioral definition of having sex. This is consistent with findings from other research that has identified similar variation in participants' behavioral definitions of having sex (Bogart, Cecil, Wagstaff, Pinkerton, & Abramson, 2000;Byers, Henderson, & Hobson, 2009;Carpenter, 2001;Gute, Eshbaugh, & Wiersma, 2008;Pitts & Rahman, 2001;Randall & Byers, 2003;Richters & Song, 1999;Sanders et al, 2010). Although age is related to the likelihood of including individual behaviors within a participant's behavioral definition of having sex, penile intercourse (the insertion of the penis into the vagina or anus) is consistently among the behaviors most likely to be included regardless of participant age .…”

“…As such, we hypothesized a positive relationship between recent number of sexual behaviors with a man and with a woman and number of behaviors included within the participant's definition of having sex. In addition, we assessed variability in the participants' definition of having sex in relation to several key demographic characteristics identified as important indicators of behavioral definitions of having sex, including sexual identity (e.g., Hill et al, 2010;Horowitz & Spicer, 2013, Richters & Song, 1999, geographic location (e.g., Hill et al, 2010), age (e.g., Binson & Catania, 1998;Sanders et al, 2010), education, (e.g., Binson & Catania, 1998) race/ethnicity, (e.g., Binson & Catania, 1998) and relationship status (e.g., Binson & Catania, 1998). Given that these variables are also associated with the expansiveness or frequency of women's reported sexual behavior in previous research, we hypothesized that participants who were older (Chandra, Copen, & Mosher, 2013;Foxman, Aral, & Holmes, 1998;Leichliter, Chandra, Liddon, Fenton, & Aral, 2007;, had a higher degree , were living in the United States , were in a relationship (Herbenick et al, 2010b), and reported relationships with both men and women (Foxman et al, 1998;Mercer et al, 2007) would include a higher number of behaviors in their definitions of "having sex" than their counterparts.…”

Youth Injuries as a Function of Sex, Life History, and Neighborhood Safety

“…First, "sex" was not explicitly defined for participants as a particular type of sexual experience (e.g., penetrative vaginal intercourse). As previous work has shown (Sanders, Hill, Yarber, Graham, Crosby, & Milhausen, 2010), this presents a limitation to our understanding of what types of sexual behaviors participants may have been reporting on. Another limitation was that we did not explicitly define "childhood" for our participants.…”

Graded Structure in Sexual Definitions: Categorizations of Having “Had Sex” and Virginity Loss Among Homosexual and Heterosexual Men and Women

“…Horowitz & Spicer, 2013). This hierarchy persists, even where percentages vary as a function of, for example, culture (e.g., Pitts & Rahman, 2001; Randall & Byers, 2003), age (e.g., Sanders et al, 2010), target (e.g., Bogart, Cecil, Wagstaff, Pinkerton, & Abramson, 2000), or context (e.g., Trotter & Alderson, 2007). Qualitative research tends to support the definitional hierarchy (e.g., Carpenter, 2001; Mehta, Sunner, Head, Crosby, & Shrier, 2011).…”