Sexual Risk Survey

Abstract

The Sexual Risk Survey (SRS) is a psychometrically validated, multidimensional self-report instrument designed by Ohio University researchers Jessica A. Turchik and John P. Garske (2009) to quantify the frequency and breadth of risky sexual behaviors among emerging adults and collegiate populations. Developed in response to the psychometric shortcomings, narrow operational definitions, and idiosyncratic scoring frameworks of legacy risk measures, the SRS systematically evaluates behavioral risk across a standardized 6-month retrospective recall window. Comprising 23 core items derived from an initial 37-item pool through exploratory data reduction, the instrument captures a comprehensive spectrum of sexual practices, partner characteristics, contextual variables, and behavioral intentions. Factor analytic investigations identify five correlated yet distinct dimensions: Sexual Risk Taking With Uncommitted Partners (8 items), Risky Sex Acts (5 items), Impulsive Sexual Behaviors (5 items), Intent to Engage in Risky Sexual Behaviors (2 items), and Risky Anal Sex Acts (3 items).

Methodologically, the SRS employs an initial open-ended, free-response frequency format that mitigates artificial categorization constraints during administration. To manage severe positive skewness typical of epidemiological sexual behavior distributions, raw frequencies are transformed using a standardized ordinal percentile blocking protocol (yielding item scores from 0 to 4 and a composite risk score ranging from 0 to 92) or mathematical continuous transformations. Psychometric evaluations demonstrate strong internal consistency (composite Cronbach’s α = .88; subscale α values spanning .61 to .89) and excellent 2-week test-retest temporal stability (total r = .93). Criterion, convergent, and concurrent validity are supported by statistically significant associations with sensation seeking, substance use, sociosexuality, and past history of sexually transmitted infections (STIs), while discriminant validity is confirmed via negligible correlations with social desirability and sexual disclosure apprehension.

Keywords

Sexual Risk Survey, SRS, sexual risk taking, college student health, psychometrics, risky sexual behavior, STI transmission, unprotected sex, impulsivity, sociosexual orientation

Authors

The Sexual Risk Survey was developed and psychometrically validated by:

• Jessica A. Turchik, Ph.D. — Department of Psychology, Ohio University, Athens, OH; currently affiliated with the Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine. Correspondence: [email protected].
• John P. Garske, Ph.D. — Department of Psychology, Ohio University, Athens, OH.

Purpose

The primary objective of the Sexual Risk Survey (SRS) is to deliver an empirically grounded, psychometrically robust, and multidimensional measurement tool tailored specifically to the behavioral, developmental, and social realities of late adolescents and emerging adults attending college. Epidemiological research continuously highlights that undergraduate students represent a disproportionately high-risk demographic for adverse sexual health outcomes, including the acquisition of human immunodeficiency virus (HIV), transmission of common viral and bacterial sexually transmitted infections (such as human papillomavirus, chlamydia, gonorrhea, and genital herpes), and unplanned pregnancies. Despite these public health vulnerabilities, previous instruments measuring sexual risk suffered from notable methodological constraints.

Prior to the introduction of the SRS, researchers frequently relied on single-item indicators (such as lifetime number of partners or binary assessments of condom usage at last intercourse), idiosyncratic indices lacking reliability testing, or instruments restricted exclusively to high-risk clinical populations, such as intravenous drug users or sex workers. Such instruments frequently suffered from floor effects when administered to collegiate cohorts or failed to capture subtle but consequential gradations of risk, such as non-penetrative hookup encounters, fluid partner concurrency, sexual negotiation failures, and alcohol-facilitated sexual activity.

