National Health and Nutrition Examination Survey

2017-2018 Data Documentation, Codebook, and Frequencies

Sexual Behavior - Adult (SXQ_J_R)

RDC Only Data File: SXQ_J_R.xpt

First Published: July 2020

Last Revised: NA

At this time, this dataset is not available publicly. Access may be obtained through the NCHS Research Data Center (https://www.cdc.gov/rdc).

Component Description

The Mobile Examination Center (MEC) Interview section on sexual behavior (variable name prefix SXQ) provides information on lifetime and current sexual behavior for both male and female. Items covered in this section included: age of first sexual encounter, number of sexual partners, sexual identity, circumcision status (male), and history of sexually transmitted diseases.

Eligible Sample

Survey participants aged 14-69 years were eligible. Several questions in this section are age-specific, and many are gender-specific. Mentally impaired participants or participants who were unable to understand English, Spanish, Korean, Vietnamese, or Chinese (traditional/Mandarin, simplified/Mandarin, and traditional/Cantonese) were not asked these questions. Only data from participants aged 18-69 years are included in this dataset. Data from participants 14-17 years are available in a separate dataset: Sexual Behavior - Youth (SXQY_J_R). Both datasets may be accessed through the NCHS Research Data Center (RDC).

Interview Setting and Mode of Administration

The sexual behavior questions were self-administered in a private room at the MEC, during the MEC Interview, using the Audio Computer-Assisted Self Interview (ACASI) system. The ACASI was conducted in one of the following languages: English, Spanish, Korean, Vietnamese, or Chinese (traditional/Mandarin, simplified/Mandarin, and traditional/Cantonese). The ACASI enables respondents to hear questions through earphones as well as read questions on the computer screen. Respondents move at their own speed and touch the screen to indicate their response. No proxy respondents or translators were used in situations when the respondents could not self-report. The questionnaire is located on the NHANES website at: https://wwwn.cdc.gov/nchs/data/nhanes/2017-2018/questionnaires/SXQ_ACASI_J.pdf.

Starting in 2017, two questions on sexual identity (one for male and one for female) were moved to the interviewer administered portion of the MEC interview, using the Computer-Assisted Personal Interview (CAPI) system. Please refer to the “Analytic Notes” section below for more information. The questionnaire is located on the NHANES website at: https://wwwn.cdc.gov/nchs/data/nhanes/2017-2018/questionnaires/SXQ_CAPI_J.pdf.

Quality Assurance & Quality Control

Both ACASI and CAPI systems are programmed with built-in consistency checks to reduce data entry errors. The systems also use online help screens to assist respondents and interviewers in defining key terms used in the questionnaire. All data was reviewed by the NHANES staff for accuracy and completeness. For details on the QA/QC process for this component, please refer to the MEC Interviewers Procedures Manual on the NHANES website.

Data Processing and Editing

The sexual behavior questionnaire in 2017-2018 is similar to cycles 2009-2016. However, analysts should be cautious when combining data with cycles prior to the NHANES 2009-2010 SXQ data, since some questions have been removed or added, and some questions have had slight wording changes. Please see the Analytic Notes below as well as Appendix 1 (for male) and Appendix 2 (for female) for detailed information on variables included in the SXQ section since the 2003-2004 cycle.

The variable SXD021 (Ever had vaginal, anal, or oral sex) was derived from whether or not the respondent reported having any of the specific types of sex. For example, if a male answered “yes” to having had any of the following types of sex: SXQ800 (Ever had vaginal sex with a woman), SXQ803 (Ever performed oral sex on a woman), SXQ806 (Ever had anal sex with a woman), or SXQ809 (Ever had any sex with a man; anal, oral); he would be coded as a “1” or “yes” in SXD021. The value of SXD021 was set to missing if the respondent missed or responded “don’t know” or “refuse” to at least one of the questions that were part of the algorithm for deriving SXD021, and had “no” responses for the other questions in the algorithm. In 2017-2018, there are 13 such records. Please note that responses to other questions are retained for these records in this dataset.

Similar to the 2015-2016 cycle, responses to age related questions in this section that were 12 years or less were grouped and coded as “12 years or younger.” This includes variables SXD031 (age first had any kind of sex), SXD633 (age first performed oral sex on woman), SXD621 (age first performed oral sex on man), and SXQ267 (age first told you had genital warts). For users interested in combining the data with those collected prior to 2015, please note that in the earlier cycles, young ages reported in SXQ were grouped at “9 years or younger”.

In the SXQ section, responses to questions about the number of sexual partners (i.e., SXQ636, SXQ639, SXQ624, SXQ627, SXD171, SXD510, SXQ824, SXQ827, SXQ410, SXQ550, SXQ836, SXQ841, SXD101, SXD450, SXQ724, SXQ727, SXQ130, and SXQ490) that were 100 or greater were grouped and coded as “100 or more.” This coding is consistent with the ones reported in the 2015-2016 cycle. Higher numbers of partners, such as “1000 or more” or “2000 or more” were used to categorize these variables in data cycles prior to 2015-2016.

Information was collected using two-part (number and unit) questions for both SXD630 (last performed oral sex on a new male partner) and SXD642 (last performed oral sex on a new female partner). This is to allow participants to report how long ago they had performed oral sex either in days, weeks, months, or years. The released variables were edited to standardize the reported length of time to number of days (in integer), using the following conversion factors: 7 days per week, 30.4 days per month, and 365.25 days per year.

In general, if a respondent was not asked a question, the response to the question is shown as “missing.” It is up to the analysts to recode the response to zero as they see fit. For example, if a respondent reported that they had zero lifetime vaginal sex partners, they wouldn't be asked the number of vaginal sex partners in the past 12 months. Since the respondent does not receive the question about partners in the past 12 months, the data will be coded as missing for this variable. Analysts may want to recode this to “0” for their analyses.

For questions that ascertain total number of partners for all types of sex (i.e., SXD171, SXD510, SXD101 and SXD450), if the respondent had reported never having any type of sex, the responses were coded as “0.”

Analytic Notes

Analysts should keep in mind that only a subset of questions were asked to respondents aged 60-69 years. It is important to refer to the codebook to see the target age for each question.

In the ACASI system, if participants did not answer the question and instead pressed “next” to move forward, they get a screen asking them to indicate: “I really meant to answer”, “I’d rather not answer”, or “I don’t know the answer.” If they chose “I really meant to answer”, they were taken back to the question so they could respond. If they selected “I’d rather not answer”, their response was coded as “refuse”. The selection of “I don’t know the answer” was coded as “don’t know.”

Although the ACASI has many advantages over interviewer-administered questionnaires for sensitive information, inconsistent responses can occur. Since the questions were self-administered, unlikely answers or confusing questions generally were not clarified by the interviewer. Although, the questionnaire was programmed to alert respondents of potential data entry errors or inconsistencies, not every possible consistency check was added. To minimize potential respondent frustration and confusion, the interview was not interrupted each time an inconsistent answer occurred in terms of the number of sexual partners for different periods of recall and/or for different types of sexual behavior.

Beginning in 2015-2016, modifications on question wording and response categories were made to the sexual identity questions (SXQ296 for male and SXQ295 for female) as the result of an extensive cognitive and field testing conducted by NCHS (Dahlhamer et al., 2014; Miller et al., 2011). These revised sexual identity questions are the same as the ones used in the National Health Interview Survey (NHIS). Starting 2017, these sexual identity questions were moved to the interviewer administered portion of the MEC interview, so the interview mode of these questions is consistent with the NHIS as well. These two questions are specifically placed at the beginning of the MEC interview to separate them from the behavioral type of questions asked later. It is to avoid the potential context effect with other behavioral questions, which may make the respondent more likely to interpret the sexual orientation question from a behavioral as opposed to a social identity perspective. During the interview, a gender-specific hand card was used with SXQ296/SXQ295 to present the response categories. Both questions have 5 response options provided to the respondent. The first two response options differ depending on the respondent’s gender; whereas, the third through fifth response options are identical for both male and female. For males, the first two options are “gay” and “straight, that is, not gay.” For females, they include “lesbian or gay” and “straight, that is, not lesbian or gay.” For both male and female, the third through fifth options are “bisexual,” “something else,” and “I don’t know the answer.” In the present dataset, the first 4 response options were coded as “1”, “2”, “3”, and “4”, respectively, in SXQ296 and SXQ295. Response “I don’t know the answer” was coded as “6” in the released variables. If the respondent refused to answer the question, the variable was coded as “7”. If the respondent expressed to the interviewer that he/she did not understand the question and/or the response options and cannot make the selection after reviewing the hand card, the variable was coded as “9” in the released file.

