Skip to main content
SpringerLink
Log in

Sexual Behavior as a Risk Factor for Sexually Transmitted Disease

  • Chapter
Reproductive Tract Infections

Part of the book series: Reproductive Biology ((RBIO))

Abstract

Sexuality is an important aspect of human behavior. It is central to people’s intimate personal lives and psychology. In addition, gender is a pivotal factor in personal identity; it determines the subjective experience of life and one’s options in life both biologically and socially. Sexuality is also of fundamental significance to society, since it is the mechanism of societal survival. Consequently, all cultures have well established, elaborate, and firm rules and norms regulating sexual behavior and all aspects of social conduct related to sexual behavior. The norms and values surrounding sexuality may vary greatly across cultures. What behaviors are allowed, who can have sexual intercourse with whom, to what extent sexuality is an appropriate subject matter for social discussion, and among which members of society are all specified by culture and tend to vary across societies. Yet, some behavioral proscriptions are similar across societies. For example, in many cultures, sexual unions between older men and younger women are acceptable, while unions between older women and younger men are not condoned. Similarly, in many societies, having multiple sex partners is an acceptable, even desirable behavior for men, while the same behavior is considered unacceptable for women.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Aral SO, Cates W. The multiple dimensions of sexual behavior as risk factor for sexually transmitted disease: the sexually experienced are not necessarily sexually active. Sex Transm Dis 1989; 12: 173–7.

    Google Scholar 

  2. Aral SO, Holmes KK. Epidemiology of sexual behavior and sexually transmitted diseases. In: Holmes KK, Mdrdh PA, Sparling PF, Wiesner PJ, eds. Sexually transmitted diseases, second edition, New York: McGraw-Hill 1990: 19–36.

    Google Scholar 

  3. Hearst N, Hulley SB. Preventing the heterosexual spread of AIDS: are we giving our patients the best advice? JAMA 1988; 259: 2428–32.

    Article  PubMed  CAS  Google Scholar 

  4. Johnson RE, Nahmias A, Magder LS et al. A seroepidemiologic survey of the prevalence of herpes simplex virus type 2 infection in the United States. N Engl J Med 1989; 321: 7–12.

    Article  PubMed  CAS  Google Scholar 

  5. Nahmias A. Prevalence of herpes infections in a health maintenance organization. Presented at the International Society for STD Research, Brighton, England, August 2, 1985.

    Google Scholar 

  6. Ronald A, Aral SO. Interactions for the prevention and control of reproductive tract infections in developing countries. Presented at the Conference on Reproductive Tract Infections in the Third World: National and International Policy Implications, Bellagio, Italy, April 29-May 3, 1991.

    Google Scholar 

  7. Edebiri AA. Cervical intraepithelial neoplasia: the role of age at first coitus in its etiology. J Reprod Med 1990; 35: 256–9.

    PubMed  CAS  Google Scholar 

  8. Herrero R, Brinton LA, Reeves WC et al. Sexual behavior, venereal diseases, hygiene practices, and invasive cervical cancer in a high-risk population. Cancer 1990; 65: 380–6.

    Article  PubMed  CAS  Google Scholar 

  9. Stavraky KM, Rawls WE, Chiavetta J, Donner AP, Wanklin JM. Sexual and socioeconomic factors affecting the risk of past infections with herpes simplex virus type 2. Am J Epidemiol 1983; 118: 109–21.

    PubMed  CAS  Google Scholar 

  10. Kjaer SK, Engholm G, Teisen C et al. Risk factors for cervical human papilloma virus and herpes simplex virus infections in Greenland and Denmark: a population-based study. Am J Epidemiol 1990; 131: 669–82.

    PubMed  CAS  Google Scholar 

  11. Reeves WC, Caussy D, Brinton LA et al. Case-control study of human papilloma viruses and cervical cancer in Latin America. Int J Cancer 1987; 40: 450–4.

    Article  PubMed  CAS  Google Scholar 

  12. Phillips RS, Hanff PA, Wertheimer A, Aronson MD. Gonorrhea in women seen for routine gynecologic care: criteria for testing. Am J Med 1988; 85: 177–82.

    Article  PubMed  CAS  Google Scholar 

  13. Shafer MA, Beck A, Blain B et al. Chlamydia trachomatis: important relationships to race, contraception, lower genital tract infection, and Papanicolaou smear. J Pediatr 1984; 104: 141–6.

    Article  PubMed  CAS  Google Scholar 

  14. Li DK, Daling Jr, Wang SP, Grayston JT. Evidence that chlamydia pneumoniae, strain TWAR, is not sexually transmitted. J Infect Dis 1989; 160: 328–31.

    Google Scholar 

  15. Cates W Jr. The epidemiology and control of sexually transmitted diseases in adolescents. In: Adolescent medicine: state of the art reviews, vol. 1, no. 3, Philadelphia: Hanley and Belfuy, 1990.

