Roberts H, Clark A, Sherman C, Heitzeg MM, Hicks BM (2021) Age, sex, and other demographic trends in sexual behavior in the United States: Initial findings of the sexual behaviors, internet use, and psychological adjustment survey. PLoS ONE 16(8): e0255371. https://doi.org/10.1371/journal.pone.0255371
Abstract: It remains unclear how the seemingly ubiquitous use of the internet impacts user’s offline personal relationships, particularly those that are romantic or sexual. Therefore, we conducted a national online survey to better understand the associations among internet use, sexual behavior, and adjustment called the Sexual Behaviors, Internet Use, and Psychological Adjustment Survey (SIPS). Here, we report patterns of sexual behavior in a sample of adults (N = 1987; ages 18–70) in the United States to establish its representativeness and consistency with similar recent surveys. We found age- and sex-related trends in oral, vaginal, and anal sex in terms of prevalence, frequency, number of partners, and age of initiation consistent with prior studies. We also detected differences in sexual behaviors based on relationship status and sexual orientation, but small and relatively few significant differences across racial and ethnic groups. The results confirm and expand upon trends identified in prior national surveys of sexual behavior, establishing the representativeness of the SIPS sample for use in future research examining the links among sexual behaviors and romantic relationships, internet use, and adjustment.
Discussion
We sought to evaluate the representativeness of the SIPS sample—a national survey conducted to better understand relationships among sexual behavior, internet use, and psychological adjustment—by examining whether the rates and demographic trends in sexual behavior replicated prior estimates from similar national surveys. Sample estimates of the prevalence, frequency, number of partners, and age of initiation in oral, vaginal, and anal sex were broadly consistent with prior studies, as were subgroup analyses examining differences in sexual behavior associated with relationship status, sexual orientation, race, and ethnicity.
Trends associated with age and sex
Results for age and sex trends in the prevalence, frequency, number of partners, and age of initiation were consistent with and expand upon previous nationally representative online samples [12]. We replicated the finding of high rates of lifetime participation in oral and vaginal sex (>80%), and a much lower, but not trivial, rate of anal sex (<40%). As our subgroup analyses on sexual orientation revealed, this difference is largely attributable to the low proportion of homosexual men in an unselected national sample. This is to be expected in population samples, where rates of non-heterosexual orientation and male-male sexual behavior are relatively low, and heterosexual couples are more likely to choose to engage in oral and vaginal sex. For example, only 17.6% of respondents reported a non-heterosexual orientation in the current sample, and only 34.4% of respondents endorsing 100% heterosexual orientation reported ever having engaged in anal sex, whereas 61.7% of respondents endorsing 100% homosexual orientation reported engaging in anal sex. The lower levels of anal sex among heterosexual participants may be explained by the stigma associated with anal sex, for example, beliefs that anal sex is immoral or “dirty,” along with historical restrictions on activities such as sodomy and same-sex marriage [27, 28].
We also replicated prior findings that the frequency of these sexual behaviors was highest in middle adulthood [12, 29]. The associations between frequency of sex and age may be at least partially attributable to relationship status. That is, people in serious relationships tend to have more frequent sex than single people, and people tend to form more serious relationships in young and middle adulthood. For example, the average age of first marriage in the United States was 29 years old in 2020 [30]. The frequency of sex may also be influenced by fertility and intention to birth children, a process that must occur before menopause (typically, before ages 45–55 years old) [31, 32].
We also replicated prior findings that men reported a greater number of sexual partners than women throughout their lifetime [10, 12, 20]. Men’s report of the number of sexual partners also exhibited higher variance than women’s report of the number of sexual partners. This was primarily due to a small proportion of men that reported an especially high number of sexual partners, increasing both the mean and variance of the number of sexual partners relative to women [33]. We also identified a considerably lower median value for the number of sexual partners compared to the mean value across gender, further illustrating the influence of the small proportion of respondents reporting a very high number of partners, with the effect being stronger in men compared to women. Further, in a study addressing why estimates of sexual partners are often higher in men than women, Mitchell et al. [34] found that men tend to estimate their number of sexual partners (often rounding up to numbers that end in 0 or 5) whereas women tend to count them, a reporting error which may have affected the point estimates in our sample.
We also found that anal sex had a much later age of initiation compared to oral and vaginal sex [18]. This is consistent with the lower prevalence rate of anal sex relative vaginal and oral sex. That is, anal sex is a less common and more sexually advanced behavior and may require greater preparation compared to oral and vaginal sex [35]. This may pose a barrier to populations with limited access to certain sexual wellness resources (i.e., lubrication).
Trends associated with relationship status, sexual orientation, race, and ethnicity
We also found that numerous aspects of sexual behavior varied by subgroups of relationship status, sexual orientation, race, and ethnicity. As oral, vaginal, or anal sex are all partnered behaviors, it follows that participating in ongoing romantic and sexual relationships facilitates access to potential sex partners, access that is more limited or at least not as readily available to people not participating in such relationships. This finding is in line with prior research, confirming that while single people may have greater opportunities for casual sex with a greater number of partners, people in a relationship have more frequent sex [14–16]. Interestingly, people that reported being in a casual relationship(s) reported a higher frequency of sex and more sexual partners, though they constituted a small proportion of the sample.