Analysis by subgroup characteristics should be conducted carefully. The sample size for the non-heterosexual subgroups is limited and may not meet the minimum sample size requirements for statistical reliability as noted in the NHANES analytic guidelines. Combining multiple years of data, which is often recommended to estimate rarer conditions within a subgroup, analysts will need to consider sample sizes, as well as the changes to the question and response categories made over the time period of analysis. Additionally, the high rate of selecting a non-specific answer to the questions should be considered (Miller et al., 2011). That is, selecting “don’t know,” “refused,” “not sure,” or “something else” as a response. Respondents select these answers for a variety of reasons that are well summarized in Table 2 of the NCHS report “Design, Development and Testing of the NHIS Sexual Identity Question” (Miller et al., 2011). For example, respondents from the lesbian, gay, bisexual, and transgender (LGBT) community may select “something else” when they use a different sexual identity label than those presented in the response options. However, the same option may also be selected by others because they are not familiar with the terms presented.

Exam sample weights should be used for analyses. Please refer to the NHANES Analytic Guidelines and the on-line NHANES Tutorial for further details on the use of sample weights and other analytic issues.

References

Dahlhamer JM, Galinsky AM, Joestl SS, Ward BW. Sexual orientation in the 2013 National Health Interview Survey: A quality assessment. Vital Health Stat 2(169) 2014. https://www.cdc.gov/nchs/data/series/sr_02/sr02_169.pdf
Miller K, Ryan JM. Design, Development and Testing of the NHIS Sexual Identity Question Questionnaire Design Research Laboratory, Office of Research and Methodology, National Center for Health Statistics, October 2011. https://wwwn.cdc.gov/QBANK/report/Miller_NCHS_2011_NHIS%20Sexual%20Identity.pdf

Codebook and Frequencies

SEQN - Respondent sequence number

Variable Name:: SEQN
SAS Label:: Respondent sequence number
English Text:: Respondent sequence number.
Target:: Both males and females 18 YEARS - 69 YEARS

SXD021 - Ever had vaginal, anal, or oral sex (B)

Variable Name:: SXD021
SAS Label:: Ever had vaginal, anal, or oral sex (B)
English Text:: Ever had vaginal, anal, or oral sex.
English Instructions:: DERIVED FROM SXQ800, SXQ803, SXQ806, SXQ809 FOR MALES, AND SXQ700, SXQ703, SXQ706, SXQ709 FOR FEMALES.
Target:: Both males and females 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	3899	3899
2	No	237	4136
7	Refused	3	4139
9	Don't know	0	4139
.	Missing	433	4572

SXD003B - CHECK ITEM

Variable Name:: SXD003B
English Instructions:: CHECK ITEM SXD003B: IF FEMALE, GO TO SXQ700. IF MALE, CONTINUE TO SXQ800.
Target:: Both males and females 18 YEARS - 69 YEARS

SXQ800 - Ever had vaginal sex with a woman (M)

Variable Name:: SXQ800
SAS Label:: Ever had vaginal sex with a woman (M)
English Text:: Have you ever had vaginal sex, also called sexual intercourse, with a woman? This means your penis in a woman's vagina.
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	1831	1831
2	No	179	2010
7	Refused	2	2012
9	Don't know	4	2016
.	Missing	2556	4572

SXQ803 - Ever performed oral sex on a woman (M)

Variable Name:: SXQ803
SAS Label:: Ever performed oral sex on a woman (M)
English Text:: Have you ever performed oral sex on a woman? This means putting your mouth on a woman's vagina or genitals.
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	1568	1568
2	No	441	2009
7	Refused	4	2013
9	Don't know	2	2015
.	Missing	2557	4572

SXQ806 - Ever had anal sex with a woman (M)

Variable Name:: SXQ806
SAS Label:: Ever had anal sex with a woman (M)
English Text:: Have you ever had anal sex with a woman? Anal sex means contact between your penis and a woman's anus or butt.
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	814	814
2	No	1199	2013
7	Refused	2	2015
9	Don't know	0	2015
.	Missing	2557	4572

SXQ809 - Ever had any kind of sex w/man (M)

Variable Name:: SXQ809
SAS Label:: Ever had any kind of sex w/man (M)
English Text:: Have you ever had any kind of sex with a man, including oral or anal?
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	104	104
2	No	1903	2007
7	Refused	2	2009
9	Don't know	5	2014
.	Missing	2558	4572

SXD862M - CHECK ITEM

Variable Name:: SXD862M
English Instructions:: BOX 1A CHECK ITEM SXD862M: IF (SXQ800, SXQ803, SXQ806, AND SXQ809) ALL EQUAL TO ('2 OR '.'), GO TO SXD171. OTHERWISE, GO TO SXD031.
Target:: Males only 18 YEARS - 69 YEARS

SXQ700 - Ever had vaginal sex with a man (F)

Variable Name:: SXQ700
SAS Label:: Ever had vaginal sex with a man (F)
English Text:: Have you ever had vaginal sex, also called sexual intercourse, with a man? This means a man's penis in your vagina.
Target:: Females only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	2000	2000
2	No	126	2126
7	Refused	5	2131
9	Don't know	5	2136
.	Missing	2436	4572

SXQ703 - Ever performed oral sex on a man (F)

Variable Name:: SXQ703
SAS Label:: Ever performed oral sex on a man (F)
English Text:: Have you ever performed oral sex on a man? This means putting your mouth on a man's penis or genitals.
Target:: Females only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	1634	1634
2	No	495	2129
7	Refused	5	2134
9	Don't know	2	2136
.	Missing	2436	4572

SXQ706 - Ever had anal sex with a man (F)

Variable Name:: SXQ706
SAS Label:: Ever had anal sex with a man (F)
English Text:: Have you ever had anal sex? This means contact between a man's penis and your anus or butt.
Target:: Females only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	756	756
2	No	1374	2130
7	Refused	3	2133
9	Don't know	3	2136
.	Missing	2436	4572

SXQ709 - Ever had any kind of sex w/woman (F)

Variable Name:: SXQ709
SAS Label:: Ever had any kind of sex w/woman (F)
English Text:: Have you ever had any kind of sex with a woman? By sex, we mean sexual contact with another woman's vagina or genitals.
Target:: Females only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	235	235
2	No	1897	2132
7	Refused	3	2135
9	Don't know	0	2135
.	Missing	2437	4572

SXD762F - CHECK ITEM

Variable Name:: SXD762F
English Instructions:: BOX 1A CHECK ITEM SXD762F: IF (SXQ700, SXQ703, SXQ706, AND SXQ709) ALL EQUAL TO ('2' OR '.'), GO TO SXD101. OTHERWISE, CONTINUE TO SXD031.
Target:: Females only 18 YEARS - 69 YEARS

SXD031 - Age first had any kind of sex (B)

Variable Name:: SXD031
SAS Label:: Age first had any kind of sex (B)
English Text:: How old were you when you had sex for the first time?
English Instructions:: AGE IN YEARS.
Target:: Both males and females 18 YEARS - 69 YEARS
Hard Edits:: 0 to 69

Code or Value	Value Description	Count	Cumulative
13 to 59	Range of Values	3673	3673
12	12 years or younger	223	3896
77	Refused	8	3904
99	Don't know	7	3911
.	Missing	661	4572

