Executive Summary - The Sexuality Research Assessment Project

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di Mauro, Diane. Executive Summary. Sexuality Research in the United States: An Assessment of the Social and Behavioral Sciences. New York: The Social Science Research Council, 1995.

This Executive Summary is part of a more comprehensive report, Sexuality Research in the United States: An Assessment of the Social and Behavioral Sciences. Both the summary and the full report are available to professionals in the field. Interested individuals should send a $3.00 postage meter strip to the project to cover the cost of priority mail. Send to:

The Sexuality Research Assessment Project
The Social Science Research Council
605 Third Avenue, 17th Floor
New York, NY 10158
212/661-0280; FAX: 212/370-7896

The Executive Summary is reproduced here by permission of the Sexuality Research Assessment Project. Permission is required to reproduce any or all of this publication.

Copyright © 1995; The Sexuality Research Assessment Project.

Contents of the Executive Summary (59k)

1. The Need for Sexuality Research in the United States
2. The Gaps and Needs in Research
3. The Barriers in Sexuality Research
4. Government and Private Sector Support
5. Assessment Recommendations
6. Conclusion

(1) The Need for Sexuality Research in the United States

Human sexuality is inherently related to many of the social and public health concerns and challenges in the United States today, including family planning and contraceptive use, adolescent pregnancy, child abuse, and the HIV/AIDS pandemic. Statistics indicate the magnitude of such problems: each year, one million girls become pregnant, and $25 billion in federal funds are spent annually on families begun by teenagers for social, health welfare services. One million Americans are currently infected with HIV, and almost a quarter million have died from AIDS, yet only one in ten children in America's schools receives comprehensive sexuality education that includes thorough information about HIV/AIDS transmission and prevention. One in five adolescent girls in grade 8-11 is subjected to sexual harassment, while 74% of girls under the age of 14 who have had sexual relations are the victims of rape.

These and other public health problems are well-documented and are increasingly understood within the context of poverty, family trauma, ethnic discrimination, lack of educational opportunities, and inadequate health services. However, there is little recognition of how these health crises are related to human sexuality or how sexual attitudes, beliefs, and values act as antecedents and contributing factors to these problems. Needed is a more fully developed understanding of how early sexual experiences and socialization patterns, as they occur within society and culture, influence adult behaviors -- both positive, as in one's ability to form lasting, affectionate relationships, and negative, as with coercive sexual behaviors. A comprehensive and effective approach to addressing these public health concerns depends on knowing answers to questions about what constitutes sexual health, what motivates sexual behavior, how sexual norms are developed and sustained, and how these evolve over time.

This information is essential to the effective planning and implementing of activities undertaken in the name of public health promotion and public policy, including direct service provision, such as school and community-based programs and public education campaigns. Such an approach will substantially inform the public policy debates about HIV/AIDS, adolescent pregnancy, and sexual coercion. These debates can be better informed if data were broadly collected on a range of sexuality topics including: the diversity and distribution of sexual values and behaviors within different populations, societies, and cultures; the impact of sexuality on personal and family relationships; and the specific and varied meanings of sexuality for individuals. Comprehensive data on contemporary sexual behaviors, attitudes, and practices are not available, nor is it understood how they are shaped by different societal, cultural, and familial contexts.

If research in sexuality had been funded and conducted over the past 30-40 years, utilizing a broad array of methods and approaches, there would exist today a body of knowledge upon which to base more effective public health and social welfare interventions. Epidemiological estimates of the transmission of HIV in the U.S. continue to be extrapolated from the work of Alfred Kinsey, which is now 40 years out of date. While some funding has been provided, there has been no major or consistent support from either the government or the private sector to conduct behavioral and social science research focusing on human sexuality since the work of Kinsey and colleagues. This lack of support has created a substantial dearth of knowledge, which, in turn, has sustained many of the social crises evident in the United States today. The opportunity now exists to expand the current research agenda, broaden the use of methodological methods of inquiry, and create a new paradigm of sexual knowledge. To do so would represent a critical investment in the capacity to anticipate, confront and overcome public health challenges in the future.

Sexuality Research Assessment Project (SRAP)

Recognizing a need to expand the knowledge base about human sexuality and to respond to insufficient funding for research in this area, representatives from the U.S. donor community, supporting both domestic and international projects, initiated a new endeavor named the Sexuality Research Assessment Project (SRAP), housed at the Social Science Research Council in New York City. The primary objective of this project was to provide an overview of social science research about sexual behavior. Its mandate included identifying research trends and gaps, priority topics, and critical issues of sexuality to advance research focusing on a social understanding of sexuality.

The assessment report entitled Sexuality Research in the United States: An Assessment of the Social and Behavioral Sciences can be obtained through the Social Science Research Council. Overall, the assessment reveals three primary concerns:

1. a need for fundamental research to expand the information base on sexuality and a need for adequate dissemination of research findings to policy makers, practitioners, educators, and groups working at the community level, as well as to the general public;
2. a need for comprehensive training for sexuality researchers, incorporating sexuality content material and research methodology skills; and
3. a need for overall strengthening of sexuality research fields in order to encourage greater academic respectability and public acceptance of research in this area.

