"First, I… then, we…": exploring the sequence of sexual acts and safety strategies reported during a sexual encounter using a modified timeline followback method.

Academic Article


  • OBJECTIVES: Assessments of sexual safety often rely on questions about the occurrence of condom use within a designated timeline, assuming that penile-vaginal intercourse (PVI) occurred once at the conclusion of the event. An investigation of all sexual acts and safety strategies that occur during a single event may present a more nuanced picture of sexual risk. METHODS: Behaviourally, bisexual women (N=45) were recruited due to the potential diversity of their sexual behaviour and safety strategies. A modified timeline follow-back method, the SEQUENCE Calendar, was designed to capture information about the participants' most recent sexual event with a male partner, including the order of each sexual act during the sexual event. Interviews took between 1 and 3 h. These acts were compiled into narratives and the behavioural sequences were reviewed and coded. RESULTS: Participants reported an average of 7.9 (SD=4.3) sexual acts. Over a third (35.9%, N=14) of the participants who reported PVI indicated engaging in genital contact after PVI and over 15% (N=6) of these participants reporting PVI at two different time points, separated by sexual behaviour. Additional potential for infection outside of condom use and PVI was also identified. CONCLUSIONS: Sexual interactions are comprised of multiple acts that occur in a variety of permutations. Understanding the complexity of people's sexual encounters has potential to inform the ways we measure condom use and consider sexual safety.
  • Published In


  • CONDOMS, SEXUAL BEHAVIOUR, SEXUAL EXPERIENCE, SEXUAL HEALTH, Behaviorism, Coitus, Condoms, Female, Humans, Male, Personality Assessment, Risk-Taking, Safe Sex, Sexual Behavior, Sexual Partners, Unsafe Sex
  • Digital Object Identifier (doi)

    Author List

  • Schick VR; Baldwin A; Bay-Cheng LY; Dodge B; Van Der Pol B; Fortenberry JD
  • Start Page

  • 272
  • End Page

  • 275
  • Volume

  • 92
  • Issue

  • 4