SXD701F - CHECK ITEM

Variable Name:: SXD701F
English Instructions:: BOX 1 CHECK ITEM SXD701F: IF (AGE 60-69 YEARS AND SXQ703 = 1), GO TO SXD621. IF (AGE 60-69 YEARS AND SXQ703 NOT= 1), GO TO SXD101. IF (AGE 18-59 YEARS AND SXQ741 = 1), GO TO SXD633. IF (AGE 18-59 YEARS AND SXQ741 NOT= 1 AND SXQ703 = 1), GO TO SXD621. OTHERWISE, GO TO SXD744F.
Target:: Females only 18 YEARS - 69 YEARS

SXD171 - # female sex partners/lifetime (M)

Variable Name:: SXD171
SAS Label:: # female sex partners/lifetime (M)
English Text:: In your lifetime, with how many women have you had any kind of sex?
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 99	Range of Values	1920	1920
100	100 or more	75	1995
77777	Refused	11	2006
99999	Don't know	7	2013
.	Missing	2559	4572

SXD815M - CHECK ITEM

Variable Name:: SXD815M
English Instructions:: BOX 2 CHECK ITEM SXD815M: IF (AGE 60-69 YEARS AND SXQ809 = 1), GO TO SXQ410. IF (SP 60-69 YEARS AND SXQ809 NOT= 1), GO TO END OF SECTION. OTHERWISE, CONTINUE TO SXD510.
Target:: Males only 18 YEARS - 69 YEARS

SXD510 - # female sex partners/year (M)

Variable Name:: SXD510
SAS Label:: # female sex partners/year (M)
English Text:: In the past 12 months, with how many women have you had any kind of sex?
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 52	Range of Values	1521	1521
100	100 or more	0	1521
77777	Refused	4	1525
99999	Don't know	3	1528
.	Missing	3044	4572

SXD821M - CHECK ITEM

Variable Name:: SXD821M
English Instructions:: BOX 3 CHECK ITEM SXD821M: IF (SXQ800, SXQ803, SXQ806, AND SXQ809) NOT EQUAL TO '1', GO TO END OF SECTION. IF SXQ800 = 1, CONTINUE TO SXQ824. OTHERWISE, GO TO SXD830M.
Target:: Males only 18 YEARS - 59 YEARS

SXQ824 - #female vaginal sex partners/lifetime(M)

Variable Name:: SXQ824
SAS Label:: #female vaginal sex partners/lifetime(M)
English Text:: In your lifetime, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman's vagina.
English Instructions:: INSTRUCTIONS TO SP: Please enter a number.
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1 to 99	Range of Values	1315	1315
100	100 or more	51	1366
77777	Refused	5	1371
99999	Don't know	5	1376
.	Missing	3196	4572

SXQ827 - # female vaginal sex partners/year (M)

Variable Name:: SXQ827
SAS Label:: # female vaginal sex partners/year (M)
English Text:: In the past 12 months, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman's vagina.
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 90	Range of Values	1367	1367
100	100 or more	1	1368
77777	Refused	2	1370
99999	Don't know	5	1375
.	Missing	3197	4572

SXD830M - CHECK ITEM

Variable Name:: SXD830M
English Instructions:: BOX 4 CHECK ITEM SXD830M: IF SXQ803 = 1, CONTINUE TO SXD633. OTHERWISE, GO TO SXD833M.
Target:: Males only 18 YEARS - 59 YEARS

SXD633 - Age first performed oral sex on woman(B)

Variable Name:: SXD633
SAS Label:: Age first performed oral sex on woman(B)
English Text:: How old were you when you first performed oral sex on a woman? Performing oral sex means your mouth on a woman's vagina or genitals.
English Instructions:: AGE IN YEARS.
Target:: Both males and females 18 YEARS - 59 YEARS
Hard Edits:: 0 to 59

Code or Value	Value Description	Count	Cumulative
13 to 58	Range of Values	1356	1356
12	12 years or younger	25	1381
77	Refused	1	1382
99	Don't know	2	1384
.	Missing	3188	4572

SXQ636 - # female oral sex partners/lifetime (B)

Variable Name:: SXQ636
SAS Label:: # female oral sex partners/lifetime (B)
English Text:: In your lifetime, on how many women have you performed oral sex?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1 to 99	Range of Values	1365	1365
100	100 or more	12	1377
77777	Refused	2	1379
99999	Don't know	5	1384
.	Missing	3188	4572

SXQ639 - # female oral sex partners/year (B)

Variable Name:: SXQ639
SAS Label:: # female oral sex partners/year (B)
English Text:: In the past 12 months, on how many women have you performed oral sex?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 38	Range of Values	1376	1376
100	100 or more	0	1376
77777	Refused	1	1377
99999	Don't know	4	1381
.	Missing	3191	4572

SXD868M - CHECK ITEM

Variable Name:: SXD868M
English Instructions:: BOX 4B CHECK ITEM SXD868M: IF SP HAD ONLY 1 LIFETIME FEMALE ORAL SEX PARTNER (CODED '1') IN SXQ636, GO TO SXD833M. OTHERWISE CONTINUE TO SXD642.
Target:: Males only 18 YEARS - 59 YEARS

SXD768F - CHECK ITEM

Variable Name:: SXD768F
English Instructions:: BOX 6B CHECK ITEM SXD768F: IF SP HAD ONLY 1 LIFETIME FEMALE ORAL SEX PARTNER (CODED '1') IN SXQ636, AND SXQ703 = 1, THEN GO TO SXD621. IF SP HAD ONLY 1 LIFETIME FEMALE ORAL SEX PARTNER (SXQ636 = 1), AND SXQ703 NOT= 1, THEN GO TO SXD744F. OTHERWISE, CONTINUE TO SXD642.
Target:: Females only 18 YEARS - 59 YEARS

SXD642 - Last performed oral sex on new female(B)

Variable Name:: SXD642
SAS Label:: Last performed oral sex on new female(B)
English Text:: How long has it been since the last time you performed oral sex on a new female partner? A new sexual partner is someone that you had never had sex with before.
English Instructions:: NUMBER OF DAYS
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 13879	Range of Values	1016	1016
77777	Refused	2	1018
99999	Don't know	9	1027
.	Missing	3545	4572

SXD833M - CHECK ITEM

Variable Name:: SXD833M
English Instructions:: BOX 5 CHECK ITEM SXD833M: IF SXQ809 = 1, CONTINUE TO SXQ410. OTHERWISE, GO TO SXD844M.
Target:: Males only 18 YEARS - 59 YEARS

SXD730F - CHECK ITEM

Variable Name:: SXD730F
English Instructions:: BOX 4 CHECK ITEM SXD730F: IF SXQ703 = 1, GO TO SXD621. OTHERWISE, GO TO SXD744F.
Target:: Females only 18 YEARS - 59 YEARS

SXQ410 - # male sex partners/lifetime(M)

Variable Name:: SXQ410
SAS Label:: # male sex partners/lifetime(M)
English Text:: In your lifetime, with how many men have you had anal or oral sex?
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1 to 80	Range of Values	93	93
100	100 or more	6	99
77777	Refused	1	100
99999	Don't know	2	102
.	Missing	4470	4572

SXQ875M - CHECK ITEM

Variable Name:: SXQ875M
English Instructions:: BOX 5B CHECK ITEM SXQ875M: IF SP IS 60-69 YEARS, GO TO SXQ836. OTHERWISE, CONTINUE TO SXQ550.
Target:: Males only 18 YEARS - 69 YEARS

SXQ550 - # male sex partners/year (M)

Variable Name:: SXQ550
SAS Label:: # male sex partners/year (M)
English Text:: In the past 12 months, with how many men have you had anal or oral sex?
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 15	Range of Values	80	80
100	100 or more	0	80
77777	Refused	0	80
99999	Don't know	0	80
.	Missing	4492	4572

SXQ836 - # male anal sex partners/lifetime (M)