Current Status of Sexuality Research

Sphere of Research:

Crossing diverse fields, sexuality research in the social sciences requires a multi-faceted definition and can include:

• behavioral studies identifying the range of sexual behaviors within different populations;
• cultural and ethnographic studies on the context in cultural issues that influence them;
• developmental studies on the evolution of sexual behaviors and practices, and their relationship to sexual values,
• attitudes and beliefs within and across specific sample populations;
• clinical studies on the physiology of sexual response and its relationship to sexual behavior and practices;
• reproductive health studies on how reproductive behaviors and decisions impact on sexual behaviors and practices and vice-versa; and
• psychological studies on the cognitive and affective processes that affect sexual behaviors and practices, and motivate individuals to reduce their risks, teach the skills for effective prevention and modify the social and cultural context in order to reduce risk-taking on a societal level. In this report, the phrase "social and behavioral research on sexuality" refers to any and all of these areas.

Sexuality research today represents the continuation of a long tradition of primarily individual scholarship on the topic. Occurring most often within a clinical or academic setting, what is typically identified as sexuality research is that which focuses on sexual physiology, anatomy, and therapeutic issues, rather than research that addresses the social, cultural, or behavioral topics of sexuality. Social and behavioral research on sexuality is often embedded within larger research questions in the range of social science disciplines, including sociology, psychology, anthropology, and history. Sexuality topics are also being addressed by researchers in education, biology, medicine, and public health, again integrated within larger issues researched by each discipline. Very little of this research has sexuality as its primary focus, and that which does is mostly limited to small population samples with a very narrow focus on specific behaviors, within the framework of the discipline.

As a cohesive field of inquiry and investigation, however, behavioral research in sexuality is largely underdeveloped. This situation is largely due to inconsistent and inadequate financial support on the part of both the government and the private sector, the political and controversial history of sexuality research in the United States, and, as a result, a hesitancy to publicly promote sexuality research. Typically, researchers obtain funding by incorporating minor sexuality components into larger research projects, especially when the work focuses on HIV/AIDS or adolescent health and is linked to intervention planning, targeted risk behaviors, or a public health context. Moreover, there exists no coordinating mechanism to provide financial, logistical, or political support to professionals conducting sexuality research. For future generations of researchers, this situation creates enormous disincentives for entering the field as evidenced by the lack of specialized training, peer support, and professional recognition for those conducting research on sexual behavior.

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(2) The Gaps and Needs in Research

Within the social sciences, the primary force for behavioral research in sexuality is a preventive health agenda that prioritizes sexuality as a social problem and behavioral risk. In biomedicine, this definition translates to a disease-prevention focus encompassing medically defined categories of analysis, epidemiological assessments, and/or pharmaceutical interventions. Within both the social sciences and in biomedicine, it is these approaches which dictate the funding for sexuality research. While some sexuality research should aim to prevent social problems and/or disease, particularly in light of the HIV/AIDS pandemic, the ramifications of a limited, preventive approach are significant. First, the research questions are focused primarily on identifying high-risk sexual behaviors and/or motivating behavioral change, and second, sexuality is conceptualized within a negative and problematic context.

The narrow research focus on singular outcomes and the inherent assumptions about what constitutes risk, and to whom, has meant that a full range of the subjects' behavior is not identified. Moreover, such narrowly defined research has been unable to adequately examine specific social and cultural factors that drive human behaviors and attitudes. While it is of critical importance to identify at-risk populations in need of disease prevention interventions, there is a dearth of information about populations not considered to be at risk and a tremendous lack of baseline data about sexuality across the life span.

What is Needed in Sexuality Research

A much-needed framework for sexuality topics is the analysis of sexual behaviors in the context of society and culture. To accomplish the goal of understanding how societal and cultural forces "structure" sexuality, research is needed to examine how sexual socialization occurs in families, schools, the media, and peer groups and to address the complex perspectives of different situations, populations, and cultural communities. Cross-cultural research might compare differences on topics like sexual socialization patterns, or the developmental aspects of sexuality, in order to identify their meaning and importance within specific cultures. Relevant social and cultural questions which have long needed exploration include:

• What is the impact of familial and societal sexual norms on the acquisition of specific sexual behaviors?
• What is the role of different social institutions -- including religious institutions, schools, and the media -- in establishing and maintaining sexual norms, values, attitudes, and behaviors?
• What individual behaviors, abilities, attributes, motivations, and practices contribute to sexual health?
• How are socializing processes perpetuated among different ethnic and cultural groups within the United States?
• What is the range of behaviors within and between different populations along the continuum of gender, orientation lifestyles, and relationships?
• What is the process by which individuals come to be labeled sexually dysfunctional?