The SRS resolves these empirical limitations by operationalizing sexual risk taking as a complex, multifaceted behavioral construct rather than a unidimensional dichotomy. Clinically and epidemiologically, the survey serves several critical functions:

• Diagnostic and Baseline Screening: Facilitating university health service screenings to detect individuals engaging in elevated co-occurring risks (e.g., combining substance intoxication with uncommitted encounters).
• Intervention Efficacy Assessment: Providing a sensitive, continuous evaluative metric for behavioral change in randomized controlled trials of sexual health education, risk reduction counseling, and digital health interventions.
• Etiological Modeling: Supplying developmental, personality, and social psychologists with a reliable metric to investigate how neurocognitive constructs (such as executive dysfunction, behavioral disinhibition, trait sensation seeking, and peer normative perceptions) predict specific topographies of sexual risk.

Psychological Construct

The construct operationalized by the Sexual Risk Survey is sexual risk taking, conceptualized as voluntary engagement in sexual activities, behaviors, or interpersonal dynamics that substantially elevate an individual’s probability of experiencing physical, physiological, or psychological harm. This includes the acquisition or transmission of STIs/HIV, unintended conception, and post-encounter distress or regret. Rather than viewing sexual risk as a homogeneous variable, the SRS models it across five distinct sub-dimensions:

1. Sexual Risk Taking With Uncommitted Partners

This subscale comprises 8 items that assess the frequency of engaging in sexual behaviors with casual, transient, or unvetted sexual partners. It captures sexual activity occurring outside the boundaries of a monogamous, committed romantic relationship, including encounters with newly met individuals, acquaintances categorized as “friends with benefits” or “fuck buddies,” and casual hookups. This dimension also measures engagement with partners known to have had extensive partner histories, concurrent partners, or unknown STI testing status. From an epidemiological standpoint, elevated scores on this dimension capture heightened biological exposure to transmission networks.

2. Risky Sex Acts

Composed of 5 items, this factor assesses direct barrier neglect across oral and vaginal sexual acts. It measures instances of vaginal intercourse without latex or polyurethane condoms, vaginal intercourse without contraceptive protection against pregnancy, and unprotected fellatio (oral-penile stimulation) and cunnilingus (oral-vaginal stimulation). This factor isolates direct physiological vector transmission opportunities, accounting for pathogen entry routes across diverse sexual modalities.

3. Impulsive Sexual Behaviors

This 5-item dimension measures behavioral dysregulation and spontaneity within sexual contexts. It indexes encounters driven by immediate gratification without prior deliberation or safety planning. Specific manifestations include engaging in unexpected, unanticipated sexual experiences, engaging in consensual sexual encounters that culminate in post-behavioral psychological regret, integrating illicit substances or alcohol immediately before or during sexual intercourse, and initiating sexual contact with a novel partner prior to communicating about sexual health histories, previous partners, disease status, or intravenous drug use.

4. Intent to Engage in Risky Sexual Behaviors

Spanning 2 items, this construct isolates proactive, goal-directed cognitions oriented toward casual, risky sexual encounters. Specifically, it indexes the frequency with which an individual visits social venues (such as bars, nightclubs, fraternities, or parties) with the premeditated objective of “hooking up”—both with the intent of engaging in non-penetrative sexual contact and with the explicit intent of having penetrative sex. This dimension provides empirical insight into pre-behavioral risk disposition, reflecting cognitive readiness to initiate risky encounters.

5. Risky Anal Sex Acts

This 3-item subscale evaluates engagement in high-transmission anal practices without appropriate barrier protection. It assesses unprotected receptive or insertive anal intercourse, anal penetration via hand (“fisting”) or foreign objects without protective gloves followed by unprotected anal contact, and unprotected analingus (“rimming”). Given that rectal mucosa is exceptionally vascularized and vulnerable to micro-trauma, anal sexual behaviors represent an elevated vector for viral transmission (e.g., HIV, HPV, hepatitis). Isolating these acts into a dedicated subscale acknowledges their unique biomedical risk profile while allowing researchers to evaluate them independently due to differential base rates in collegiate samples.

