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The human papilloma virus (HPV) is a multifocal infection that can involve the cervix, vagina, vulva, anus, and oropharynx. The objective of our study was to determine if standard sexual history questions capture the sexual behaviors of women that put them at increased risk for HPV-related neoplasias.We conducted a cross-sectional survey study at the Colposcopy Clinic at Women and Infants Hospital. Women who presented with HPV-related cervical, vulvar, or vaginal abnormalities were eligible. All eligible women were offered enrollment, signed informed consent and a sexual history questionnaire was self-administered. Additional demographic information was obtained from chart review.Interim analysis was conducted half way through recruitment. Seventy one eligible women were approached, 63 (89%) consented and all 63 enrolled (ages 22–64). Sixty-five percent of women reported receiving oral penetration of the vagina, 81% reported receiving vaginal fingering and 100% participated in vaginal intercourse. Forty-six percent reported participating in some type of anal-related sexual practice, including anal fingering, oral penetration on the anus and anal intercourse. Of those participating in anal-related practices, 10% reported only anal fingering or oral-anal penetration. Forty-eight percent of respondents said they used sex toys, 100% vaginal and 13% anal.We found women are willing to report their participation in a wide range of sexual practices. Ten percent of women only participated in anal play and not anal intercourse, which would be missed by the standard sexual history questions. These results will enable clinicians to better counsel their patients on risky sexual behaviors.