The Need for a Developmental Framework

Within the framework of society and culture, research on sexual behavior should be structured within a developmental framework that utilizes an expanded view of human sexuality throughout the life cycle, starting with infancy and early childhood and extending beyond the reproductive years. This approach looks at the normative influence of sexual socialization as it is communicated, internalized, and acted upon by the individual. It recognizes that sexuality is not a series of individual, episodic behaviors linked to specific acts and the physical body, but represents a range of sexual activities and norms, whose meaning and significance for both the individual and society change over time. Research adopting a developmental approach would necessarily focus on those crucial junctures of sexual development, such as adolescence, as potential intervention points for educational prevention efforts.

Research on the following questions would be an important step toward addressing sexuality as a lifelong component of human development:

• How is sexuality defined and what does it signify or represent over the life span for individuals in varied and changing social roles?
• How are these varied definitions internalized by the individual as normative concepts and how do they impact upon behavior?
• What is the effect of aging on sexuality? How is sexuality experienced as people age?
• What are the ramifications of physical and mental disability on the development of sexual behaviors and values and on sexual physiology?
• What are the impact and effects of drug, alcohol, and pharmaceutical use on sexual behaviors?

Research Topics

Priority topics discussed in the SRAP report include: gender; HIV/AIDS; adolescent sexuality; sexual orientation; and sexual coercion. With regard to these specific research topics, the following needs have been identified:

Gender: More sophisticated explorations are needed to further understand how gender-role socialization is linked to the development of sexual norms, behaviors, and relationships. Investigations are needed on the particular social and cultural agents involved in this process and on how the individual internalizes prescribed gender norms pertaining to sexuality. Important questions are:

• How are male and female roles and attributes assumed and what is the significance of this process for sexual behaviors expressed at various developmental junctures?
• How do individuals conceptualize their gender roles and how do they "practice" or enact gender in their sexual behaviors/relationships?
• How are social and cultural expectations about sexuality learned during gender-role socialization?
• How is sexuality constructed for different gendered individuals and what is the flexibility within their roles?
• How do gender identity and gender-role behavior develop as part of psychosexual differentiation during childhood?
• What is the process and mechanism by which individuals acquire and express sexual gender scripts?
• What is the intersection of gender, power, violence, and sexuality?
• What are the cultural and social rules that rationalize gender power differences and what is their impact on the expression of male/female sexuality?
• What is the link between male and female gender roles and the risks and responsibility of sexual behaviors?
• How does understanding gender practices help to encourage individuals to avoid risky sexual behaviors?

HIV/AIDS: For the past eight to ten years, behavioral research about sexuality has been driven by public health efforts to decrease HIV transmission rates. In the absence of a comprehensive research agenda investigating the full range of sexual behavior and norms, HIV/AIDS research -- as conducted both in the medical and social sciences -- has produced a wealth of information about those sexual behaviors that decrease or increase the likelihood of viral transmission, including, primarily, condom use.

A concerted effort is needed to promote and conduct baseline sexuality research that is more representative of both the general population and of select segments and that broadens the agenda to explore a variability and range of different sexual acts, images, and partners, within their respective social contexts. To be programmatically relevant, this agenda needs to incorporate research that delineates the process by which low-risk sexual behavior can be effectively identified and assimilated within the sexual repertoire.

A major, national behavioral study on sexuality needs to be undertaken to effectively inform HIV/AIDS policy and prevention efforts. Such a study would: identify behavioral norms; delineate the complex interactions for motivating and sustaining behavior change; and explore the dynamics of sexual relationships within social networks.

To be both effective and germane to the needs of diverse communities, a new approach requires an examination of the following factors:

• Behavioral norms and the complex interactions for motivating and sustaining behavior change and for a more consistent incorporation of preventive behaviors.
• The dynamics of sexual relationships including cultural and social networks among youth, men, and women engaging in heterosexual, homosexual and bisexual behaviors.
• The diversity and distribution of sexual values, beliefs, and behaviors within different populations and their meanings for individuals.
• The changing realities of HIV infection and the significant markers of HIV prevention in different populations;
• The role and functioning of the community in either inadvertently promoting or effectively preventing sexual transmission among its members.
• Correlative and/or causal links of HIV/AIDS, and other STDs.
• An understanding of how specific economic circumstances place certain individuals at particular risk.

Adolescent Sexuality: Adolescence is the crucial time during which individuals establish life styles and behavioral patterns that have profound effects on adult health. Yet, current research cannot identify the specific factors and processes that shape adolescent sexuality -- developmentally, socially, or culturally. Instead, much of the research approaches adolescence as the time of trouble and potential disaster, in which sexual issues are problems adolescents should be helped to solve. While current research might be able to identify what adolescents do or do not know about sexuality, what sexuality means to adolescents, how it relates to other aspects of teenage life, and what strategies teens use to manage or incorporate it have not been studied in any detail. Very little is known about the role of the parent or caretaker in the development of sexual norms and scripts or the significance of parental modeling of affectionate and supportive relationships, negotiation, and communication.

