Global study dispels some myths about sexual behaviour

November 1, 2006 The first comprehensive global study of sexual behaviour, published today as part of The Lancet's Sexual and Reproductive Health Online Series, found that people aren't losing their virginity at ever younger ages, married people have the most sex, and there is no firm link between promiscuity and sexually transmitted diseases.

Experts say data gleaned from the study will be useful not only in dispelling popular myths about sexual behaviour, but in shaping policies that will help improve sexual health across the world. Researchers looked at previously published studies on sexual behaviour in the last decade.

Professor Kaye Wellings, of the London School of Hygiene and Tropical Medicines, and her colleagues analysed data on sexual behaviour in the last decade from 59 countries.

The report also shows no support for the common notion that there is a culture of multiple sexual partners in countries with poor sexual health. Multiple sexual partners, it turns out, are more common in industrialised than in developing nations.

The study also found that contrary to popular belief, sexual activity is not starting earlier. Nearly everywhere, men and women have their first sexual experiences in their late teens; from 15 to 19 years old — with generally younger ages for women than for men, especially in developing countries.

"A single woman is more able to negotiate safe sex in certain circumstances than a married woman," said Paul van Look, director of Reproductive Health and Research at the World Health Organisation, who was unconnected to the study and points out that "married women in Africa and Asia are often threatened by unfaithful husbands who frequent prostitutes".

There is much greater equality between women and men with regard to the number of sexual partners in rich countries than in poor countries, the study found. This imbalance has significant public health implications. Because of the diversity of sexual habits worldwide, Wellings warns that no single approach to sexual health will work everywhere. "There are very different economic, religious and social rules governing sexual conduct across the world," Wellings said.

For example, men and women in Australia, Britain, France and the United States tend to have an almost equal number of sexual partners. In contrast, in Cameroon, Haiti, and Kenya, men tend to have multiple partners while women tend only to have one.

Along with other industrialised countries, Australia was one in which having two or more sexual partners in the past year was comparatively common.

Single men and women in Africa were fairly sexually inactive: only two-thirds of them reported recent sexual activity, compared with three-quarters of their counterparts in developed countries.

In what researchers said was proof the sexual double standard was still strong, more men than women reported having more than one partner.

"These findings beg the question of who the men are having sex with," they wrote. Italy had one of the lowest percentages of men who had sex before age 15 (4 per cent), compared to 18 per cent in the United States and 30 per cent in Brazil and the Dominican Republic. The researchers said early initiation was more likely to be non-consensual, unsafe and generally to be regretted later.

The study suggests that unequal treatment of girls and women as the major sexual-health issue.

The researchers call for providing sexual health services to unmarried young women, supplying condoms, decriminalizing commercial sex and homosexual sex, and prosecuting the perpetrators of sexual violence.

Experts say data gleaned from the study will be useful not only in dispelling popular myths about sexual behaviour, but in shaping policies that will help improve sexual health across the world.

"There's a misperception that there's a great deal of promiscuity in Africa, which is one of the potential reasons for HIV/AIDS spreading so rapidly," said van Look

Fewer than half of unmarried non-virgins reported having sex in the past month.

Some of the major findings the survey found were:
 * School-based sexual education delays and does not hasten onset of sexual activity.
 * First sexual experience is often forced or sold.
 * Marriage is no safeguard of sexual health. It is more difficult for married women to negotiate safe sex and condom use than it is for single women.
 * Condom use is increasing, but condom-use rates remain low in many developing countries.
 * Among girls who marry at a very young age, "very early sexual experience within marriage can be coercive and traumatic."
 * While there is no major trend toward earlier sexual experience, a trend toward later marriage has led to an increase in premarital sex.
 * Public health measures to improve sexual health should focus not only on individual behaviours but also on broader issues such as gender, poverty, and mobility.
 * Public-health messages intended to reduce sexual risk-taking "should respect diversity and preserve choice."
 * Monogamy is the dominant pattern in most parts of the world. Men report more multiple partnerships than do women. Such men are more likely to live in developed nations.