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Insights For Sexual Health from a New Nationally Representative Study of Sexual Behaviors and Condom Use Among the U.S.

Insights For Sexual Health from a New Nationally Representative Study of Sexual Behaviors and Condom Use Among the U.S. Population Aged 14 - 94. Michael Reece, Ph.D., MPH. CSHP Team. Debby Herbenick, Ph.D., MPH J. Dennis Fortenberry, MD, MS Stephanie Sanders, Ph.D. Vanessa Schick, Ph.D.

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Insights For Sexual Health from a New Nationally Representative Study of Sexual Behaviors and Condom Use Among the U.S.

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  1. Insights For Sexual Health from a New Nationally Representative Study of Sexual Behaviors and Condom Use Among the U.S. Population Aged 14 - 94 Michael Reece, Ph.D., MPH

  2. CSHP Team • Debby Herbenick, Ph.D., MPH • J. Dennis Fortenberry, MD, MS • Stephanie Sanders, Ph.D. • Vanessa Schick, Ph.D. • Brian Dodge, Ph.D. • Susan Middlestadt, Ph.D.

  3. National Survey of Sexual Health and Behavior (NSSHB)

  4. The Need for the NSSHB • The limited availability of nationally representative data related to condoms and sexual behaviors. • Significant social shifts past 17 years since last major study. • Significant methodological advances in research methods past 17 years. • Importance of contemporary sexual behavior baseline of US population.

  5. Methods • Population-based sample of U.S. adults and adolescents. • Data collected via Knowledge Networks using established nationally representative research panels. • Address Based Sampling (ADS) • Internet-Based Data Collection • Application of post-stratification data weights during statistical analyses to be presented today. • Current Population Survey December 2008

  6. Study Samples Adolescent and Adult Samples (N = 5,865) • Adults N = 5,045 • Response to Email: 64% • Consent Rate: 82% • Adolescents N = 820 • Parent Consent to Adolescent Recruitment: 62% • Adolescent Consent Rate: 99%

  7. Measures • Sociodemographics • Sexual Behaviors (lifetime and current occurrence and frequency) • Condom Use • Past Year Condom Use Trends • Event-Level Condom Use Most Recent Sexual Event - Partner, Situational, and Behavioral Characteristics - Lubrication, Pain, Erectile Function - Reasons for Sex - Qualitative Assessment of Condom Use History with Partner - Condom Characteristics and Perceptions of Effectiveness • Other Contraceptives and Perceptions of Effectiveness • Sexual Health History • Condom Education • Condom Access Trends

  8. Measures Sexual Behavior • History of Solo and Partnered Sexual Activity • Past Month, Past 6 Months, Past Year, Lifetime • Gendered Interactions for Oral Intercourse • Receptive and Insertive (male) for Anal • Descriptors for Adolescents (e.g., butthole) • Most Recent Sexual Event

  9. Measures Condom Use • Most Recent Sexual Event if Vaginal or Anal Intercourse • General Social Survey, National Household Survey of Drug Abuse, National Survey of Family Growth [NSFG], Youth Risk Behavior Surveillance Survey [YRBS], The National Longitudinal Study of Adolescent Health [Add Health] • Condom Use During Past 10 Vaginal and Anal Intercourse • National AIDS Behavioral Survey, National Household Survey of Drug Abuse, National Social Life, Health, and Aging Project [NSHAP], NSFG, National Sexual Health Survey

  10. Insights from the NSSHB

  11. From early adolescence through advanced age sexuality is a component of our being. The sexual repertoire is complex, rarely involving only one behavior at any given sexual event.

  12. Adolescent sexual expression looks much like adult sexual expression, with identifiable developmental trends as youth move toward adulthood.

  13. Any Partnered Sexual Activity, Past Year by Gender (partner masturbation, oral-genital, vaginal intercourse, or anal intercourse)* *Other studies show that less than 15% of sexual events are vaginal sex only (See Richters et al. J Sex Research, 2006)

  14. The adolescent sexual repertoire includes coital abstinence as well as a variety of sexual behaviors.

  15. Sexual behaviors reported at most recent sexual eventby gender (among those with vaginal sex past year)

  16. Vaginal Intercourse Past yearby gender and age Overall Women – 30% Men - 35%

  17. Oral-Genital Sex, Past Yearby gender and partner gender Behavior n Past Year % Adolescent Women Given to Male 400 18.3 Received from Male 401 17.2 Given to Female 399 4.8 Received from Female 398 3.1 Adolescent Men Given to Female 409 13.5 Received from Female 409 21.5 Given to Male 409 2.2 Received from Male 410 2.4

  18. Condom use appears be somewhat “normative” among the general population of adolescents

  19. Condom Use, % of last 10 vaginal eventsby gender

  20. Condom use, % during most recent vaginal event

  21. “Condom use” may not always be “condom use.”

  22. Characteristics of condom use during last intercourse, by gender

  23. Even among adolescents, issues of sexual pleasure and orgasm may have linkages to sexual health promotion

  24. Pleasure, arousal & orgasm at most recent coitusadolescent women, by condom use

  25. Pleasure, arousal & orgasm at most recent coitusadolescent men, by condom use

  26. Adult Sexual Behavior CONFIDENTIAL

  27. Adults remain sexually active over much of the lifespan, with a great deal of “normalcy” in the sexual repertoire over time.

  28. Percentage of Women who Engaged in Masturbation and Vaginal Intercourse over the Past Year by Age

  29. Adult Women: % Anal Intercourse (n = 2391) CONFIDENTIAL

  30. Adult Men: % Vaginal Intercourse (n = 2441) CONFIDENTIAL

  31. Adult Men: % Insertive Anal Intercourse (n = 2427) CONFIDENTIAL

  32. Issues of arousal, and lubrication, remain a challenge for some women across the lifespan. Pain during intercourse also quite prevalent among women.

  33. Women’s Arousal and Lubrication by Age

  34. Women’s Reported Pain by Age

  35. Condom Use Rates for the U.S. Population

  36. Condom Use Last Vaginal Event (N = 2081)All Individuals Having Vaginal Intercourse Last Event CONFIDENTIAL

  37. Overall Rates of Condom Use at Last Vaginal Event by Age (N = 2081) Consistent with Past 10 Event Rate of 40.3% CONFIDENTIAL

  38. Total Population Condom Use Rates by Age & Gender % of Past Ten Vaginal Intercourse Events (N = 3457) CONFIDENTIAL

  39. Condom Use Rates by Relationship Status % of Past Ten Vaginal Intercourse Events (N = 3018) CONFIDENTIAL

  40. Adult Condom Use Rates among Unmarried Adults by Ethnicity & Age % of Past Ten Vaginal Intercourse Events (N = 1201) CONFIDENTIAL

  41. Summary • A contemporary snapshot of US sexual behavior and condom use. • Developmental trends, but a great deal of consistency within a range of diversity. • Insights for clinicians and educators.

  42. Supplemental Issue of JSM • October 4, 2010 • 9 Scientific Papers • Commentaries • Head of HIV/STD at CDC • Former Surgeon General Dr. Joycelyn Elders • President American Social Health Association • Large Media Effort • Global Dissemination

  43. Download Papers www.nationalsexstudy.indiana.edu

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