Current intervention strategies for promoting adolescent health-care are based on outdated theories of adolescent development and have little applicability to adolescents today. Primary research about the issues and concerns of adolescents today is seriously needed to provide new and more relevant models. While great emphasis is placed on helping adolescents become aware of the risks and negative consequences of behavior and on helping them to engage in responsible decision-making processes, it is still not known what motivates adolescents to strive toward sexual health. A new approach is needed to highlight "sexually healthy" adolescents/adolescence and the developmental, sexual assets that allow a "healthy" adult to emerge. These findings would be of paramount importance for practitioners and policymakers.

Some of the specific research questions can include:

• What is the range of adolescent sexual behaviors? In what context do they occur and what do they represent in the development of healthy adult sexuality?
• How is adolescence experienced by an individual? How does an individual feel about her/his changing body at critical developmental junctures?
• What is the relationship between sexual behavior and other adolescent behaviors and life events?
• What is the impact of peer relations on sexual activity?
• How do adolescents experience the emergence of sexual desire and what are their strategies for directing it? How do they negotiate sexual relationships in light of sexual arousal?
• What are the cognitive processes leading to responsible sexual decision-making and skill-building?
• What is the social context for risky sexual behaviors among adolescents?
• What are the adult attitudes and experiences, both positive and negative, that impact on adolescent sexual behavior?
• What shapes and defines a community's values, perceptions, and patterns of behaviors about adolescents' sexuality and their use of contraception?

Sexual Orientation: Research on origin has predominated the agenda concerning the topic of sexual orientation. In the social sciences, this focus has historically been on the influence of childhood scripting and social learning; in the biomedical sciences, on biological, genetic, and neuro-anatomical origins. Additionally, there is a tendency to extrapolate from research prevalence figures of homosexual individuals in the population, even though determining "how many" may not be the primary intent of the study. While it is important to acquire prevalence data or explore the origins of sexual orientation -- whether biological, social, or familial, or a combination thereof -- a research agenda that focuses primarily on these issues misses important points. In research, sexual orientation is typically represented as individual self-identification, rather than understood to include a variable range of behaviors, experiences, and desire expressed over time that may or may not be acted upon. Moreover, what is rarely addressed is how and why societal bias regarding same-gender sexuality, expressed in the form of homophobia is linked to sexual and gender role socialization and other gender issues, or how homophobia influences public policy issues relating to sexuality, such as sexuality education curricula and the relevance of sexual orientation to military service.

In this regard, answers to the following questions on this subject would be helpful:

• What do individuals know and understand about sexual orientation? How does homophobia develop as part of sexual socialization?
• How do individuals give meaning to their sexuality regarding a range of heterosexual, homosexual, or bisexual behaviors and experiences?
• What are the developmental sequelae of sexual identity and orientation? What are their psychological, physiological, and socio-cultural components?

Sexual Coercion: It is important to consider what constitutes sexual coercion and how it is represented in social and behavioral research on sexuality. The term "sexual coercion" denotes the range of sexual encounters that are unwelcome or imposed by force, intimidation, threat, exploitation, fear, or domination. Sexual coercion refers to those occurrences of violence and expressions of power inequity that have been sexualized: sexual abuse, rape, coercion to engage in sexual behaviors, and sexual harassment. Sexual coercion can also include incest and childhood sexual abuse. In contrast to other well-researched behavioral topics, prevalence data in this case is notably lacking. The statistics that do indicate prevalence of coercive and abusive sexuality range widely, and there is little known about the breakdowns of all its permutations within the general population.

The significant gaps in the research on the topic of sexual coercion include:

• What is the actual prevalence and range of experiences of abusive and coercive sexuality in the United States?
• What are the social and familial contexts in which sexual abuse and coercion are expressed?
• What are the etiologic factors of sexual coercion? What role does gender-role socialization play in sexual coercion? For example, is male puberty a critical time for developing the "destructive link between eroticism and anger against women"?
• What role do sexual-communication patterns play in encouraging or discouraging coercion?
• What impact do experiences of sexual coercion as a child have on subsequent adult sexual development and behaviors?

Research Methodology: The field of sexuality research requires continual methodological development of its various techniques and approaches in order to help formulate more effective educational and public health interventions regarding sexuality. Part of this process is to address the methodological constraints and needs inherent in research on sexuality. Methodological issues refer both to the practical concerns of conducting research, such as confidentiality and methodological biases, and theoretical ones, such as the relevance of different techniques and approaches. Steps to develop a greater methodological sophistication include promoting comparative methodology research to determine the relevance and effectiveness of quantitative methods, and making greater use of integrative research that incorporates both approaches.

