Significant and non-significant associations between technology use and sexual risk: a need for more empirical attention.

parents and teachers are critical stakeholders. Many would be uncomfortable allowing their children or students to participate in a survey that is so sexually explicit. It is worth noting that the age range in the Sanders study was 18e96 years, and included no minors. To achieve community buy-in, which is critical, one must be careful not to burden respondents and other key stakeholders. Administration of the Youth Risk Behavior Survey (YRBS) requires teachers to lose precious instruction time. The YRBS has nearly 100 questions and typically takes an entire class period for students to complete. When we created our supplemental survey, we only had the capacity for 20 items. Because we could not link our supplemental survey to the main YRBS survey, we were faced with having to re-ask all of the demographic and sex risk questions we wanted to analyze. Asking 14 questions about sex was not realistic, regardless of how explicit those questions were. In addition, it was important that our questions address the assessment needs of the Los Angeles Unified School District. The content of their sexual health curriculum encourages youth to use condoms for all sexual activities (i.e., oral, vaginal, and anal sex). Although human immunodeficiency virus risk is low with oral sex, other sexually transmitted infections can certainly be transmitted through oral sex (e.g., gonorrhea, chlamydia, herpes). Assessing youth with respect to these recommended sexual health practices was important. To address all of these issues (respondent burden, explicit content for minors, and the district’s sexual health education content), we agreed collectively that appropriate wording was: “Have you ever had sexual intercourse (vaginal, oral, or anal sex)? (A) Yes; (B) No,” followed immediately by “The last time you had sexual intercourse, did you or your partner use a condom? (A) I have never had sexual intercourse; (B) Yes; (C) No.” These two questions closely mimic the questions asked in the main YRBS. The slight modification “(vaginal, oral, or anal sex)” was made to the first question so as to bemore inclusive of sexual behaviors of sexual minority youth, many of whom do not engage in penileevaginal sex, and to incorporate the sexual health education content of the schools. Although we appreciate Ruben’s commentary on misclassification bias, the realities of participant burden and community participation can often affect the decision-making process when research is conducted in schools and other community settings. It is critical for researchers to wrestle with issues such as misclassification bias, so as to create the most robust findings possible. It is also critical for researchers to wrestle with how their study participants and community partners experience and perceive the research being conducted, to conduct meaningful research with community partners.