Theoretical Framework

The Sexual Risk Survey is conceptually anchored in integrative models of health psychology, social cognition, and behavioral decision theory. Three prominent theoretical frameworks directly inform the structure and item content of the SRS:

1. The Information-Motivation-Behavioral Skills (IMB) Model

Developed by Fisher and Fisher (1992), the Information-Motivation-Behavioral Skills model asserts that engaging in sexual risk-reduction behaviors (e.g., consistent condom usage, interpersonal assertiveness, partner risk screening) requires three fundamental prerequisites: accurate health information, personal and social motivation to practice prevention, and behavioral self-efficacy to execute preventive actions in real-world settings. The SRS captures breakdowns across all three components. For example, item 20 (failing to discuss disease status or sexual history before intercourse) reflects a failure of interpersonal behavioral skills, while items indexing intentional hookups reflect explicit motivational states directed toward high-risk environments.

2. The Theory of Planned Behavior (TPB)

Icek Ajzen’s Theory of Planned Behavior (1991) posits that behavioral execution is determined by behavioral intentions, which are shaped by attitudes toward the behavior, subjective norms, and perceived behavioral control. The inclusion of the Intent to Engage in Risky Sexual Behaviors subscale directly operationalizes the intentionality construct of the TPB. By assessing whether participants attend social environments with premeditated intentions to hook up, the SRS bridges cognitive intention with downstream behavioral execution.

3. Dual-Process and Impulsivity Models of Adolescent Decision Making

Contemporary developmental cognitive neuroscience emphasizes dual-process neurobiological frameworks (e.g., the Prototype Willingness Model of Gibbons & Gerrard; Steinberg’s Dual Systems Model). These models demonstrate that late adolescents and emerging adults often make risk decisions within affective, socially charged, “hot” cognitive states. In such environments, immediate sensations overwhelm deliberative, “cold” executive control. The SRS subscale measuring Impulsive Sexual Behaviors reflects these reactive, unreflective trajectories, measuring instances where situational factors (such as acute alcohol intoxication, spontaneous opportunities, and emotional disinhibition) circumvent deliberative protective intentions.

Validity

During its initial psychometric development and subsequent empirical replications, the Sexual Risk Survey demonstrated robust evidence of content, concurrent, convergent, and discriminant validity across diverse investigative parameters.

Content Validity

Content validity was established through systematic literature reviews of existing sexuality surveys, qualitative reviews of risk behaviors identified by emerging adults, and a pilot study with college undergraduates. Items were constructed to reflect contemporary collegiate dating and hookup practices, incorporating modern terminology (e.g., “hooking up,” “friends with benefits,” “fuck buddies”) alongside exact behavioral descriptions to ensure cognitive clarity and semantic equivalence across respondents.

Convergent and Concurrent Validity

The convergent validity of the SRS was established by evaluating its statistical associations with validated psychological measures conceptually linked to sexual risk taking:

• Sensation Seeking and Impulsivity: Total SRS scores correlated positively and significantly with Zuckerman’s Sensation Seeking Scale Form V (SSS-V), particularly the Disinhibition and Experience Seeking subscales (r values ranging from .35 to .48, p < .001).
• Substance Use: Substantial positive correlations emerged between SRS total and subscale scores and validated metrics of alcohol consumption frequency, binge drinking episodes, and illicit recreational drug use (r values between .30 and .52, p < .001).
• Sociosexuality: The SRS showed strong convergence with the Sociosexual Orientation Inventory (SOI / SOI-R), demonstrating that individuals with uncommitted, unrestricted socio-sexual orientations exhibited significantly higher scores on the Sexual Risk Taking With Uncommitted Partners subscale (r = .58, p < .001).
• Concurrent Clinical Outcomes: Elevated scores on the SRS significantly predicted real-world sexual health complications, including lifetime diagnoses of STIs, the necessity for emergency contraception, and retrospective reports of unwanted sexual experiences.

Discriminant Validity

To confirm that the SRS was not merely capturing general non-compliance or socially desirable responding, Turchik and Garske administered the Marlowe-Crowne Social Desirability Scale and measures of perceived sexual threat and disclosure anxiety. The SRS demonstrated negligible, statistically non-significant correlations with social desirability (r values < .10), confirming that self-reported behavioral frequencies on the SRS are largely independent of defensive response biases when administered with appropriate confidentiality safeguards.