Within the social science research community there is considerable discussion about the roles and relative significance of applied (or intervention) research and basic (or fundamental) research. In the sexuality fields, the failure to recognize basic research's potential value in generating new insights for possible interventions has resulted in a financial prioritizing of intervention research at the expense of basic research, reinforcing a view of sexuality as problematic. Three priority areas of applied and basic research in sexuality that need to be recognized are:

1. Basic research that integrates an expanded definition of sexuality and provides a thorough knowledge base of human sexuality;
2. Relevant intervention research that is attuned to community needs and incorporates appropriate evaluative processes; and
3. A more accepting and positive depiction of sexuality as the perceived risks and liabilities of sexual behaviors currently emphasized in research contribute to inadequate and ineffective intervention implementation.

Private foundations and government agencies need to pay greater attention to methodological issues in sexuality research by establishing funding priorities and support policies for research in this area. These methodological issues and constraints are discussed at length in Chapter Three of the needs assessment report.

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(3) The Barriers in Sexuality Research

Two of the most formidable barriers to strengthening and developing social and behavioral research in sexuality are the lack of comprehensive research training and inadequate dissemination of research findings. The continuing fragmentation of the social science fields in sexuality research, the low status given to sexuality research, and lack of sufficient research funding comprise the major factors that hinder training in this area, a situation which, consequently, has a significant impact on the availability of professionals to conduct sexuality research. Inadequate dissemination of existing data has hampered intervention and policy initiatives and has contributed to poorly informed public debates on issues related to sexuality.

Training

The lack of comprehensive research training in sexuality is one of the primary obstacles to a more cohesive and well-developed field of multi-disciplinary research in sexuality. Professionals who identify themselves as researchers in the social sciences come from diverse disciplinary backgrounds, including anthropology, education, history, medicine, psychology, and sociology. But few have had specific training in designing, conducting, and evaluating research in sexuality. Varied disciplinary backgrounds can enrich interdisciplinary research, but cannot substitute for substantive training in the practical and theoretical concerns of a particular research field, including sexuality.

A training model for sexuality researchers should include training in both human sexuality and research methodology. Placed within an historical context, such instruction would provide an overview of the philosophy of science and the history of sexuality research, including its controversies, political significance, and terminology. The sexuality component should emphasize the effective use of research techniques in discussing sexuality topics comfortably and explicitly, and should include the following:

• sexual anatomy, physiology, and endocrinology;
• sexuality as a social and cultural construct;
• psycho-sexual development; and
• topical areas, such as reproductive health, sexual orientation, and HIV/AIDS.

Comprehensive training would provide for the development of the highest technical and methodological skills, including research design, execution, analysis, and critique. It would also address the issues of adequate research dissemination, the practical application of research findings, and the need for adequate public communication skills.

A crucial incentive for this development will necessarily be sufficient funding for sexuality research that includes a training component -- in the form of fellowships, post-doctorate positions, and research grants -- to ensure sufficient motivation on the part of the institution to address this issue. A genuine investment in such a training program will ensure the viability of the sexuality research field and initiate a new generation of well-prepared researchers.

Research Dissemination

A frequent grievance expressed by both practitioners and researchers pertains to inadequate mechanisms and efforts to disseminate research findings to those who need such information: policymakers, advocates, practitioners, and program representatives in diverse communities. In turn, the concerns of these groups are seldom integrated into the research agenda, making it difficult to obtain information needed to design educational and programmatic efforts.

Journal articles presenting the findings of sexuality research are typically inaccessible to both a general audience and to professionals outside the discipline from which the research originated. Often written in language particular to each field, these articles are typically buried in the many publications of the different social science disciplines with little cross-fertilization. Practitioners and policy makers are even less likely to have access to research articles published in theoretical journals written exclusively for academic audiences.

In the absence of public forums for explicit and rational discussions about sexuality, sporadic media coverage of sexuality research has become a default mode of dissemination, serving as a primary source of information and influence. Unfortunately, media representation of research findings has historically been paltry, distorted, or sensationalist, and only the most provocative has been regarded as newsworthy.

The current situation highlights the need to adequately inform local, state, and national policymakers on sexuality issues in the public health arena. Providing opportunities for media interaction with researchers can promote a more responsible, adequate, and "de-sensationalized" media representation of research findings. Research dissemination might benefit from an in-depth examination and discussion of the political constraints of sexuality research, and of their impact on dissemination issues.

Other important questions include:

• How is sexuality talked about in public and private arenas and as an empirical issue? How is sexuality presented and defined by various institutional, cultural, and media arenas?
• Why is the public rhetoric and treatment of sexuality issues so distinct?
• What are the political constraints regarding research in this area, and how can they be addressed?
• How do different social movements in the U.S. make use of sexuality topics to frame public debates?
• What is the process of integrating, communicating, and applying research knowledge derived from raw or analyzed data?
• What is the participation of the media in these processes?
• How does knowledge produced by research get disseminated and refracted through a political lens?
• How is information about sexuality, and specifically about sexual behavior, translated into public policy, service provision, and intervention strategies?