Variable Name:: SXQ836
SAS Label:: # male anal sex partners/lifetime (M)
English Text:: In your lifetime, with how many men have you had anal sex?
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 75	Range of Values	96	96
100	100 or more	4	100
77777	Refused	0	100
99999	Don't know	2	102
.	Missing	4470	4572

SXQ839M - CHECK ITEM

Variable Name:: SXQ839M
English Instructions:: BOX 6 CHECK ITEM SXQ839M: IF SP IS 60-69 YEARS, GO TO SXQ853. IF SP HAD NO ANAL SEX PARTNERS (CODED '0000' IN SXQ836), GO TO SXQ853. OTHERWISE, CONTINUE TO SXQ841.
Target:: Males only 18 YEARS - 69 YEARS

SXQ841 - # male anal sex partners/year (M)

Variable Name:: SXQ841
SAS Label:: # male anal sex partners/year (M)
English Text:: In the past 12 months, with how many men have you had anal sex?
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 12	Range of Values	57	57
100	100 or more	0	57
77777	Refused	0	57
99999	Don't know	0	57
.	Missing	4515	4572

SXQ853 - Ever performed oral sex on a man (M)

Variable Name:: SXQ853
SAS Label:: Ever performed oral sex on a man (M)
English Text:: Have you ever performed oral sex on a man? Performing oral sex means your mouth on a man's penis or genitals.
Target:: Males only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	73	73
2	No	28	101
7	Refused	1	102
9	Don't know	0	102
.	Missing	4470	4572

SXD847M - CHECK ITEM

Variable Name:: SXD847M
English Instructions:: BOX 7 CHECK ITEM SXD847M: IF SP NEVER HAD ORAL MALE PARTNER (CODED '2', '7', OR '9') IN SXQ853 AND SP IS 60-69 YEARS, GO TO END OF SECTION. IF SP NEVER HAD ORAL MALE PARTNER (CODED '2', '7', OR '9') IN SXQ853 AND SP IS 18-59 YEARS, GO TO SXD844M. OTHERWISE, CONTINUE TO SXD621.
Target:: Males only 18 YEARS - 69 YEARS

SXD621 - Age first performed oral sex on man (B)

Variable Name:: SXD621
SAS Label:: Age first performed oral sex on man (B)
English Text:: How old were you when you first performed oral sex on a man? Performing oral sex means your mouth on a man's penis or genitals.
English Instructions:: AGE IN YEARS.
Target:: Both males and females 18 YEARS - 69 YEARS
Hard Edits:: 13 to 69

Code or Value	Value Description	Count	Cumulative
13 to 60	Range of Values	1662	1662
12	12 years or younger	40	1702
77	Refused	3	1705
99	Don't know	2	1707
.	Missing	2865	4572

SXQ624 - # male oral sex partners/lifetime (B)

Variable Name:: SXQ624
SAS Label:: # male oral sex partners/lifetime (B)
English Text:: In your lifetime, on how many men have you performed oral sex?
Target:: Both males and females 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
1 to 89	Range of Values	1688	1688
100	100 or more	8	1696
77777	Refused	5	1701
99999	Don't know	6	1707
.	Missing	2865	4572

SXD850B - CHECK ITEM

Variable Name:: SXD850B
English Instructions:: BOX 8 CHECK ITEM SXD850B: IF MALE AND AGE 60-69 YEARS, GO TO END OF SECTION. IF FEMALE AND 60-69 YEARS, GO TO SXD101. OTHERWISE, CONTINUE TO SXQ627.
Target:: Both males and females 18 YEARS - 69 YEARS

SXQ627 - # male oral sex partners/year (B)

Variable Name:: SXQ627
SAS Label:: # male oral sex partners/year (B)
English Text:: In the past 12 months, on how many men have you performed oral sex?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 24	Range of Values	1398	1398
100	100 or more	0	1398
77777	Refused	2	1400
99999	Don't know	3	1403
.	Missing	3169	4572

SXD865M - CHECK ITEM

Variable Name:: SXD865M
English Instructions:: BOX 8B CHECK ITEM SXD865M: IF SP HAD ONLY 1 LIFETIME MALE ORAL SEX PARTNER (CODED '1') IN SXQ624, GO TO SXD844M. OTHERWISE, CONTINUE TO SXD630.
Target:: Males only 18 YEARS - 59 YEARS

SXD765F - CHECK ITEM

Variable Name:: SXD765F
English Instructions:: BOX 5 CHECK ITEM SXD765F: IF SP HAD ONLY 1 LIFETIME MALE ORAL SEX PARTNER (CODED '1') IN SXQ624, GO TO SXD744F. OTHERWISE, CONTINUE TO SXD630.
Target:: Females only 18 YEARS - 59 YEARS

SXD630 - Last perform oral sex on new male (B)

Variable Name:: SXD630
SAS Label:: Last perform oral sex on new male (B)
English Text:: How long has it been since the last time you performed oral sex on a new male partner? A new sexual partner is someone that you had never had sex with before.
English Instructions:: NUMBER OF DAYS
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 18993	Range of Values	979	979
77777	Refused	5	984
99999	Don't know	8	992
.	Missing	3580	4572

SXD844M - CHECK ITEM

Variable Name:: SXD844M
English Instructions:: BOX 9A CHECK ITEM SXD844M: IF SP DID NOT HAVE A PARTNER IN PAST 12 MONTHS (SXD510, SXQ827, SXQ639, SXQ550, SXQ841, AND SXQ627 CODED '0000' OR MISSING OR '77777' OR '99999'), GO TO SXQ260. IF SP HAD ORAL SEX PARTNER IN PAST 12 MONTHS (SXQ627 OR SXQ639 GREATER THAN '0000' BUT LESS THAN '77777'), CONTINUE TO SXQ645. OTHERWISE, GO TO SXQ648.
Target:: Males only 18 YEARS - 59 YEARS

SXD744F - CHECK ITEM

Variable Name:: SXD744F
English Instructions:: BOX 7A CHECK ITEM SXD744F: IF SP DID NOT HAVE A PARTNER IN PAST 12 MONTHS (SXD450, SXQ727, SXQ627, SXQ639, AND SXQ490 CODED '0000' OR MISSING OR '77777' OR '99999'), GO TO SXD101. IF SP HAD ORAL SEX PARTNER IN PAST 12 MONTHS (SXQ627 OR SXQ639 GREATER THAN '0000' BUT LESS THAN '77777'), THEN CONTINUE TO SXQ645. OTHERWISE, GO TO SXQ648.
Target:: Females only 18 YEARS - 59 YEARS

SXQ645 - Use protection when perform oral sex (B)

Variable Name:: SXQ645
SAS Label:: Use protection when perform oral sex (B)
English Text:: When you performed oral sex in the past 12 months, how often would you use protection, like a condom or dental dam?
English Instructions:: THE ITEM INCLUDES SEX WITH BOTH MALE AND FEMALE PARTNERS.
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Never	1573	1573
2	Rarely	125	1698
3	Usually	81	1779
4	Always	112	1891
5	Unsure	35	1926
7	Refused	0	1926
9	Don't know	0	1926
.	Missing	2646	4572

SXQ648 - Had sex with a new partner past 12mos(B)

Variable Name:: SXQ648
SAS Label:: Had sex with a new partner past 12mos(B)
English Text:: In the past 12 months, did you have any kind of sex with a person that you never had sex with before?
English Instructions:: THE ITEM INCLUDES SEX WITH BOTH MALE AND FEMALE PARTNERS.
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	442	442
2	No	2161	2603
7	Refused	1	2604
9	Don't know	1	2605
.	Missing	1967	4572

SXD859M - CHECK ITEM

Variable Name:: SXD859M
English Instructions:: BOX 10A CHECK ITEM SXD859M: IF (SXQ800, SXQ806, AND SXQ809) NOT EQUAL TO '1', GO TO SXD856M. OTHERWISE, CONTINUE TO SXQ610.
Target:: Males only 18 YEARS - 59 YEARS

