Development of a multi-item scale to quantitatively assess sexual behaviors and the transmission of high- and low-risk human papillomaviruses

Background: Epidemiologic research is frequently hindered by the inherent difficulty in quantifying the risk of sexually transmitted disease (STD) acquisition associated with individual patterns of sexual behavior. Goal of the Study: To develop a quantitative sexual behavior risk scale and demonstrate its predictive validity in an assessment of risk factors for incident infection with human papillomaviruses (HPVs). Study Design: Data from a prospective study of HPV infection in female university students was used to generate quantitative multi-item sexual behavior scales which were used in Cox regression analyses. Results: Although risk was incurred both in casual sexual encounters and in noncasual relationships, risk in these contexts were only weakly correlated. The construction of separate measurement scales was performed. Conclusions: Improved precision of measurement of STD risk demonstrated that significant risk was associated with different patterns of sexual behavior and was incurred in both casual and/or noncasual relationships. Scores on the sexual behavior risk scales were highly predictive of incident infection with HPV types of both high and low oncogenic potential.