Current Trends Perceptions about Sexual Behavior: Findings from a National Sex Knowledge Survey -- United States, 1989

Perceptions of specific risk behaviors for sexually transmitted diseases (STDs) can influence socially accepted norms of sexual behavior and knowledge of STD risk among different demographic groups. This report summarizes findings from a national survey (conducted by The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University) that addressed perceptions regarding the prevalence of high-risk sexual behaviors (1).

During October 14-20, 1989, a multistage, stratified, probability sample of 1974 U.S. adults (persons greater than or equal to 18 years of age) were interviewed in their homes by a private polling organization. Respondents were asked six questions in face-to-face interviews and 12 questions by anonymous, self-administered questionnaires in the presence of the interviewers. In the face-to-face interview, participants were asked to estimate the age at which the "average or typical American" first has sexual intercourse and to estimate the proportion of married men who have had an "extramarital affair." The self-administered questionnaire included items on the prevalence of heterosexual anal intercourse and male homosexual behavior. Refusal rates for the interview questions (Table 1, questions 1 and 2) were less than 1%, and for the self-administered questionnaire (Table 1, questions 3 and 4), 14%.

Most respondents (62% (95% confidence interval (CI)=plus or minus 2)) believed the "typical American" has first sexual intercourse at or before 15 years of age (Table 1, question 1). Women (29% (95% CI=plus or minus 3)) were more likely than men (21% (95% CI=plus or minus 3)) to believe the age at first intercourse was less than or equal to 13 years (p less than 0.05). Persons who were younger, reported lower income, or claimed less formal education consistently estimated younger ages at first intercourse (Figure 1, Table 1). More black respondents (41% (95% CI=plus or minus 7)) than white respondents (23% (95% CI=plus or minus 2)) estimated younger ages at first sexual intercourse (less than or equal to 13 years; p less than 0.05).

Half the respondents believed that greater than or equal to 50% of married men have had an "extramarital affair" (Table 1, question 2). Women (25% (95% CI=plus or minus 3)) were more likely than men (17% (95% CI=plus or minus 2)) and blacks (33% (95% CI=plus or minus 6)) were more likely than whites (19% (95% CI=plus or minus 2)) to estimate that a high percentage of married men (greater than or equal to 70%) have had an "extramarital affair." Respondents with lower income (26% (95% CI=plus or minus 3) vs. 18% (95% CI=plus or minus 3)) and with less formal education (26% (95% CI=plus or minus 4) vs. 22% (95% CI=plus or minus 3) vs. 18% (95% CI=plus or minus 3)) were more likely to estimate this behavior to be this prevalent. Separated and divorced respondents (34% (95% CI=plus or minus 7)) were the most likely to estimate this high prevalence, followed by single (24% (95% CI=plus or minus 4)) and married (18% (95% CI=plus or minus 2)) respondents.

More than one third (37% (95% CI=plus or minus 2)) estimated that less than or equal to 20% of U.S. women have ever had anal intercourse (Table 1, question 3); 28% (95% CI=plus or minus 2) indicated "don't know." Respondents estimating that greater than or equal to 30% of U.S. women have had anal intercourse were more likely to be 18-44 years of age (43% (95% CI=plus or minus 3) vs. 24% (95% CI=plus or minus 3)), unmarried (except widowed) (45% (95% CI=plus or minus 4) vs. 34% (95% CI=plus or minus 3)), or black (43% (95% CI=plus or minus 7) vs. 34% (95% CI=plus or minus 3)). A "don't know" response was 2.4 times more likely from respondents aged greater than or equal to 60 years (48% (95% CI=plus or minus 5)) than from those aged 18-44 years (20% (95% CI=plus or minus 2)); 1.4 times more likely from those without a high school diploma (34% (95% CI=plus or minus 5)) than from those with some college education (24% (95% CI=plus or minus 3)); 1.3 times more likely from those reporting an annual income less than $25,000 (30% (95% CI=plus or minus 4)); and 1.3 times more likely from women (31% (95% CI=plus or minus 3)).

When asked if 25% of U.S. men have had a homosexual experience, 36% of respondents (95% CI=plus or minus 2) answered "don't know" (Table 1, question 4). This response was most common among those widowed (52% (95% CI=plus or minus 8)), aged greater than or equal to 60 years (47% (95% CI=plus or minus 5)), black (41% (95% CI=plus or minus 7)), and without a high school diploma (40% (95% CI=plus or minus 5)). Of the remaining 64% of respondents, two thirds estimated that less than 25% of U.S. men have had a homosexual experience. Reported by: JM Reinisch, PhD, CA Hill, PhD, M Ziemba-Davis, SA Sanders, PhD, The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana Univ, Bloomington, Indiana. The Roper Organization, New York City. Behavioral Studies Br, Div of STD/HIV Prevention, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note:

Collection of information on perceptions, knowledge, and behavior is difficult. Because race, education, and income are correlated and blacks were not oversampled, the results in this report that are related to these variables should be interpreted cautiously. Some groups, such as teenagers, have higher rates of certain risk behaviors for STD transmission and high rates of STDs (2). The data in this report suggest that the perception that certain high-risk behaviors are more prevalent is also more common in some groups. These perceptions may reinforce continued practice of these high-risk behaviors.

Since perceptions of socially accepted norms influence behaviors (3), subjective estimates of the prevalence of specific sexual behaviors have substantial public health importance. For younger persons in particular, perceptions of the "average" age at which others initiate sexual activity is likely to affect sexual decision making. Accordingly, public health strategies directed toward alteration of perceived norms could influence behavior (4). Specifically, interventions related to sexual behavior may potentially reduce disease transmission (5).

Disseminating accurate data from surveys of sexual behavior can assist in changing perceptions of norms regarding high-risk sexual behaviors. The dissemination of such information represents a potential intervention by providing alternative perceptions that could lead to changes in behavioral expectations, expectations about what is acceptable to others, and risky behavior.

References

1. Reinisch JM, Beasley R. The Kinsey Institute new report on sex: what you must know to be sexually literate. New York: St. Martin's Press, 1990:1-26.

2. Cates W Jr. The epidemiology and control of sexually transmitted diseases in adolescents. In: Schydlower M, Shafer M-A, eds. Adolescent medicine: state of the art reviews. Vol

3. Philadelphia: Hanley and Belfus, 1990:409-27.

4. Sussman S, Dent CW, Mestel-Rauch J, Johnson CA, Hansen WB, Flay BR. Adolescent nonsmokers, triers, and regular smokers' estimates of cigarette smoking prevalence: when do overestimations occur and by whom? J Appl Soc Psychol 1988;18:537-51.

5. Murray DM, Johnson CA, Luepker RV, Mittelmark MB. The prevention of cigarette smoking in children: a comparison of four strategies. J Appl Soc Psychol 1984;14:273-88.

6. Stall RD, Coates TJ, Hoff C. Behavioral risk reduction for HIV infection among gay and bisexual men: a review of results from the United States. Am Psychol 1988;43:878-85.

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