SXD759F - CHECK ITEM

Variable Name:: SXD759F
English Instructions:: BOX 8A CHECK ITEM SXD759F: IF (SXQ700 OR SXQ706) = 1, CONTINUE TO SXQ610. OTHERWISE, GO TO SXD750F.
Target:: Females only 18 YEARS - 59 YEARS

SXQ610 - Had vaginal/anal sex in past 12 mos (B)

Variable Name:: SXQ610
SAS Label:: Had vaginal/anal sex in past 12 mos (B)
English Text:: In the past 12 months, about how many times have you had {vaginal or anal/vaginal/anal} sex?
English Instructions:: THE ITEM INCLUDES SEX WITH BOTH MALE AND FEMALE PARTNERS.
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0	Never	101	101
1	Once	129	230
2	2-11 times	657	887
3	12-51 times	814	1701
4	52-103 times	459	2160
5	104-364 times	364	2524
6	365 times or more	44	2568
77	Refused	2	2570
99	Don't know	7	2577
.	Missing	1995	4572

SXD245M - CHECK ITEM

Variable Name:: SXD245M
English Instructions:: BOX 10 CHECK ITEM SXD245M: IF SP DID NOT HAVE VAGINAL OR ANAL SEX (CODED '0') IN SXQ610, GO TO SXD856M. OTHERWISE, CONTINUE TO SXQ251.
Target:: Males only 18 YEARS - 59 YEARS

SXD246F - CHECK ITEM

Variable Name:: SXD246F
English Instructions:: BOX 8 CHECK ITEM SXD246F: IF SP DID NOT HAVE VAGINAL OR ANAL SEX (CODED '0') IN SXQ610, GO TO SXD750F. OTHERWISE, CONTINUE TO SXQ251.
Target:: Females only 18 YEARS - 59 YEARS

SXQ251 - Had vaginal/anal sex without condom (B)

Variable Name:: SXQ251
SAS Label:: Had vaginal/anal sex without condom (B)
English Text:: In the past 12 months, about how often have you had {vaginal or anal/vaginal/anal} sex without using a condom?
English Instructions:: THE ITEM INCLUDES SEX WITH BOTH MALE AND FEMALE PARTNERS.
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Never	591	591
2	Less than half of the time	322	913
3	About half of the time	166	1079
4	Not always, but more than half of the time	184	1263
5	Always	1207	2470
7	Refused	5	2475
9	Don't know	1	2476
.	Missing	2096	4572

SXD856M - CHECK ITEM

Variable Name:: SXD856M
English Instructions:: BOX 11 CHECK ITEM SXD856M: IF SP 18-29 YEARS, CONTINUE TO SXQ590. OTHERWISE, GO TO SXQ260.
Target:: Males only 18 YEARS - 59 YEARS

SXD750F - CHECK ITEM

Variable Name:: SXD750F
English Instructions:: BOX 9 CHECK ITEM SXD750F: IF AGE 18-29 YEARS, CONTINUE TO SXQ590. OTHERWISE, GO TO SXD101.
Target:: Females only 18 YEARS - 59 YEARS

SXQ590 - # sex partners 5 years older/year (B)

Variable Name:: SXQ590
SAS Label:: # sex partners 5 years older/year (B)
English Text:: Of the persons you had any kind of sex with in the past 12 months, how many were five or more years older than you?
English Instructions:: THE ITEM INCLUDES SEX WITH BOTH MALE AND FEMALE PARTNERS.
Target:: Both males and females 18 YEARS - 29 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 11	Range of Values	757	757
77777	Refused	0	757
99999	Don't know	0	757
.	Missing	3815	4572

SXQ600 - # sex partners 5 years younger/year (B)

Variable Name:: SXQ600
SAS Label:: # sex partners 5 years younger/year (B)
English Text:: Of the persons you had any kind of sex with in the past 12 months, how many were five or more years younger than you?
English Instructions:: THE ITEM INCLUDES SEX WITH BOTH MALE AND FEMALE PARTNERS.
Target:: Both males and females 18 YEARS - 29 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 10	Range of Values	756	756
77777	Refused	1	757
99999	Don't know	0	757
.	Missing	3815	4572

SXD004B - CHECK ITEM

Variable Name:: SXD004B
English Instructions:: CHECK ITEM SXD004B: IF MALE, GO TO SXQ260. IF FEMALE, CONTINUE TO SXD101.
Target:: Both males and females 18 YEARS - 29 YEARS

SXD101 - # male sex partners/lifetime (F)

Variable Name:: SXD101
SAS Label:: # male sex partners/lifetime (F)
English Text:: In your lifetime, with how many men have you had any kind of sex?
Target:: Females only 18 YEARS - 69 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 99	Range of Values	2109	2109
100	100 or more	11	2120
77777	Refused	12	2132
99999	Don't know	2	2134
.	Missing	2438	4572

SXD715F - CHECK ITEM

Variable Name:: SXD715F
English Instructions:: BOX 2 CHECK ITEM SXD715F: IF SP 60-69 YEARS, GO TO END OF SECTION. OTHERWISE, CONTINUE TO SXD450.
Target:: Females only 18 YEARS - 69 YEARS

SXD450 - # male sex partners/year (F)

Variable Name:: SXD450
SAS Label:: # male sex partners/year (F)
English Text:: In the past 12 months, with how many men have you had any kind of sex?
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 30	Range of Values	1666	1666
100	100 or more	0	1666
77777	Refused	1	1667
99999	Don't know	2	1669
.	Missing	2903	4572

SXD721F - CHECK ITEM

Variable Name:: SXD721F
English Instructions:: BOX 3 CHECK ITEM SXD721F: IF (SXQ700, SXQ703, SXQ706, AND SXQ709) NOT EQUAL TO '1', GO TO END OF SECTION. IF SXQ700 = 1, CONTINUE TO SXQ724. OTHERWISE, GO TO SXD733F.
Target:: Females only 18 YEARS - 59 YEARS

SXQ724 - # male vaginal sex partners/lifetime (F)

Variable Name:: SXQ724
SAS Label:: # male vaginal sex partners/lifetime (F)
English Text:: In your lifetime, with how many men have you had vaginal sex? Vaginal sex means a man's penis in your vagina.
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1 to 99	Range of Values	1543	1543
100	100 or more	8	1551
77777	Refused	5	1556
99999	Don't know	2	1558
.	Missing	3014	4572

SXQ727 - # male vaginal sex partners/year (F)

Variable Name:: SXQ727
SAS Label:: # male vaginal sex partners/year (F)
English Text:: In the past 12 months, with how many men have you had vaginal sex? Vaginal sex means a man's penis in your vagina.
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 12	Range of Values	1556	1556
100	100 or more	0	1556
77777	Refused	1	1557
99999	Don't know	1	1558
.	Missing	3014	4572

SXD733F - CHECK ITEM

Variable Name:: SXD733F
English Instructions:: BOX 6 CHECK ITEM SXD733F: IF SXQ709 = 1, CONTINUE TO SXQ130. OTHERWISE, GO TO SXQ753.
Target:: Females only 18 YEARS - 59 YEARS

SXQ130 - # female sex partners/lifetime (F)

Variable Name:: SXQ130
SAS Label:: # female sex partners/lifetime (F)
English Text:: In your lifetime with how many women have you had sex? By sex, we mean sexual contact with another woman's vagina or genitals.
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1 to 25	Range of Values	212	212
100	100 or more	0	212
77777	Refused	0	212
99999	Don't know	0	212
.	Missing	4360	4572

SXQ490 - # female sex partners/year (F)

Variable Name:: SXQ490
SAS Label:: # female sex partners/year (F)
English Text:: In the past 12 months, with how many women have you had sex? By sex, we mean sexual contact with another woman's vagina or genitals.
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
0 to 6	Range of Values	211	211
100	100 or more	0	211
77777	Refused	0	211
99999	Don't know	1	212
.	Missing	4360	4572