    Google Scholar 

  16. CDC, Premarital sexual experience among adolescent women, United States, 1970–1988. MMWR 1990; 39 (51,52): 929–32.

    Google Scholar 

  17. Greenberg J, Aral SO, Magder L. Age at sexual debut: a marker for risky sexual behavior. Poster presented at the 12th Annual Meeting of the Society for Behavioral Medicine, Washington DC, March 22, 1991.

    Google Scholar 

  18. Moscicki A-B, Winkler B, Irwin CE Jr, Schachter J. Differences in biologic maturation, sexual behavior, and sexually transmitted disease between adolescents with and without cervical intraepithelial neoplasia. J Pediatr 1989; 115: 487–93.

    Article  PubMed  CAS  Google Scholar 

  19. Kjaer SK, Teisen C, Haugaard BJ et al. Risk factors for cervical cancer in Greenland and Denmark: a population-based cross-sectional study. Int J Cancer 1989; 44: 40–7.

    Article  PubMed  CAS  Google Scholar 

  20. Cates W Jr, Rolfs RT Jr, Aral SO. Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update. Epidemiol Rev 1990; 12: 199–220.

    PubMed  Google Scholar 

  21. Marchbanks PA, Lee NC, Peterson HB. Cigarette smoking as a risk factor for pelvic inflammatory disease. Am J Obstet Gynecol 1990; 162: 639–44.

    Article  PubMed  CAS  Google Scholar 

  22. Chow JM, Yonekura L, Richwald GA, Greenland S, Sweet RL, Schachter J. The association between Chlamydia trachomatis and ectopic pregnancy: a matched-pair, case-control study. JAMA 1990; 263: 3164–7.

    Article  PubMed  CAS  Google Scholar 

  23. Brunham RC, Maclean JW, Binns B et al. Chlamydia trachomatis: its role in tubal infertility. J Infect Dis 1985; 152: 1275–82.

    Article  PubMed  CAS  Google Scholar 

  24. Schachter J, Stoner E, Moncada J. Screening for chlamydia infections in women attending family planning clinics. West J Med 1983; 138: 375–9.

    PubMed  CAS  Google Scholar 

  25. Handsfield HH, Jasman LL, Roberts PL, Hanson VW, Kothenbeutal RL, Stamm WE. Criteria for selective screening for Chlamydia trachomatis in women attending family planning clinics. JAMA 1986; 255: 1730–4.

    Article  PubMed  CAS  Google Scholar 

  26. Breinig MK, Kingsley LA, Armstrong JA et al. Epidemiology of genital herpes in Pittsburgh: serologic, sexual, and racial correlates of apparent and inapparent herpes simplex infections. J Infect Dis 1990; 162: 299–305.

    Article  PubMed  CAS  Google Scholar 

  27. Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papilloma virus infection. Epidemiol Rev 1988; 10: 122–63.

    PubMed  CAS  Google Scholar 

  28. Alter MJ, Ahtone J, Weisfuse I, Starko K, Vacalis TD, Maynard JE. Hepatitis B virus transmission between heterosexuals. JAMA 1986; 256: 1307–10.

    Article  PubMed  CAS  Google Scholar 

  29. Darrow WW, Echenberg DF, Jaffe HW et al. Risk factors for human immunodeficiency virus (HIV) infections in homosexual men. Am J Public Health 1987; 77: 479–83.

    Article  PubMed  CAS  Google Scholar 

  30. Hunter D, Maggwa A, Mati J et al. Risk factors for HIV infection among women in a low risk population in Nairobi, Kenya. Sixth International Conference on AIDS, Abstract No. Thc.573, Vol. 1, San Francisco, June 21, 1990.

    Google Scholar 

  31. Harrison HR, Costin M, Meder JB et al. Cervical Chlamydia trachomatis infection in university women: relationship to history, contraceptive, ectopy, and cervicitis. Am J Obstet Gynecol 1985; 153: 244–51.

    PubMed  CAS  Google Scholar 

  32. Johnson BA, Poses RM, Former CA, Meier FA, Dalton HP. Derivation and validation of a clinical diagnostic model for chlamydial cervical infection in university women. JAMA 1990; 264: 3161–70.

    Article  PubMed  CAS  Google Scholar 

  33. Pederson AHB, Bonin P. Screening females for asymptomatic gonorrhea infection. Northwest Med 1971; 70: 255–61.

    Google Scholar 

  34. Rothenberg R. The geography of syphilis: a demonstration of epidemiologic diversity. In: Morriset R, Kurstak E, eds. Advances in sexually transmitted diseases, Utrecht, Netherlands: VNU Science Press, 1986: 125–33.

    Google Scholar 

  35. Schmid GP, Sanders LL, Blount JH et al. Chancroid in the United States: re-establishment of an old disease. JAMA 1987; 258: 3265–68.

