Background and Considerations on the National Survey of Sexual Health and Behavior (NSSHB) from the Investigators

A we enter the second decade of the 21st century, the United States continues to face significant challenges in terms of the sexual and reproductive health of its population. With the Human Immunodeficiency Virus (HIV) continuing to have considerable and disproportionate impacts on diverse communities, high rates of other sexually transmissible infections and high numbers of unintended pregnancies each year, those on the front lines of public health and medicine are challenged to implement appropriate and effective strategies in response. While sexual health problems such as these have driven much of the nation’s social and health priorities and research agendas in the past, it remains the case that sexual behaviors, and the associated behaviors that occur within the context of a sexual event (e.g., condom use), continue to garner significant interest among both scientific and lay communities. However, the delivery of sexual health services and the conduct of sexual health research remain challenging and, at times, controversial. Just over 60 years ago, Dr. Alfred Kinsey and his research teammade available, to both scientists and the general public, the first large-scale systematic studies of human sexual behavior [1–2]. For decades, much of what was known about human sexual behaviors was based upon the thousands of interviews conducted by Kinsey and his team, most of which were collected during the 1930s and 1940s. Later on, in the 1980s, the realities of the epidemics of HIV and Acquired Immune Deficiency Syndrome (AIDS) made clear how little was known about contemporary human sexual interactions, how they had changed over time, and the manner in which individuals and couples make decisions to protect themselves from infection and pregnancy. In 1994, a team of researchers had a profound impact on our understanding of these issues with the results from the first nationally representative probability study of sex and sexuality-related behavior in theU.S. (theNational Health and Social Life Survey-NHSLS), which they had conducted two years earlier [3–4]. Since that time, there have been thousands of studies focusing on specific sexuality and health-related topics among a diverse range of communities that have continued to advance scientific understanding of sexuality-related behaviors, condom and contraceptive use, and that have driven the development of increasingly effective public health interventions. There have been only a few nationally representative probability samples of sexual behavior among specific age groups (e.g., Youth Risk Behavior Survey;National Social Life, Health, and Aging Project) or of sexual concerns or distress. Studies specific to condom use have been more frequent, with a great deal of effort being expended to document trends in cond om use both across the general population and within specific communities disproportionately impacted by sexual health problems for which the latex condom is an accessible and efficacious solution. Studies such as these have clear relevance for the development and delivery of social service and health programs that address issues related to sexuality and sexual health. They are also central to those individuals whose scientific interests are grounded within areas related to human sexuality, and over the past two decades, such scientists have discussed and debated the need for, and the possible mechanisms for conducting, a contemporary 243