SXQ741 - Ever performed oral sex on a woman (F)

Variable Name:: SXQ741
SAS Label:: Ever performed oral sex on a woman (F)
English Text:: Have you ever performed oral sex on a woman? Performing oral sex means your mouth on a woman's vagina or genitals.
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	175	175
2	No	37	212
7	Refused	0	212
9	Don't know	0	212
.	Missing	4360	4572

SXQ753 - Ever told that you had HPV (F)

Variable Name:: SXQ753
SAS Label:: Ever told that you had HPV (F)
English Text:: Has a doctor or other health care professional ever told you that you had human papillomavirus or HPV?
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	168	168
2	No	1419	1587
7	Refused	3	1590
9	Don't know	0	1590
.	Missing	2982	4572

SXQ260 - Ever told that you had genital herpes(B)

Variable Name:: SXQ260
SAS Label:: Ever told that you had genital herpes(B)
English Text:: Has a doctor or other health care professional ever told you that you had genital herpes?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	128	128
2	No	2864	2992
7	Refused	3	2995
9	Don't know	0	2995
.	Missing	1577	4572

SXQ265 - Ever told that you had genital warts (B)

Variable Name:: SXQ265
SAS Label:: Ever told that you had genital warts (B)
English Text:: Has a doctor or other health care professional ever told you that you had genital warts?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative	Skip to Item
1	Yes	117	117
2	No	2874	2991	SXQ270
7	Refused	2	2993	SXQ270
9	Don't know	1	2994	SXQ270
.	Missing	1578	4572

SXQ267 - Age first told you had genital warts (B)

Variable Name:: SXQ267
SAS Label:: Age first told you had genital warts (B)
English Text:: How old were you when you were first told that you had genital warts?
English Instructions:: AGE IN YEARS.
Target:: Both males and females 18 YEARS - 59 YEARS
Hard Edits:: 0 to 59

Code or Value	Value Description	Count	Cumulative
14 to 58	Range of Values	115	115
12	12 years or younger	2	117
77	Refused	0	117
99	Don't know	0	117
.	Missing	4455	4572

SXQ270 - Ever told that you had gonorrhea (B)

Variable Name:: SXQ270
SAS Label:: Ever told that you had gonorrhea (B)
English Text:: In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	12	12
2	No	2979	2991
7	Refused	3	2994
9	Don't know	0	2994
.	Missing	1578	4572

SXQ272 - Ever told that you had chlamydia (B)

Variable Name:: SXQ272
SAS Label:: Ever told that you had chlamydia (B)
English Text:: In the past 12 months, has a doctor or other health care professional told you that you had chlamydia?
Target:: Both males and females 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Yes	45	45
2	No	2947	2992
7	Refused	2	2994
9	Don't know	0	2994
.	Missing	1578	4572

SXD005B - CHECK ITEM

Variable Name:: SXD005B
English Instructions:: CHECK ITEM SXD005B: IF FEMALE, GO TO SXQ295. IF MALE, CONTINUE TO SXQ280.
Target:: Both males and females 18 YEARS - 59 YEARS

SXQ280 - Circumcised or uncircumcised? (M)

Variable Name:: SXQ280
SAS Label:: Circumcised or uncircumcised? (M)
English Text:: Are you circumcised or uncircumcised?
English Instructions:: CAPI INSTRUCTIONS: Display the sketches below each selection. Sketch should display by default. ACASI FIGURE SXQ1 - CLINICAL SKETCH OF CIRCUMCISED PENIS. ACASI FIGURE SXQ2 - CLINICAL SKETCH OF UNCIRCUMCISED PENIS.
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative	Skip to Item
1	Circumcised	996	996	SXQ296
2	Uncircumcised	401	1397	SXQ296
7	Refused	3	1400	SXQ296
9	Don't know	4	1404	SXQ296
.	Missing	3168	4572

SXQ295 - Describe sexual identity (F)

Variable Name:: SXQ295
SAS Label:: Describe sexual identity (F)
English Text:: Which of the following best represents how you think of yourself?
English Instructions:: HAND CARD SXQ1
Target:: Females only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative	Skip to Item
1	Lesbian or Gay	39	39	End of Section
2	Straight, that is, not lesbian or gay	1504	1543	End of Section
3	Bisexual	75	1618	End of Section
4	Something else	23	1641	End of Section
6	I don't know the answer	63	1704	End of Section
7	Refused	1	1705	End of Section
9	Don't know	5	1710	End of Section
.	Missing	2862	4572

SXQ296 - Describe sexual identity (M)

Variable Name:: SXQ296
SAS Label:: Describe sexual identity (M)
English Text:: Which of the following best represents how you think of yourself?
English Instructions:: HAND CARD SXQ2
Target:: Males only 18 YEARS - 59 YEARS

Code or Value	Value Description	Count	Cumulative
1	Gay	25	25
2	Straight that is not gay	1445	1470
3	Bisexual	17	1487
4	Something else	11	1498
6	I don't know the answer	47	1545
7	Refused	0	1545
9	Don't know	2	1547
.	Missing	3025	4572

Appendix 1. Sexual Behavior (SXQ) Data for Males in NHANES 2003-2018 Release Files