Reliability

The psychometric evaluation of the Sexual Risk Survey demonstrates robust internal consistency and temporal reliability across collegiate samples.

Internal Consistency

In the primary validation study (N = 613 undergraduate students), the overall 23-item instrument exhibited high internal consistency, yielding a composite Cronbach’s alpha of .88. Coefficient alphas across the five underlying dimensions were as follows:

• Sexual Risk Taking With Uncommitted Partners: α = .88 (8 items)
• Risky Sex Acts: α = .80 (5 items)
• Impulsive Sexual Behaviors: α = .78 (5 items)
• Intent to Engage in Risky Sexual Behaviors: α = .89 (2 items)
• Risky Anal Sex Acts: α = .61 (3 items)

The relatively lower Cronbach’s alpha observed for the Risky Anal Sex Acts subscale is attributable to the low base-rate endorsement of unprotected anal intercourse and anal penetration within general collegiate samples, resulting in restricted item variance. Turchik and Garske noted that the statistical inclusion or exclusion of the Risky Anal Sex Act items did not adversely impact the internal consistency or reliability coefficients of the total SRS composite score.

Test-Retest Reliability and Administration Formats

Temporal stability was established across a 2-week test-retest assessment protocol. The total SRS composite score exhibited a 2-week test-retest reliability coefficient of r = .93 (p < .001), indicating high measurement stability over time. The 2-week test-retest coefficients for the five subscales were:

• Sexual Risk Taking With Uncommitted Partners: r = .90
• Risky Sex Acts: r = .89
• Impulsive Sexual Behaviors: r = .79
• Intent to Engage in Risky Sexual Behaviors: r = .70
• Risky Anal Sex Acts: r = .58

Additionally, the authors investigated administration modality equivalence by comparing the standard self-administered paper-and-pencil format with an individually administered, structured clinical interview format. Total scores across the two modalities demonstrated an inter-method correlation of r = .90, establishing that the SRS retains its measurement fidelity across both written self-report and structured clinical interview administrations.

Factor Analysis

The latent structure of the SRS was delineated using an exploratory data reduction methodology on an initial pool of 37 candidate items administered to 613 undergraduate students (Turchik & Garske, 2009). The initial item pool was systematically reduced based on strict psychometric exclusion criteria:

• Items displaying low base rates (less than 10% of participants endorsing a frequency greater than zero).
• Low corrected item-total correlations (r < .40).
• Low communalities extracted during initial factor runs (h² < .40).
• Low primary factor loadings (< .40) or severe cross-loadings across multiple latent dimensions.

Fourteen items met criteria for elimination, yielding the final 23-item instrument. A subsequent Principal Components Analysis (PCA) with orthogonal (Varimax) rotation revealed a clear, interpretable five-factor solution. These five factors collectively accounted for the majority of the cumulative variance in the item set.

Factor 1 (Sexual Risk Taking With Uncommitted Partners) exhibited high primary factor loadings ranging from .54 to .81, capturing partner volume, partner concurrency, and unknown partner histories. Factor 2 (Risky Sex Acts) loaded cleanly on barrier omission variables (.58 to .79). Factor 3 (Impulsive Sexual Behaviors) reflected situational behavioral disinhibition with loadings spanning .50 to .75. Factor 4 (Intent to Engage in Risky Sexual Behaviors) accounted for intention variables with primary loadings > .80. Factor 5 (Risky Anal Sex Acts) loaded specifically on the three items assessing unprotected anal sexual practices (.52 to .78).