    Article  PubMed  CAS  Google Scholar 

  36. Lee NC, Rubin GL, Boruck R. The intrauterine device and pelvic inflammatory disease revisited: new results from the Women’s Health Study. Obstet Gynecol 1988; 72: 1–6.

    PubMed  CAS  Google Scholar 

  37. Marchbanks PA, Lee NC, Peterson HB. Cigarette smoking as a risk factor for pelvic inflammatory disease. Am J Obstet Gynecol 1990; 162: 639–44.

    Article  PubMed  CAS  Google Scholar 

  38. Wolner-Hanssen P, Eschenbach DA, Paavonen J et al. Decreased risk of symptomatic chlamydial pelvic inflammatory disease associated with oral contraceptive use. JAMA 1990; 263: 54–9.

    Article  PubMed  CAS  Google Scholar 

  39. Lee NC, Rubin GL, Grimes DA. Measures of sexual behavior and the risk of pelvic inflammatory disease. Obstet Gynecol 1991; 77: 425–30.

    PubMed  CAS  Google Scholar 

  40. Padian NS, Shibaski SC, Jewell NP. Heterosexual HIV transmission and frequency of intercourse. J Infect Dis 1990; 161: 883–7.

    Article  PubMed  CAS  Google Scholar 

  41. Jones R, Wasserheit JN. Introduction to the biology and natural history of sexually transmitted diseases. In: Wasserheit JN, Aral SO, Holmes KK, eds. Research issues in human behavior and sexually transmitted diseases in the AIDS era, American Society of Microbiology Publications.

    Google Scholar 

  42. De Vincenzi J, Ancelle-Park R, for the European Community Study Group. Heterosexual transmission of HIV: a European study. II, Female-to-male transmission. Fifth International Conference on AIDS, Abstract No. Th.A.0.20, Montreal, June 4–9, 1989.

    Google Scholar 

  43. Eschenbach D, Harnich JP, Holmes KK. Pathogens of acute pelvic inflammatory disease: role of contraception and other risk factors. Am J Obstet Gynecol 1977; 128: 838.

    PubMed  CAS  Google Scholar 

  44. Sweet R, Blankford-Dayle M, Robbie MO et al. The occurrence of chlamydial and gonococcal salpingitis during the menstrual cycle. JAMA 1985; 255: 2062.

    Google Scholar 

  45. Kingsley LA, Detels R, Kaslow R et al. Risk factors for seroconversion to human immunodeficiency virus among male homosexuals. Lancet 1987; 1: 345–9.

    Article  PubMed  CAS  Google Scholar 

  46. European Study Group. Risk factors for male to female transmission of HIV. Br Med J 1989; 298: 411–5.

    Article  Google Scholar 

  47. Schreeder MT, Thompson SE, Hadler SC et al. Hepatitis B in homosexual men: prevalence of infection and factors related to transmission. J Infect Dis 1982; 146: 7–15.

    Article  PubMed  CAS  Google Scholar 

  48. Sackel SG, Alpert S, Fiumara NJ, Donner A, Laughlin KA, McCormick WM. Orogenital contact and the isolation of Neisseria gonorrhoeae, mycoplasma hominis, and ureaplasma urealyticum from the pharynx. Sex Transm Dis 1979; 6: 44.

    Google Scholar 

  49. Aral SO, Soskolne V, Joesoef RM, O’Reilly KR. Sex partner selection as risk factor for STDs: clustering of risky modes. Sex Transm Dis 1991; 18: 10–7.

    Article  PubMed  CAS  Google Scholar 

  50. Upchurch DM, Brady WE, Reichart CA, Hook EW. Behavioral contributions to acquisition of gonorrhea in patients attending an inner city sexually transmitted disease clinic. J Infect Dis 1990; 161: 938–41.

    Article  PubMed  CAS  Google Scholar 

  51. Rolfs RT, Goldberg M, Sharrar RG. Risk factors for syphilis: cocaine use and prostitution. Am J Public Health 1990; 80: 853–7.

    Article  PubMed  CAS  Google Scholar 

  52. Peters RK, Thomas D, Hagan DG, Mack TM, Henderson BE. Risk factors for invasive cervical cancer among Latinas and non-Latinas in Los Angeles County. J Natl Cancer Inst 1986; 77: 1063–77.

    PubMed  CAS  Google Scholar 

  53. Harris RW, Brinton LA, Cowdell RH et al. Characteristics of women with dysplasia or carcinoma in situ of the cervix uteri. Br J Cancer 1980; 42: 359–69.

    Article  PubMed  CAS  Google Scholar 

  54. Chu SY, Peterman TA, Doll LS, Buehler JW. Bisexual men with AIDS in the United States: epidemiology and their role in the AIDS epidemic in women. Amer J Public Health 19912, Vol. 82, No. 2; 220–4.

