More than meets the eye: What we miss when we use cross-sectional data to examine sexual health behaviors and attitudes

At any given point in time, 9% of women are pregnant or seeking pregnancy, 62% are using contraception and 8% are at risk of unintended pregnancy because they are not using birth control. Most sexual health research examines these behaviors as if they are relatively stable among individuals over time. This study suggests otherwise. We gathered data at three points in time over a 12-month period from a national sample of >2,400 U.S. women. Preliminary findings reveal that many sexual health indicators fluctuate over a relatively short time period. While 7% of non-pregnant women were trying to get pregnant at any point in time, only 3% did so during all three time periods; 12% of the sample reported trying to get pregnant at least once but had shifting intentions. One in five women had not had sex with a man in the last 30 days, but only 11% were consistently sexually inactive; 35% of the sample was sexually inactive during at least one time period. While 75% of women used contraception consistently during one of the survey periods, only 45% reported doing so during all three.  Among women at risk of unintended pregnancy, 68% of those who relied on long acting methods (LARCS) used them all 12 months, comparable to pill users (67%). Only half of condom users (49%) reported using the method over the entire 12-month period. These findings demonstrate that sexual health attitudes and behaviors are dynamic and should be addressed in future data collection efforts and research.