title: INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW.
abstract: BACKGROUND
  Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures.
  
  
  METHODS
  we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added.
  
  
  RESULTS
  Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin.
  
  
  CONCLUSIONS
  Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.
authors.affiliation: Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mirzaei
authors.affiliation: Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Khodabakhsh
authors.initials: K
authors.lastname: Ahmadi
authors.affiliation: Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed-Hassan
authors.initials: SH
authors.lastname: Saadat
authors.affiliation: Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Arash
authors.initials: MA
authors.lastname: Ramezani
keywords: Sexual behavior; hypersexuality; prostate-specific antigen; risk assessment; risk taking