Much of our information on the types of sex that people are having comes from public health literature and this tends to focus on groups that are perceived as being at high risk of negative sexual health outcomes. Commercially funded sex surveys are widely quoted in media, but theseare often problematic, especially when the results are cited as if they are nationally representative. There are, however, a few broad surveys of sexual behaviour among the general population as well as information from general health studies, which are informative about current sexual attitudes and experiences.
The information that we have suggests that what counts as ‘having sex’ changes over time. There has been a general increase in reported numbers of ‘opposite-sex’ partners, ‘same sex’ partnerships, concurrent partnerships, and ‘opposite-sex’ anal intercourse over time. However, sexual frequency has been found to be in decline in the most recent NATSAL survey, as has the number of ‘opposite sex’ partners for men, though the number of ‘opposite sex’ partners for women have risen. Open interest in kinky, or BDSM, practices has increased – as reflected in the open discussion around the Fifty Shades of Grey trilogy. New online communities and events have sprung up around various specific kinds of sexual interest and around asexuality. Of course it is hard to determine whether these represent increases in the proportion of people who identify in these ways, or are interested in these practices, or simply in the number who are willing to be open about it now that there is appreciation and acceptance of greater sexual diversity.
Penis in Vagina (PIV) intercourse is seen by most people as ‘sex’ and in partnered sex it is the most common practice, though fewer men and women experience it in older age. Increases in consistent condom use have been reported over time, and have appeared to be greatest for men with multiple partners in the past year. This suggests that sexual health promotion messages may be having some impact. Sexual health clinic attendance and HIV testing have increased, particularly in groups of people who have more sexual partners.
In 2008/09, 75% of women under 50 were using at least one method of contraception. The contraceptive pill and the male condom were the most popular methods of contraception, with partner sterilization and selfsterilization the next most popular methods. Other methods of contraception included the intrauterine device (IUD) (6%), withdrawal (4%), hormonal injection (3%) and hormonal intrauterine system (IUS) (2%). 25% were not currently using a method of contraception – over half of these were not engaged in a sexual relationship with someone of the ‘opposite sex’. These figures have shown little change over the last few years. There has been a small decrease in the numbers of women relying on sterilization (from 10% in 2005/06 to 6 % in 2008/09). The promotion of Long Acting Reversible Contraceptive methods has been a Public Health priority since 2005 because of its greater efficacy and value for money.
What counts as sex may vary by age and sexuality. US studies have found oral-genital contact is less likely to be considered ‘sex’ than in the 1990s, particularly among young people. Young women who identify as lesbian or bisexual may be more likely to consider a range of forms of genital stimulation as ‘sex’ than young women or men who identify as heterosexual. Women who include a greater variety of activities in a sexual encounter are more likely to experience orgasm. Meanings of ‘virginity’ and ‘abstinence’ also vary by gender, ethnicity and the extent of people’s sexual experience. Masturbation is more prevalent among men than women . Men and women with same sex partners are significantly more likely to report masturbation. In the most recent NATSAL survey those aged between 25 and 44 were most likely to have masturbated in the last four weeks.
54. For example, Durex (2012.) First Sex. THE FACE OF GLOBAL SEX 2012 -DurexHCP.co.uk
55. See http://www.drpetra.co.uk/blog/concerns-about-the-durex-global-sex-survey/ .
56. For example, the National Survey of Sexual Attitudes and Lifestyles (NATSAL) I, II and III, http://www.natsal.ac.uk/
57. For example, Waylen, A. E., Ness, A., Mcgovern, P., Wolke, D. & Low, N. (2010). Romantic and Sexual Behavior in Young Adolescents: Repeated Surveys in a Population-Based Cohort. The Journal of Early Adolescence, 30, 432-443.
58. Sanders, S.A. & Reinisch, J.M. (1999). Would you say you ‘had sex’ if…? Journal of the American Medical Association, 281(3), 275-7.
59. Mercer, C. H., Tanton, C., Prah, P., Erens, B., Sonnenberg, P., Clifton, S. … & Johnson, A. M. (2013). Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). The Lancet, 1781-1794.
60. Herbenick, D., Reece, M., Schick, V., Sanders, S. A., Dodge, B. & Fortenberry, J. D. (2010). Sexual Behavior in the United States: Results from a National Probability Sample of Men and Women Ages 14–94. The Journal of Sexual Medicine, 7, 255-265.
61. Herbenick, D., Reece, M., Schick, V., Sanders, S. A., Dodge, B. & Fortenberry, J. D. (2010). An event-level analysis of the sexual characteristics and composition among adults ages 18 to 59: results from a national probability sample in the United States. The Journal of Sexual Medicine, 7(Supplement 5), 346-361.
62. Johnson, A. M., Mercer, C. H., Erens, B., Copas, A. J., Mcmanus, S., Wellings, K., Fenton, K. A., Korovessis, C., Macdowall, W., Nanchahal, K., Purdon, S. & Field, J. (2001). Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. The Lancet, 358, 1835-1842.
63. NATSAL (2013). Sexual attitudes and lifestyles in Britain: Highlights from Natsal-3, http://www.natsal.ac.uk/media/823260/natsal_findings_final.pdf?utm_source=2013%20Findings&utm_medium=Download&utm_campaign=Infographic%20findings%202013
64. NICE (2005). Long acting reversible contraception, http://www.nice.org.uk/nicemedia/live/10974/29909/29909.pdf
65. Hans, J. D., Gillen, M. & Akande, K. (2010). Sex Redefined: The Reclassification Of Oral-Genital Contact. Perspectives on Sexual and Reproductive Health, 42(2), 74-78.
66. Horowitz, A. D. & Spicer, L. (2011). ‘Having Sex’ as a Graded and Hierarchical Construct: A Comparison of Sexual Definitions among Heterosexual and Lesbian Emerging Adults in the U.K. Journal of Sex Research, 50, 139-150.
67. Richters, J., De Visser, R. O., Rissel, C. E. & Smith, A.M.A. (2006). Sexual practices at last heterosexual encounter and occurrence of orgasm in a national survey. Journal of Sex Research, 43, 217-226; Herbenick, D., Reece, M., Schick, V., Sanders, S. A., Dodge, B. & Fortenberry, J. D. (2010). An event-level analysis of the sexual characteristics and composition among adults ages 18 to 59: results from a national probability sample in the United States. The Journal of Sexual Medicine, 7 (Supplement 5), 346-361.
68. Bersamin, M. M., Fisher, D. A., Walker, S., Hill, D. L. & Grube, J. (2007). Defining Virginity and Abstinence: Adolescents’ Interpretations of Sexual Behaviors. Journal of Adolescent Health, 41, 182-188.
69. Robbins, C. L., Schick, V., Reece, M., Herbenick, D., Sanders, S. A., Dodge, B. & Fortenberry, J. D. (2011). Prevalence, Frequency, and Associations of Masturbation With Partnered Sexual Behaviors Among US Adolescents. Archives of Pediatrics & Adolescent Medicine, 165, 1087-1093.
70. Gerressu, M., Mercer, C., Graham, C., Wellings, K. & Johnson, A. (2008). Prevalence of Masturbation and Associated Factors in a British National Probability Survey. Archives of Sexual Behavior, 37, 266-278.
71. NATSAL (2013). Sexual attitudes and lifestyles in Britain: Highlights from Natsal-3, http://www.natsal.ac.uk/media/823260/natsal_findings_final.pdf?utm_source=2013%20Findings&utm_medium=Download&utm_campaign=Infographic%20findings%202013; see also http://www.natsal.ac.uk/