Consistent with prior findings regarding sexual orientation, heterosexual and bisexual men reported higher rates of vaginal sex than homosexual men. This finding is easily understood via anatomical constraints, that is, vaginal sex is not possible in cisgender male-male partnerships. Further, homosexual males reported higher rates of anal sex than heterosexual and bisexual males. As discussed previously, the stigma surrounding anal sex may account for lower rates of anal sex in non-homosexual subgroups. We also found that bisexual respondents participated in a wide variety of sexual behavior and reported a particularly high frequency of sex and earlier age of sexual initiation compared to other sexual orientation groups. Similar trends were also observed for respondents that endorsed a mostly heterosexual or mostly homosexual orientation. Some prior work suggests that sexual minority groups have more liberal attitudes about sex compared to heterosexual people, that is, a greater acceptance of recreational sex, potentially contributing to an earlier age of sexual initiation and a higher frequency of sex [36, 37].
Results for racial differences in sexual behaviors were less consistent with prior findings. We did detect a significant difference for earlier ages of initiation for oral and vaginal sex for White and Black participants relative to Asian participants, and that Black participants reported more lifetime vaginal sex partners than White participants. Although the effects were small (Cohen’s d < .30), we did observe a trend for Black participants to report a higher frequency, more partners, and an earlier age of initiation for oral and vaginal sex than White and Asian participants as reported in prior studies [14, 15, 21–23]. The lack of significant differences could be due to a different design than most prior studies of general sexual behavior (i.e., our use of internet-based recruitment and survey methods assessing oral, vaginal, and anal sex separately). While Herbenick and colleagues [12] examined oral, vaginal, and anal sex trends in an online-based survey, they did not report on racial differences, which would have provided a useful comparison for the current study and allowed us to explore if racial differences in sexual behavior are smaller or less robust relative to factors such as relationship status and sexual orientation, or if racial differences in sexual behavior in the US are narrowing over time. Additionally, research is limited as to why these racial differences in normative sexual behavior may be present. It will be useful for future studies to expand analyses beyond simple group differences, and to test if additional covariates (e.g., cultural attitudes about sex and relationships) can account for any racial differences in these sexual behaviors.
For ethnicity, we also found that Hispanic respondents reported a higher frequency of oral, vaginal, and anal sex than non-Hispanic respondents, as well as slightly fewer lifetime vaginal sex partners and an earlier age of initiation of anal sex. To our knowledge, all prior studies explicitly examining ethnic differences in sexual behavior did so using the umbrella term “sexual intercourse” [14, 15]. We assessed sexual behavior in greater detail, specifying between oral, vaginal, and anal sex, expanding upon prior examinations of ethnic differences in sexual behavior. It will be important to replicate and dismantle such differences in future research.
Limitations
While the online survey design provided for a highly efficient mode of data of collection for a national sample, several limitations should be noted. Although the Qualtrics XM platform ensures a sample that mirrors the US general population for the quota variables, all participating respondents had either internet or cell phone access. Though the large majority of the U.S. population does have internet access, there remains a small percentage who do not. Also, while Qualtrics guarantees specific quotas, it does not guarantee representation on other non-quota variables. Furthermore, due to time constraints, we focused on assessing oral, vaginal, and anal sex. Other surveys have asked about a wide range of sexual behaviors including solo behaviors, participation in group sex, use of sex toys, and various kink behaviors. While we did not include that breadth, we were able to delve into greater detail of oral, vaginal, and anal sex than some prior reports.
Additionally, multivariate logistic and linear regression models were used to explore the effects of Age, Age2, Sex, and their interactions on oral, vaginal, and anal sex. We did not, however, perform these analyses within demographic subgroups. While one-way ANOVAs were useful in testing for mean differences across subgroups, we did not test for interactions among age, sex, and the other demographic variables. Given we identified numerous group differences in sexual behavior, this will be an important goal for future research, though some subgroup analyses may require larger sample sizes than the SIPS to provide adequate power to detect differences (e.g., non-heterosexual orientation subgroups). There are also other demographic variables that we did not examine (e.g., income, education), as well as other behaviors (e.g., internet use, substance use) and psychological characteristics (e.g., personality) that are associated with sexual behavior, some of which we intend to examine in future reports. Subgroups could also be further dissected in large samples, e.g., sexual attraction as a distinct facet of sexual orientation [38]. There are other demographic variables that we did not examine (e.g., income, education), as well as other behaviors (e.g., internet use, pornography consumption, substance use) and psychological characteristics (e.g., personality) that may be associated with sexual behavior, some of which we intend to examine in future reports [39, 40].
Overall, the results are consistent with most prior findings regarding patterns of oral, vaginal, and anal sex in the United States, and help establish the representativeness of the SIPS sample. The evidence for its representativeness provides a basis on which future investigations can examine and make valid inferences regarding associations among sexual behavior, technology, and adjustment. Future reports will analyze additional correlates of sexual behavior, including social media and dating app use, substance use, mental health, personality, and interpersonal relationship traits to explore how modern technology usage impacts the expression of sexual and romantic behavior.
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