	2003-2004 Variable name/Question	2005-2006 Variable name/Question	2007-2008† Variable name/Question	2009-2018 Variable name/Question
Target age	14-59 years	14-59 years	14-69 years	14-69 years
Ever had any type of sex	SXQ020 The next set of questions is about your sexual behavior. By sex, we mean vaginal, oral, or anal sex. Please remember that your answers are strictly confidential. Have you ever had sex?	SXQ021 The next set of questions is about your sexual behavior. By sex, we mean vaginal, anal, or oral sex. Please remember that your answers are strictly confidential. Have you ever had vaginal, anal, or oral sex?	SXQ021 The next set of questions is about your sexual behavior. By sex, we mean vaginal, anal, or oral sex. Please remember that your answers are strictly confidential. Have you ever had vaginal, anal, or oral sex?	SXD021 Ever had vaginal, anal, or oral sex. Derived from: SXQ800 SXQ803 SXQ806 SXQ809 SXQ615¥
	Not included	Not included	Not included	SXQ800 Have you ever had vaginal sex, also called sexual intercourse, with a woman? This means your penis in a woman’s vagina.
	Not included	Not included	Not included	SXQ803 Have you ever performed oral sex on a woman? This means putting your mouth on a woman’s vagina or genitals.
	Not included	Not included	Not included	SXQ806 Have you ever had anal sex with a woman? Anal sex means contact between your penis and a woman’s anus or butt.
	Not included	Not included	Not included	SXQ809 Have you ever had any kind of sex with a man, including oral or anal?
Age of having sex for the first time	SXD030 How old were you when you had sex for the first time?	SXD031 When you first had vaginal, anal, or oral sex, how old were you?	SXD031 When you first had vaginal, anal, or oral sex, how old were you?	SXD031€ How old were you the first time you had any kind of sex, including {vaginal, anal, or oral/vaginal or anal/vaginal or oral/anal or oral/vaginal/anal/oral}?
Life time female sex partner(s)	SXQ170 In your lifetime, with how many women have you had sex?	SXD171 In your lifetime, with how many females have you had vaginal, anal, or oral sex?	SXD171 In your lifetime, with how many females have you had vaginal, anal, or oral sex?	SXD171 In your lifetime, with how many women have you had any kind of sex?
	Not included	SXQ400 With how many of these females have you had only oral sex?	SXQ400* With how many of these females have you had only oral sex?	Not included
	Not included	Not included	Not included	SXQ824* In your lifetime, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman’s vagina.
	Not included	Not included	Not included	SXQ636* In your lifetime, on how many women have you performed oral sex?
Female sex partner(s) in the last 12 months	SXQ190 In the past 12 months, with how many women have you had sex?	SXQ510 In the past 12 months, with how many females have you had vaginal, anal, or oral sex?	SXQ510* In the past 12 months, with how many females have you had vaginal, anal, or oral sex?	SXD510* In the past 12 months, with how many women have you had any kind of sex?
	Not included	SXQ530 With how many of these females have you had only oral sex?	SXQ530* With how many of these females have you had only oral sex?	Not included
	Not included	Not included	Not included	SXQ827* In the past 12 months, with how many women have you had vaginal sex? Vaginal sex means your penis in a woman’s vagina.
	Not included	Not included	Not included	SXQ639* In the past 12 months, on how many women have you performed oral sex?
Oral sex with female partner	Not included	Not included	Not included	SXD633* How old were you when you first performed oral sex on a woman? Performing oral sex means your mouth on a woman’s vagina or genitals.
Oral sex with female partner	Not included	Not included	Not included	SXD642* How long has it been since the last time you performed oral sex on a new female partner? A new sexual partner is someone that you had never had sex with before.
Life time male sex partner(s)	SXQ200 In your lifetime, with how many men have you had sex?	SXQ410 In your lifetime, with how many males have you had anal or oral sex?	SXQ410 In your lifetime, with how many males have you had anal or oral sex?	SXQ410 In your lifetime, with how many men have you had anal or oral sex?
	Not included	SXQ430 With how many of these males have you had only oral sex?	SXQ430 With how many of these males have you had only oral sex?	Not included
	Not included	Not included	Not included	SXQ836 In your lifetime, with how many men have you had anal sex?
	Not included	Not included	Not included	SXQ624 In your lifetime, on how many men have you performed oral sex?
Male sex partner(s) in the last 12 months	SXQ220 In the past 12 months, with how many men have you had sex?	SXQ550 In the past 12 months, with how many males have you had anal or oral sex?	SXQ550* In the past 12 months, with how many males have you had anal or oral sex?	SXQ550* In the past 12 months, with how many men have you had anal or oral sex?
	Not included	SXQ570 With how many of these males have you had only oral sex?	SXQ570* With how many of these males have you had only oral sex?	Not included
	Not included	Not included	Not included	SXQ841* In the past 12 months, with how many men have you had anal sex?
	Not included	Not included	Not included	SXQ627* In the past 12 months, on how many men have you performed oral sex?
Oral sex with male partner	Not included	Not included	Not included	SXQ853 Have you ever performed oral sex on a man? Performing oral sex means your mouth on a man’s penis or genitals.
	Not included	Not included	Not included	SXD621 How old were you when you first performed oral sex on a man? Performing oral sex means your mouth on a man’s penis or genitals.
	Not included	Not included	Not included	SXD630* How long has it been since the last time you performed oral sex on a new male partner? A new sexual partner is someone that you had never had sex with before.
Sex in the past 12 months	SXQ241 In the past 30 days, with how many people have you had sex?	SXQ610 In the past 12 months, about how many times have you had vaginal or anal sex?	SXQ610* In the past 12 months, about how many times have you had vaginal or anal sex?	SXQ610€* In the past 12 months, about how many times have you had {vaginal or anal/vaginal/anal} sex?
	Not included	SXQ590 Of the persons you had sex with in the past 12 months, how many were five or more years older than you?	SXQ590* Of the persons you had sex with in the past 12 months, how many were five or more years older than you?	SXQ590£ Of the persons you had any kind of sex with in the past 12 months, how many were five or more years older than you?
	Not included	SXQ600 Of the persons you had sex with in the past 12 months, how many were five or more years younger than you?	SXQ600* Of the persons you had sex with in the past 12 months, how many were five or more years younger than you?	SXQ600£ Of the persons you had any kind of sex with in the past 12 months, how many were five or more years younger than you?
	Not included	Not included	Not included	SXQ648* In the past 12 months, did you have any kind of sex with a person that you never had sex with before?
	SXQ250 In the past 30 days, how many times have you had sex without using a condom?	SXQ251 In the past 12 months, about how often have you had vaginal or anal sex without using a condom?	SXQ251* In the past 12 months, about how often have you had vaginal or anal sex without using a condom?	SXQ251€* In the past 12 months, about how often have you had {vaginal or anal/vaginal/anal} sex without using a condom?
	Not included	Not included	Not included	SXQ645* When you performed oral sex in the past 12 months, how often would you use protection, like a condom or dental dam?
History of sexually transmitted diseases	SXQ260 Has a doctor or other health professional ever told you that you had genital herpes?	SXQ260 Has a doctor or other health professional ever told you that you had genital herpes?	SXQ260* Has a doctor or other health professional ever told you that you had genital herpes?	SXQ260* Has a doctor or other health professional ever told you that you had genital herpes?
	SXQ265 Has a doctor or health care professional ever told you that you had genital warts?	SXQ265 Has a doctor or health care professional ever told you that you had genital warts?	SXQ265* Has a doctor or health care professional ever told you that you had genital warts?	SXQ265* Has a doctor or health care professional ever told you that you had genital warts?
	Not included	Not included	Not included	*SXQ267‡** How old were you when you were first told that you had genital warts?
	SXQ270 In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?	SXQ270 In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?	SXQ270* In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?	SXQ270* In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?
	SXQ272 In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?	SXQ272 In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?	SXQ272* In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?	SXQ272* In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?
Circumcision status	SXQ280 Are you circumcised or uncircumcised?	SXQ280 Are you circumcised or uncircumcised?	SXQ280* Are you circumcised or uncircumcised?	*SXQ280₮** Are you circumcised or uncircumcised?
Sexual identity/ attraction	SXQ292# Do you think of yourself as…	SXQ292# Do you think of yourself as…	SXQ292# Do you think of yourself as…	SXQ292# Do you think of yourself as... SXQ296#± Which of the following best represents how you think of yourself?
Interview status	Not included	SXAISC Interview status code	SXAISC Interview status code	Not included


†	Questions were changed during data collection: “vaginal, anal, and oral” qualifiers were removed. See documentation accompanied 2007-2008 data file (available at: https://wwwn.cdc.gov/nchs/nhanes/2007-2008/SXQ_E.htm) for more details.
¥	Target age: 14-17 years.
*	Target age: 14-59 years.
£	Target age changed from 14-59 years to 14-29 years in 2009-2010.
€	Question was edited to include "fills". For example, depending on what types of sex respondents indicated having determines the fills in the question.
#	Target age: 18-59 years.
‡	Question was added in 2013-2014.
₮	In 2013-2018, the circumcision question was not asked to men who answered “No” (code=2) to all of the type-specific sex questions (i.e., SXQ800, SXQ803, SXQ806, and SXQ809). However, the question was asked to youth 14-17 years who answered “No” to SXQ615 during the same data collection cycles.
±	Wording and response categories for question modified in 2015-2016. Moved to interviewer-administered MEC CAPI interview in 2017-2018.