    Google Scholar 

  55. Day S. Prostitute women and AIDS: anthropology. AIDS 1988; 2: 421.

    Article  PubMed  CAS  Google Scholar 

  56. Stone KM, Grimes DA, Magder LS. Personal protection against sexually transmitted diseases. Am J Obstet Gynecol 1986; 155: 180–8.

    PubMed  CAS  Google Scholar 

  57. Forrest KA, Washington AE, Daling JR, Sweet RL. Vaginal douching as a possible risk factor for pelvic inflammatory disease. J Natl Med Assoc 1989; 81: 159–65.

    PubMed  CAS  Google Scholar 

  58. Wolner-Hanssen P, Eschenbach DA, Paavonen J et al. Association between vaginal douching and acute pelvic inflammatory disease. JAMA 1990; 263: 1936–41.

    Article  PubMed  CAS  Google Scholar 

  59. Chow W-H, Dating JR, Weiss NS, Moore DE, Soderstrom R. Vaginal douching as a potential risk factor for tubal ectopic pregnancy. Am J Obstet Gynecol 1985; 153: 727–9. (Also see reference 22.)

    Google Scholar 

  60. Aral SO, Mosher WD, Cates W Jr. Vaginal douching among reproductive age women in the United States: 1988. Am J Public Health 1992, Vol. 82, No. 2; 210–4.

    Article  PubMed  CAS  Google Scholar 

  61. Gardner JW, Schuman KL, Slattery ML, Sanborn JS, Abbott TM, Overall JC. Is vaginal douching related to cervical carcinoma? Am J Epidemiol 1991; 133: 368–75.

    PubMed  CAS  Google Scholar 

  62. Taylor PK, Rodin P. Herpes genitalis and circumcision. Br J Vener Dis 1975; 51: 274.

    PubMed  CAS  Google Scholar 

  63. Parker SW et al. Circumcision and sexually transmissible disease. Med J Aus 1983; 2: 288.

    CAS  Google Scholar 

  64. Cameron DW, Lourdes JD, Gregory MM et al. Female-to-male transmission of human immunodeficiency virus type I: risk factors for seroconversion in men. Lancet 1989; 2: 403–7.

    Article  PubMed  CAS  Google Scholar 

  65. Fischl M, Fayne T, Flanagan S et al. Seroprevalence and risks of HIV infections in spouses of persons infected with HIV. Fourth International Conference on AIDS, Abstract No. 4060, Stockholm, 1988.

    Google Scholar 

  66. Wasserheit JN. Epidemiological synergy: inter-relationships between HIV infection and other STDs. Presented at the International Workshop on AIDS and Reproductive Health, Bellagio, Italy, October 29—November 2, 1990.

    Google Scholar 

  67. Simonsen JN, Cameron DW, Gakinya MN et al. Human immunodeficiency virus infection among men with sexually transmitted diseases. N Engl J Med 1988; 319: 274–8.

    Article  PubMed  CAS  Google Scholar 

  68. Aral SO, Holmes KK. Epidemiology of sexual behavior and sexually transmitted diseases. In: Holmes KK, Mârdh PA, Sparling PF, Wiesner PJ, eds. Sexually transmitted diseases, second edition, New York: McGraw-Hill 1990: 19–36.

    Google Scholar 

  69. Larson A. Social context of human immunodeficiency virus transmission in Africa: historical and cultural cases of East and Central African sexual relations. Rev Infect Dis 1989; 11: 716–31.

    Article  PubMed  CAS  Google Scholar 

  70. Holmes KK, Aral SO. Behavioral interventions in developing countries. In: Wasserheit JN, Aral SO, Holmes KK eds. Research issues in human behavior and sexually transmitted diseases in the AIDS era, American Society of Microbiology Publications, 1991.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of STD/HIV Prevention, Centers for Disease Control, Atlanta, Georgia, 30333, USA

    Dr. Sevgi O. Aral

Authors
  1. Dr. Sevgi O. Aral
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. International Women’s Health Coalition, New York, New York, USA

    Adrienne Germain

  2. University of Washington, Seattle, Washington, USA

    King K. Holmes

  3. Institut de Medicina Tropicale, Antwerp, Belgium

    Peter Piot

  4. National Institutes of Health, Bethesda, Maryland, USA

    Judith N. Wasserheit

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Science+Business Media New York

About this chapter

Cite this chapter

Aral, S.O. (1992). Sexual Behavior as a Risk Factor for Sexually Transmitted Disease. In: Germain, A., Holmes, K.K., Piot, P., Wasserheit, J.N. (eds) Reproductive Tract Infections. Reproductive Biology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0691-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-0691-5_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-0693-9

  • Online ISBN: 978-1-4899-0691-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation