Increased reporting of male-to-male sexual activity in a national survey

Background: Prevention program designers need information on sexual behaviors to plan and evaluate their activities. Questions on sexual behavior have been added to a number of nationally representative interview surveys. Goal. The goal was to measure the percentage of adult men who have engaged in male-to-male sex in the past year and since age 18 years and to observe and interpret changes over time in these measurements. Study Design: Data are from the General Social Survey, a nationally representative, household-based survey of adults conducted in 1988, 1989, 1990, 1991, 1993, 1994, 1996, 1998, and 2000. Questions on sexual behavior were part of a self-administered questionnaire completed by respondents. Estimates of male-to-male sex in the past year and since age 18 years were computed. Results: Estimates of male-to-male sex in the past year were higher for surveys conducted beginning in 1996 (3.1%-3.7% compared with 1.7%-2.0% for earlier surveys), a difference that remains statistically significant when controlling for background factors associated with nonresponse. These estimates are also higher than observed from other similar surveys. The estimates are affected by high level of missing data and an unknown level of underreporting. Conclusion: Previous estimates of the size of this population subgroup based on survey research may be too low. Methods that increase survey respondents' sense of privacy and improve completeness of data collection are needed to improve quality of measurement of sensitive sexual behaviors.