Appendix 2. Sexual Behavior (SXQ) Data for Females in NHANES 2003-2018 Release Files


	2003-2004 Variable name/Question	2005-2006 Variable name/Question	2007-2008† Variable name/Question	2009-2018 Variable name/Question
Target age	14-59 years	14-59 years	14-69 years	14-69 years
Ever had any type of sex	SXQ020 The next set of questions is about your sexual behavior. By sex, we mean vaginal, oral, or anal sex. Please remember that your answers are strictly confidential. Have you ever had sex?	SXQ021 The next set of questions is about your sexual behavior. By sex, we mean vaginal, anal, or oral sex. Please remember that your answers are strictly confidential. Have you ever had vaginal, anal, or oral sex?	SXQ021 The next set of questions is about your sexual behavior. By sex, we mean vaginal, anal, or oral sex. Please remember that your answers are strictly confidential. Have you ever had vaginal, anal, or oral sex?	SXD021 Ever had vaginal, anal, or oral sex. Derived from: SXQ700 SXQ703 SXQ706 SXQ709 SXQ615¥
	Not included	Not included	Not included	SXQ700 Have you ever had vaginal sex, also called sexual intercourse, with a man? This means a man’s penis in your vagina.
	Not included	Not included	Not included	SXQ703 Have you ever performed oral sex on a man? This means putting your mouth on a man’s penis or genitals.
	Not included	Not included	Not included	SXQ706 Have you ever had anal sex? This means contact between a man’s penis and your anus or butt.
	Not included	Not included	Not included	SXQ709 Have you ever had any kind of sex with a woman? By sex, we mean sexual contact with another woman’s vagina or genitals.
Age of having sex for the first time	SXD030 How old were you when you had sex for the first time?	SXD031 When you first had vaginal, anal, or oral sex, how old were you?	SXD031 When you first had vaginal, anal, or oral sex, how old were you?	SXD031€ How old were you the first time you had any kind of sex, including {vaginal, anal, or oral/vaginal or anal/vaginal or oral/anal or oral/vaginal/anal/oral}?
Life time male sex partner(s)	SXQ100 In your lifetime, with how many men have you had sex?	SXQ101 In your lifetime, with how many males have you had vaginal, anal, or oral sex?	SXQ101 In your lifetime, with how many males have you had vaginal, anal, or oral sex?	SXD101 In your lifetime, with how many men have you had any kind of sex?
	Not included	SXQ350 With how many of these males have you had only oral sex?	SXQ350* With how many of these males have you had only oral sex?	Not included
	Not included	Not included	Not included	SXQ724* In your lifetime, with how many men have you had vaginal sex? Vaginal sex means a man’s penis in your vagina.
	Not included	Not included	Not included	SXQ624* In your lifetime, on how many men have you performed oral sex?
Male sex partner(s) in the last 12 months	SXQ120 In the past 12 months, with how many men have you had sex?	SXQ450 In the past 12 months, with how many males have you had vaginal, anal, or oral sex?	SXQ450* In the past 12 months, with how many males have you had vaginal, anal, or oral sex?	SXD450* In the past 12 months, with how many men have you had any kind of sex?
	Not included	SXQ470 With how many of these males have you had only oral sex?	SXQ470* With how many of these males have you had only oral sex?	Not included
	Not included	Not included	Not included	SXQ727* In the past 12 months, with how many men have you had vaginal sex? Vaginal sex means a man’s penis in your vagina.
	Not included	Not included	Not included	SXQ627* In the past 12 months, on how many men have you performed oral sex?
Oral sex with male partner	Not included	Not included	Not included	SXD621* How old were you when you first performed oral sex on a man? Performing oral sex means your mouth on a man’s penis or genitals.
Oral sex with male partner	Not included	Not included	Not included	SXD630* How long has it been since the last time you performed oral sex on a new male partner? A new sexual partner is someone that you had never had sex with before.
Life time female sex partner(s)	SXQ130 In your lifetime, with how many women have you had sex?	SXQ130 In your lifetime, with how many women have you had sex?	In your lifetime, with how many women have you had sex?	SXQ130* In your lifetime with how many women have you had sex? By sex, we mean sexual contact with another woman’s vagina or genitals.
Life time female sex partner(s)	Not included	Not included	Not included	SXQ636* In your lifetime, on how many women have you performed oral sex?
Female sex partner(s) in the last 12 months	SXQ150 In the past 12 months, with how many women have you had sex?	SXQ490 In the past 12 months, with how many females have you had sex?	SXQ490* In the past 12 months, with how many females have you had sex?	SXQ490* In the past 12 months, with how many women have you had sex? By sex, we mean sexual contact with another woman’s vagina or genitals.
Female sex partner(s) in the last 12 months	Not included	Not included	Not included	SXQ639* In the past 12 months, on how many women have you performed oral sex?
Oral sex with female partner	Not included	Not included	Not included	SXQ741* Have you ever performed oral sex on a woman? Performing oral sex means your mouth on a woman’s vagina or genitals.
	Not included	Not included	Not included	SXD633* How old were you when you first performed oral sex on a woman? Performing oral sex means your mouth on a woman’s vagina or genitals.
	Not included	Not included	Not included	SXD642* How long has it been since the last time you performed oral sex on a new female partner? A new sexual partner is someone that you had never had sex with before.
Sex in the past 12 months	SXQ241 In the past 30 days, with how many people have you had sex?	SXQ610 In the past 12 months, about how many times have you had vaginal or anal sex?	SXQ610* In the past 12 months, about how many times have you had vaginal or anal sex?	SXQ610€* In the past 12 months, about how many times have you had {vaginal or anal/vaginal/anal} sex?
	Not included	SXQ590 Of the persons you had sex with in the past 12 months, how many were five or more years older than you?	SXQ590* Of the persons you had sex with in the past 12 months, how many were five or more years older than you?	SXQ590£ Of the persons you had any kind of sex with in the past 12 months, how many were five or more years older than you?
	Not included	SXQ600 Of the persons you had sex with in the past 12 months, how many were five or more years younger than you?	SXQ600* Of the persons you had sex with in the past 12 months, how many were five or more years younger than you?	SXQ600£ Of the persons you had any kind of sex with in the past 12 months, how many were five or more years younger than you?
	Not included	Not included	Not included	SXQ648* In the past 12 months, did you have any kind of sex with a person that you never had sex with before?
	SXQ250 In the past 30 days, how many times have you had sex without using a condom?	SXQ251 In the past 12 months, about how often have you had vaginal or anal sex without using a condom?	SXQ251* In the past 12 months, about how often have you had vaginal or anal sex without using a condom?	SXQ251€* In the past 12 months, about how often have you had {vaginal or anal/vaginal/anal} sex without using a condom?
	Not included	Not included	Not included	SXQ645* When you performed oral sex in the past 12 months, how often would you use protection, like a condom or dental dam?
History of sexually transmitted diseases	SXQ260 Has a doctor or other health professional ever told you that you had genital herpes?	SXQ260 Has a doctor or other health professional ever told you that you had genital herpes?	SXQ260* Has a doctor or other health professional ever told you that you had genital herpes?	SXQ260* Has a doctor or other health professional ever told you that you had genital herpes?
	SXQ265 Has a doctor or health care professional ever told you that you had genital warts?	SXQ265 Has a doctor or health care professional ever told you that you had genital warts?	SXQ265* Has a doctor or health care professional ever told you that you had genital warts?	SXQ265* Has a doctor or health care professional ever told you that you had genital warts?
	Not included	Not included	Not included	*SXQ267‡** How old were you when you were first told that you had genital warts?
	Not included	Not included	Not included	SXQ753* Has a doctor or other health care professional ever told you that you had human papillomavirus or HPV?
	SXQ270 In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?	SXQ270 In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?	SXQ270* In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?	SXQ270* In the past 12 months, has a doctor or other health care professional told you that you had gonorrhea, sometimes called GC or clap?
	SXQ272 In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?	SXQ272 In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?	SXQ272* In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?	SXQ272* In the past 12 months, has a doctor or other health care professional told you that you had Chlamydia?
Sexual identity/ attraction	SXQ294# Do you think of yourself as…	SXQ294# Do you think of yourself as…	SXQ294# Do you think of yourself as…	SXQ294# Do you think of yourself as... SXQ295#± Which of the following best represents how you think of yourself?
Interview status	Not included	SXAISC Interview status code	SXAISC Interview status code	Not included


†	Questions were changed during data collection: “vaginal, anal, and oral” qualifiers were removed. See documentation accompanied 2007-2008 data file (available at: https://wwwn.cdc.gov/nchs/nhanes/2007-2008/SXQ_E.htm) for more details.
¥	Target age: 14-17 years.
*	Target age: 14-59 years.
£	Target age changed from 14-59 years to 14-29 years in 2009-2010.
€	Question was edited to include "fills". For example, depending on what types of sex respondents indicated having determines the fills in the question.
#	Target age: 18-59 years.
‡	Question was added in 2013-2014.
±	Wording and response categories for question modified in 2015-2016. Moved to interviewer-administered MEC CAPI interview in 2017-2018.

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