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  (4) Government and Private Sector Support

  Both the Reagan and Bush administrations conveyed serious mistrust and opposition to government funding of social science research on sexuality. While the Clinton administration may represent a suspension of federal-level ideological barriers to sexuality research by favoring government support for such studies, funding in the area of sexuality remains inconsistent and skewed toward a biomedical and epidemiological analysis. Both the public and private sectors have provided support for behavioral research whose tendency is to problematize the topic; in contrast, little funding has been given to those projects that employ a more contextual or theoretical approach. For example, substantial support has been provided for research on adolescent pregnancy, but very little support has been provided for research on adolescent health or for integrated and comparative research designs.

  The Government Sector

  Support for large-scale, long-term behavioral studies in sexuality is viewed primarily as a responsibility of the federal government, since it possesses the necessary resources to fund such studies and the expertise to provide sufficient scientific supervision for these efforts. Since the inauguration of a new administration, there have been indications of increasing federal recognition of funding responsibility. In 1993, the National Commission on AIDS endorsed increased behavioral and social science research to curb the HIV epidemic, as did the Institute of Medicine's National Academy of Science in its congressionally mandated study, "AIDS and Behavior: An Integrated Approach." Other government advancements include:

  • funding of a major adolescent study on risk behaviors (ADD Health) in the amount of $20 million over 5 years;
  • establishment of new NIH offices (the Office of AIDS Research, the Office of Behavioral and Social Science Research and the Office for Research in Women's Health); and
  • and increased willingness on the part of the federal government to consider sexuality-related research.

  An unprecedented amount of federal research money has recently become available for research on sexual behaviors. The primary source of these new funds are HIV/AIDS federal monies, specifically for research on sexual-risk behaviors. This new infusion of funding for AIDS-related sexuality research has coincided with efforts to increase social and behavioral research at the National Institutes of Health (NIH). Currently, approximately 8% of NIH's extramural research budget is allocated for behavioral research, but this figure includes research on hormonal and genetic links to behavior; it is undetermined what fraction is available for strictly social science behavioral research.

  The most active government agencies supporting research on sexuality topics are: the National Institute of Alcoholism and Alcohol Abuse (NIAAA); the National Institute of Mental Health (NIMH); the National Institute of Drug Abuse (NIDA); and the National Institute of Child Health and Human Development (NICHD). The National Institute of Child Health and Human Development, whose efforts are primarily focused on adolescent development and population studies, is the federal institute with the largest emphasis on behavioral research. Research supported by NICHD has included: studies about bio-social factors of adolescent sexual behaviors; condom use and the decision-making process; the social context of sexual behaviors; condom use and the decision-making process; the social context of sexual behavior; community interventions; social demography of interpersonal relations; and contextual effects of reproductive behavior in the U.S.

  Behavioral research supported by other agencies is as follows:

  • NIDA has conducted epidemiological studies on drug-related behavior, research on the relationship between drug use and AIDS, and intervention research for risk reduction among injection drug users and their partners;
  • NIAAA has funded studies on the HIV-related risk-behavior consequences of alcohol-related impairment of decision-making; and
  • NIMH support has facilitated large-scale intervention research and assessed mental health consequences of HIV infection.

  Although government support for research still comes from a largely biomedical perspective, small but important steps have been taken in promoting an expanded federal research agenda in behavioral research, much of which incorporates sexuality topics. However, such progress has only recently occurred due largely to the considerable prodding on the part of public advocates and researchers. There is still some distance to go before research on sexuality is fully supported; given anticipated budget cuts, this support does not seem likely in the immediate future. While it is certainly too early to specify whether consistent and sufficient funding for research in sexuality will come to pass, it is encouraging to note the support that currently exists for work in this area.

  The Private Sector

  At present, private-sector funding relating to human sexuality consists primarily of support for policy development, educational initiatives, and health-related interventions. These program areas include: comprehensive sexuality and HIV/AIDS education; school-based adolescent health care; adolescent pregnancy prevention; reproductive health care; HIV/AIDS prevention; sexual abuse; and general public health services. Some of the specific projects supported by private foundations include:

  • National surveys of sexuality education implementation;
  • Evaluation of sexuality education guidelines and state legislative mandates;
  • Training workshops and community demonstration projects for the implementation of sexuality education guidelines;
  • Development of preschool sexuality education guidelines;
  • Evaluation research on condom availability and effectiveness of school-based clinics;
  • Creation of a national commission on adolescent sexual health;
  • Development of promotional material and provision of technical assistance for communities implementing sexuality education;
  • Sexuality and social policy seminar series; and
  • Community teenage pregnancy prevention projects.

