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    What America Thinks
    What You Don't Know
    Can Kill You

    By Richard Morin
    Washington Post Polling Director
    Monday, Aug. 24, 1998

    Most Americans believe that sexually transmitted diseases can't possibly happen to them, according to a new survey by the Henry J. Kaiser Family Foundation. But they're wrong, perhaps dead wrong: One in four Americans will contract a sexually transmitted disease sometime in their lives, according to the federal Centers for Disease Control and Prevention (CDC).

    And it's this information gap that the Kaiser Foundation in partnership with Glamour magazine is trying to close with a comprehensive new national survey on America's hidden epidemic: sexually transmitted diseases (STD).

    The survey found that most men and women of reproductive age – 18 to 44 – seriously "underestimate how common STDs are," Kaiser analysts wrote in a summary of their results. "Most men and women also do not know about some of the most common, and potentially damaging STDs, and very few believe themselves to be at personal risk."

    According to the poll, 74 percent of men and 69 percent of women think that only one in 10 or fewer Americans will get an STD sometime in their lifetimes, far below the actual rate. "Only 14 percent of all men and 8 percent of all women say they think they are at risk of getting one – and single men (24 percent) and women (15 percent) are not much more likely to feel they are at risk."

    Those claims of invulnerability stand in stark contrast to the facts. Nationally, about 12 million men and women, two-thirds under the age of 25, get a sexually transmitted disease each year. One in five adults today has herpes, and "as many as 100 million people are living with an incurable viral STD such as herpes or human papillomavirus (HPV)," the Kaiser Foundation and Glamour reported.

    About one in seven men in the Kaiser-Glamour magazine poll, to appear in the magazine's September issue, said they knew they have had a sexually transmitted disease – a "stunningly large percentage," says Judith Wasserheit, director of the division of STD prevention at the CDC.

    Other survey findings were just as stunning. Education, the researchers found, didn't make a difference. About one in eight men with a high school education said they've had a sexually transmitted disease, identical to the proportion who finished college or graduate school.

    STDs victimize the middle class as much as the poor. About 15 percent of men interviewed who made less than $20,000 reported they had an STD, compared with 13 percent of men who made more than $60,000 a year.

    Less of a surprise: Past sexual experience does matter. Eight percent of men who had three to six sexual partners in their lifetime said they've had an STD, compared with 37 percent who had more than 20 partners.

    Those Troublesome Wording Effects

    Pollsters know words matter. And here's more evidence, taken from Gallup overnight surveys for USA Today and CNN conducted the night of President Clinton's speech admitting an improper relationship with Monica Lewinsky and the following night.

    The speech night poll analysis reported a stunning 20 percentage point drop in Clinton's favorable rating, from 60 percent to 40 percent, in just a week.

    One problem: In the heat of battle (and I can attest to the fact it can get pretty hot), Gallup used a slightly different question in the two surveys.

    Gallup's standard question, asked in a survey conducted Aug. 10-12, read: "I'd like to get your overall opinion of some people in the news. As I read each name, please say if you have a favorable or unfavorable opinion of this person – or if you have never heard of him or her." I'll call this the standard version.

    When Bill Clinton was named, 60 percent said they had a favorable impression of him.

    But the following Monday night, after the president's mea culpa speech, they asked this slightly different question: "Now thinking about Bill Clinton as a person, do you have a favorable or unfavorable opinion of him?" Let's call this the enhanced version. Anyway, 40 percent said they had a favorable impression of him when asked this question.

    Of course, both questions are perfectly good. Gallup's problem came when the pollster and its media clients CNN and USA Today treated the questions as identical and trended the two results to report a 20 percentage point drop in Clinton's favorability rating.

    That struck more than a few dedicated poll-watchers as odd. So Gallup conducted a split sample test the following night, asking the two questions to different halves of their 884-person national sample.

    The result: 55 percent of those who were asked the standard version said they had a favorable impression of Clinton, a more modest 5 percentage point drop from the poll the previous week. And 44 percent had a favorable impression when asked the enhanced version of the question, not statistically different from the 40 percent who responded the same way the previous night.

    "Although the reported change from last week to Monday night on this measure – in our opinion – reflected a real and significant drop as a result of yesterday's events, the over-time difference would have been in the range of 10 percentage points had the change in wording not been made," Gallup editor in chief Frank Newport said to the Hotline political digest.

    Why do these two questions produce such different results? My guess it's the words "as a person" in the enhanced version – words that don't appear in the standard question. Those missing words make the standard wording more general and undoubtedly capture people's favorable impressions of the way Clinton is doing his job as president, as opposed to the way Clinton is handing his personal life.

    Thus the standard version may be a surrogate for job approval, which stood above 60 percent in the two Gallup polls, while the enhanced version forces people to focus on Clinton's decidedly unenviable personal character.

    Richard Morin is director of polling for The Washington Post. "What Americans Think" appears Mondays in The Washington Post National Weekly Edition. Morin can be reached at .

    © Copyright 1998 The Washington Post Company

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