A First Look at Female Sexual Health in Arkansas: Bidimensional Groups of Sexual Behavior Risk and Attitudes across Age

Background The southern United States bears a disproportionate burden of sexually transmitted infections (STIs), yet research examining sexual health among women in this region remains limited. Most existing studies assess sexual risk behaviors or attitudes individually, potentially overlooking important variations in how these dimensions interact.Objective This study aimed to identify female sexual health groups in Arkansas with a bidimensional approach that simultaneously considers behavioral and attitudinal risk.Methods A cross-sectional survey was conducted with 115 sexually active women aged 20–74 residing in Arkansas. Participants completed the Sexual Risk Behavior Scale (SRBS), Sexually Transmitted Disease Attitude Scale (STDAS), Sexual Sensation Seeking Scale (SSSS), and Female Sexual Function Index (FSFI). Groups were derived by crossing behavioral (SRBS) and attitudinal (STDAS) risk dimensions with median splits. Multinomial logistic regression examined predictors of group membership.Results Four distinct groups emerged: Group A, low behavioral risk + low risk attitudes (30.4%); Group B, low behavioral risk + high risk attitudes (27.8%); Group C, high behavioral risk + low risk attitudes (18.3%); and Group D, high behavioral risk + high risk attitudes (23.5%). SRBS and STDAS scores were not significantly correlated (r = .157, p = .094), confirming the independence of both dimensions. Age functioned as a protective factor, while sexual sensation seeking predicted membership in high behavioral risk groups (C and D) relative to Group A (reference category), but did not distinguish between the two low behavioral risk groups (A and B). Sexual functioning did not differ across groups.Conclusions Sexual risk behaviors and attitudes operate as independent constructs. The bidimensional approach revealed groups that single-measure assessments would overlook. These findings support tailored interventions addressing behavioral and attitudinal dimensions separately.