Instrument / Measurement Tool

The structured parameters of the Sexual Risk Survey are summarized below:

• Instrument Name: Sexual Risk Survey (SRS)
• Authors: Jessica A. Turchik, Ph.D., and John P. Garske, Ph.D. (2009)
• Target Population: Undergraduate college students, late adolescents, and emerging adults (ages ~18–25)
• Administration Format: Self-administered paper-and-pencil questionnaire, digital web-based survey, or structured individual clinical interview
• Administration Time: Approximately 5 to 10 minutes
• Assessment Window: Past 6 months
• Total Number of Items: 23 behavioral frequency items
• Response Modality: Open-ended free-response format wherein participants record the absolute integer frequency (number of times or number of partners) for each behavior
• Response Scoring & Transformation Protocol:

  Given that raw sexual behavior frequency counts exhibit severe positive skewness and long right tails, data must undergo standardization prior to linear parametric analysis. In the original validation framework, raw integer counts are recoded into an ordinal 5-point scale (coded 0 to 4):

  • Score 0: Represents strictly a reported frequency of 0 (complete non-engagement).
  • Scores 1 to 4: Non-zero reported frequencies are blocked based on the empirical distribution of active respondents using the following normative percentile guideline:
  • 1: Lowest 40% of non-zero responses
  • 2: Next 30% of non-zero responses
  • 3: Next 20% of non-zero responses
  • 4: Upper 10% of non-zero responses (highest frequency risk takers)

  Note: Where restricted response variability makes percentile blocking infeasible, continuous mathematical transformations (e.g., logarithmic log(x + 1) or inverse transformations) may be utilized to normalize distributions.

• Score Calculation:
  • Total SRS Score: Sum of all 23 recoded item scores (Range: 0 to 92). Higher scores reflect greater overall sexual risk taking.
  • Subscale Scores: Calculated by summing recoded items within each designated dimension:
  • Sexual Risk Taking With Uncommitted Partners: Sum of items 1, 8, 16, 17, 20, 21, 22, 23 (8 items; Range: 0–32)
  • Risky Sex Acts: Sum of items 9, 10, 11, 12, 13 (5 items; Range: 0–20)
  • Impulsive Sexual Behaviors: Sum of items 2, 3, 6, 7, 18 (5 items; Range: 0–20)
  • Intent to Engage in Risky Sexual Behaviors: Sum of items 4, 5 (2 items; Range: 0–8)
  • Risky Anal Sex Acts: Sum of items 13, 14, 15 (3 items; Range: 0–12) (Note: Item 13 refers to unprotected anal sex)
• Supplementary Administration Aids: Administration guidelines recommend providing respondents with a 6-month visual calendar and an accompanying glossary defining sexual terms to enhance recall accuracy and standardize construct interpretations.

Permissions & Fee and Test Year

The Sexual Risk Survey was developed and validated in 2009 by Jessica A. Turchik and John P. Garske at Ohio University, with primary findings published in the peer-reviewed journal Archives of Sexual Behavior. The SRS is in the public domain for non-commercial academic research, clinical screening, and educational evaluations. No licensing fees or royalty payments are required to administer the instrument. Researchers and clinicians utilizing the SRS are expected to cite the original validation publication in all resulting scholarly works and presentations.

Inquiries regarding the scale, scoring algorithms, or the standardized participant terminology glossary may be directed to Dr. Jessica A. Turchik at Ohio University, Department of Psychology, 200 Porter Hall, Athens, OH 45701, or via email at [email protected].

References

• Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T
• Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111(3), 455–474. https://doi.org/10.1037/0033-2909.111.3.455
• Simpson, J. A., & Gangestad, S. W. (1991). Individual differences in sociosexuality: Evidence for convergent and discriminant validity. Journal of Personality and Social Psychology, 60(6), 870–883. https://doi.org/10.1037/0022-3514.60.6.870
• Turchik, J. A., & Garske, J. P. (2009). Measurement of sexual risk taking among college students. Archives of Sexual Behavior, 38(6), 936–948. https://doi.org/10.1007/s10508-008-9388-7
• Zuckerman, M. (1994). Behavioral expressions and biosocial bases of sensation seeking. Cambridge University Press. https://doi.org/10.1017/CBO9780511752940

13. Items of the Scale (Questionnaire)