Australia’s national sex survey

1. Australia’s national sex survey Juliet Richters Sydney

2. The Australian Study of Health and Relationships • Telephone survey of 19,307 people aged 16–59 • Carried out in 2001–02 • Representative sample • 73% response rate Drew on methodology of earlier surveys in USA, UK and France

3. The Australian Study of Health and Relationships The team • Anthony Smith (La Trobe University, Melbourne) • Chris Rissel (University of Sydney and NSW Health Department) • Juliet Richters (University of New South Wales) • Andrew Grulich (University of New South Wales) • Richard de Visser (La Trobe University, now at University of Sussex)

4. Not the only national survey There have also been national surveys— • of secondary school students • of technical college students • and a smaller telephone survey of adults and in progress— • a national longitudinal sex and attitudes survey (yearly follow-up)

5. Why do a national sex survey?

6. What people want to know Policy makers • How do we address our teenage pregnancy problem? (Do we even have one?) • Why are hepatitis C and chlamydia out of control but HIV not? Ordinary people • Am I normal? • Are all the attractive single men over 35 dysfunctional or gay?

7. Competing motivations • Epidemiology: answers to technical questions: prevalence, frequency, risk • Sociology: desire to answer ‘how’ and ‘why’ questions about society • Psychology: desire to answer questions about personal and individual mechanisms

8. Epidemiological modelling Reproductive rate of an infection: measure of potential for growth of infectious disease epidemic It depends on: • likelihood of transmission of infection per contact • duration of infectiousness • pattern of infectious contacts within host population (i.e. frequency of sex and frequency of partner change)

9. Epidemiological modelling So sex survey researchers need to ask: • how often people have different sexual practices • how many partners per year • overlap between partners • incidence and prevalence of infection

10. Getting in some sociology … • Inclusion of social class/disadvantage measures (suburb, education, occupation) • Sex as social practice: phrasing of questions, mode of analysis and interpretation • viewing less common tastes as minority sexual interests or subcultures rather than pathology or moral failure (homosexuality, BDSM) • ? Liberatory agenda

11. A sex survey or a health survey? • Pressure to avoid ‘sexy’ questions and focus on health • Sex, religion and politics: talking about it makes it so (anal intercourse)

12. Interest groups • Sex industry ‘In the last 12 months, have you called a telephone sex line?’ ‘… have you gone to a sex site on the Internet on purpose?’ ‘... have you watched an X-rated video or film?’ ‘... have you used a sex toy such as a vibrator or dildo?’

13. Interest groups • Sex therapists, manufacturers of sexuopharmaceuticals ‘In the last year has there been a period of a month or more when you lacked interest in having sex?’ ‘were unable to come to orgasm?’ ‘came to orgasm too quickly?’ ‘experienced physical pain during intercourse?’ ‘had trouble with keeping an erection / with vaginal dryness?’

14. Political interference • UK survey (NATSAL) funded by competitive grant system, but blocked by Thatcher Government • USA survey (NHSLS) funded by competitive grant system, but blocked by former Bush Government • Australian survey pilot funded by competitive grant system and main survey directly by the (conservative) Howard Australian Government • History of joint response to HIV/AIDS from both sides of politics

15. Political interference The only interference we have suffered is that bureaucrats asked us to remove the funder’s name from one recent paper: ‘Sexual practices at last heterosexual encounter and occurrence of orgasm in a national survey’ Journal of Sex Research August 2006.

16. Media responses Sydney Morning Herald • ‘We’re a broadminded lot, most of us’ • ‘Lots of teen lovers but virgins aplenty’ • ‘Gay Australia: small in number but many are curious’ Adelaide Advertiser • ‘in real life, there’s not much sex in the city … indicates that we are a sexually frustrated nation’

17. Radio responses One commentator: ‘Australia seems fairly liberated and relaxed about sexual and moral issues’. What most interviewers wanted to know: • How do we compare with other countries? • What surprised us (the researchers)? • How often do people have sex? • Are teenagers starting younger? • Do people tell the truth?

18. Young people

19. Age at first intercourse

20. Use of contraception at first intercourse

21. Young people • High rate of condom use at first sex (90% Australia vs about 36% US in NHSLS) • Teenage pregnancy lower in Australia than US or UK (but higher than many European countries) • Reasons for good outcome: easy access to information (leaflets, books, magazines, internet), school sex education, lack of religious controversy, access to health care including contraception

22. Young people • Most people become sexually active around the time they leave school • 50% of students starting university are virgins • Repertoire wider, young women more similar to young men • Erosion of the ‘double standard’ • Most sex is in steady relationships, but casual often unsafe sex in party situations e.g. backpackers

23. Change in sexual culture • In last 30–50 years, period of sexual experimentation and partner change has extended • People start sex a little younger • Settle down much later • Series of short and medium-length relationships • Get divorced or break up and re-partner • Have more partners • Australia similar to US in this respect

24. Attitudes Australians are relatively tolerant about: • abortion • homosexuality • premarital sex but intolerant of ‘two-timing’: • 78% think ‘having an affair when in a committed relationship is always wrong’ • 96% in relationships expect not to have sex with anyone else

25. Attitudes Sex outside a regular relationship: • A sexual health issue? (chlamydia, herpes, HIV) • Or a threat to the survival of the relationship? Does intolerance of ‘infidelity’ make relationships unstable?

26. Outcomes • Results of survey have become widely accepted and are quoted without attribution by journalists and health authorities • Media coverage and popular book extended awareness • Findings incorporated into health policy such as recent NSW strategy on sexually transmitted infections • ‘Normalises’ sex by showing it can be studied like any other social behaviour

27. What surveys can’t do • Tell us about people not in sampling frame (people with no landline phones, or in prison or boarding school, or who can’t speak English) • Tell much about why they do what they do • Tell us what people refuse to talk about • Tell us about community/network structures • Tell us distressing things (sexual abuse)

28. Do people tell the truth in surveys? • No, not all the time • Varies by mode of administration (telephone survey saves ‘face’) • People are not good at consistent lying over a series of questions • Sex is not special! (health, housing, drinking) • Refusal rates for masturbation question 2% men, 5% women; for household income 4% men, 7% women • Good question design and editing for ‘flow’ are important