  Like government efforts, private-sector support has been particularly extensive and wide-reaching in the area of HIV/AIDS. Funding has primarily focused on HIV/AIDS prevention, social services and health care, HIV/AIDS behavioral research, and advocacy. Some specific supported projects include: adolescent HIV/AIDS prevention programs; social marketing for condoms, support services for people living with AIDS; research on AIDS stigma and discrimination; and various information dissemination and educational prevention campaigns.

  Private-sector funding for sexuality parallels federal support in that it is primarily biomedical and/or epidemiological and represents a public health or risk-behavior focus.

  Private support emphasizes disease prevention or adolescent pregnancy prevention, while support for social science research on sexuality continues to be sporadic and minimal. Most foundations do not have a defined objective to provide direct support for research on sexuality issues in the U.S. As a result, foundations generally subsume research interests within programmatic endeavors as mentioned above or support sexuality-related social science research internationally.

  Complementary Government and Private Efforts

  Support from the private sector may very well act as an incentive for much-needed government research support. Formal or informal collaborative initiatives can take the form of private-sector funding for initiating pilot studies (seed money) with government support for long-term, longitudinal studies. Private foundations can fund smaller components of large government-funded projects, such as the identification of sample populations and the use of survey instruments and their analyses. Foundations may also follow up on large, government- supported studies by funding small phase II projects or support the use of qualitative research methods to conduct an in-depth probe of an issue or to test a survey on different populations.

  Complementary efforts between the private and government sectors can include more qualitative work or more in-depth data analyses. Also, private foundations can support research on particular topics and issues away from which federal funding has shied. The success and effectiveness of any venture is more likely assured by a commitment of support during the entire course of research design, implementation, and evaluation.

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  (5) Assessment Recommendations

  Advancing the Sexuality Research Field

  There is an urgent need for support of sexuality research and for activities that can build capacity and improve mechanisms for the design and implementation of research relevant to public policy, service provision, and intervention strategies.

  These fall into three primary categories:

  A. Expanding the research base;
  B. Comprehensive training in sexuality and research methodology; and
  C. Building a constituency to advance sexuality research fields.

  A. Expanding the Research Base

  Insufficient and erratic funding coupled with a narrowly designed research agenda that focuses on a "risk-factor approach" have contributed to a paucity of research on sexuality. Steady funding for sexuality research is critical to: 1) attract new students to this research field; 2) sustain the work of more senior researchers; and 3) promote an expanded research agenda that allows for a wider range of topics and explores new approaches to current social and health issues. In particular, there is a need for basic, fundamental research that advances our conceptual/theoretical frameworks as well as our understanding of sexuality-related behaviors, attitudes, and structures in populations of varied cultural and social backgrounds. Long-term support for the systematic exploration and implementation of the activities below, beginning with the planning phase and continuing through a second phase of in-depth research, is needed. To achieve this goal, the scope of existing research can be expanded to integrate sexuality topics either in current research award programs or existing public health projects. Additionally, new research on sexuality must be supported.

  Recommendations

  • Sexuality research awards programs can be established within universities, research institutes or appropriate organizations at the national level. Established guidelines can encourage interdisciplinary or practitioner-researcher teams, mentor relationships, combined quantitative/qualitative approaches, or policy-oriented studies. Funding can be awarded to professionals conducting basic research and applied intervention research.
  • Research awards can complement the building of research/training sites or networks by linking award recipients to one or more centers. Recipients throughout the country can be linked to a network that meets to discuss research protocols, to hold short training sessions on particular methodological issues, and to develop effective dissemination plans.

  B. Support for Comprehensive Training

  A second major obstacle to a more cohesive and developed field of multi-disciplinary research in sexuality is the lack of comprehensive training in this area. More formal opportunities for research training focused on sexuality are urgently needed at both the graduate and post-graduate levels. Training can be provided by a multi-disciplinary faculty team to students trained in different disciplines with the intention of promoting multi-disciplinary research capabilities. Training for future generations of sexuality researchers should integrate knowledge about human sexuality with skills in research methodology.

  Recommendations

  • Specialized programs of study that teach research methodology and issues specific to sexuality should be created. These can be developed within existing social science degree programs at the Masters and Ph.D. levels.
  • Formal fellowships in the social science degree programs at the Masters and Ph.D. levels should be provided.
  • Existing research institutes and university research programs can be supported to create multi-disciplinary research training programs at the post-doctorate level.
  • Comprehensive curriculum and training materials for instruction in sexuality and research methodology can be compiled and developed.
  • A sexuality module for undergraduate curricula can be developed. A more concerted effort is needed to incorporate information about sexuality and sexuality research in the social sciences and other relevant disciplines. In this way, students can be exposed to the idea that sexuality plays an important role in many social structures and policy topics.

  C. Building Constituencies

  There has been no strong constituency either in or outside of the research community that has been able to effectively advocate for the importance of sexuality as a substantive area of inquiry. The taboo nature of the topic has historically meant that proposed or existing research on sexuality has, at times, become the convenient focal point for large controversies regarding social norms and conceptions of the role of the family and the state. Controversies regarding sexuality research have, in turn, deterred increased funding for sexuality research at the federal, state, and local levels. Sympathetic policy makers and funders have periodically been able to support the work of committed researchers, either through discreet small-scale funding or, most commonly, through the inclusion of sexuality topics in larger research projects.

  If sexuality research is to advance, support is needed for activities aimed at raising awareness within and outside the research community on the centrality of sexuality research. Two suggested activities discussed there are strengthening networks of researchers and other professionals and improving the dissemination of their work. These activities taken together or in phases, will greatly contribute to the legitimacy of the field of sexuality research and its mainstreaming into academic and public discourse.

  Recommendations for Strengthening Research Networks

  • There is a need for a unified constituency to link researchers with each other and with other professionals concerned with sexuality issues. An established network can publicly promote the usefulness of research in sexuality and provide greater public visibility to important sexuality issues. Researchers and other professionals working in sexuality need to be better prepared to counter controversy that may erupt. A support network can provide effective and timely support to individual researchers, providers, and/or policy officials during times of controversy. Possible strategies for a support network include the following:
  • A compilation of case studies and resource material developed from past controversies, highlighting effective responses and resolutions;
  • The formulation of guidelines for researchers to work more effectively with the communities' studies, including parents, school boards, community and religious leaders, and the local media; and
  • A series of public seminars could target diverse audiences, such as private and public funders; federal, state, and local policymakers, advocacy organizations; and community groups and the media. Tailored to the needs and priorities of these different constituencies, these seminars can promote a better understanding of the need for sexuality research, its applications, and how efforts in this area will advance public health and social well-being.

  Recommendations for Improving Research Dissemination

  • Effective dissemination of research findings is critical for well-designed policies, interventions, and services. Various dissemination projects, in the form of a publication series and well-designed public forums, for example, can provide opportunities for in-depth, rational discussions that provide greater access to sexuality research findings.
  • Involve potential constituencies, including the communities studied, in the research project, as appropriate. Researchers, funders, policymakers, advocacy organizations, and community groups can discuss the design and purpose of particular research projects, plans for presenting preliminary research findings at initial stages, and their optimal use in final format.
  • Publishers, editors, authors, and representatives of the intended readership of journals that publish articles on sexuality can come together in discussion/brainstorming groups.
  • Media education is critical for adequate dissemination. Educational forums can bring together media representatives, researchers, policymakers, and other professionals to address how research findings can be represented more accurately and in a less sensational manner. Such forums can provide opportunities for discussions on the significance of particular research projects and on how to present research findings in different media outlets. Media training programs can also be developed for researchers and other professionals interested in working directly with the media.
  • A publication series for policymakers, perhaps in the form of a newsletter, can highlight many of the important issues on current research and areas of debate.
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  CONCLUSION

  A range of organizational mechanisms should be established if the researcher, practitioner, policy, and funding communities are to engage in a more systematic exploration and implementation of the steps suggested above. While individual researchers or funders may act independently, forming networks or some form of loose associations will:

  1. maximize intellectual and financial resources;
  2. provide political support; and
  3. allow for more in-depth exploration of proposed activities such as developing training curricula and organizing public forums on issues of dissemination and media education. Two proposals to accomplish these goals are as follows:

  Recommendations

  • Establish an interdisciplinary task force comprised of social science and other professionals concerned with advancing the field of sexuality research and its applications.
  • Establish a formal network of grant makers to advance the philanthropic response to gaps in current sexuality research. This group can share information on currently funded projects and explore possibilities for collaborative efforts, as well as help meet the more general informational and programmatic needs of its members. Individual foundation interest in promoting research in the social sciences and in building programs around themes related to sexuality, such as sexuality education or HIV/AIDS prevention, can also be served by this network.

  The steps outlined above will require more funds and a longer term commitment that is likely to be immediately generated from within the private philanthropic community. It is critical that efforts on the part of private philanthropy both complement and motivate increased government funding for comprehensive sexuality research. Historically, foundation support has been able to legitimize research and draw attention to topic areas such as population and child survival programs. These issues were initially ignored by federal funding agencies but private foundation interest eventually translated into federal involvement. The donor community can contribute to this field without taking on the full financial burden of supporting all sexuality research efforts. Public/private collaboration will require considerable commitment, receptiveness, and involvement from both sectors, but will substantially enhance the credibility and legitimacy of sexuality research.

  If there is any optimal moment for expanding support in this area, the time is now. The ingredients that can ensure a successful endeavor are in place: a plethora of opportunities for interdisciplinary work, a supportive research environment, and a pronounced need for research in this area. Efforts to support sexuality research will have a significant impact in expanding the knowledge base and providing crucial answers to social challenges. Equally important, these efforts can and will promote a much-needed view of sexuality, not as a source of problems and risks, but as a domain of well-being and human potential.

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