Sexually speaking, Americans are mixing it up a good deal more than they have in the past.
The first comprehensive snapshot of Americans' sexual activity in almost two decades suggests a social landscape changed by HIV and AIDS and by an increasingly open national conversation about sexual acts other than plain old intercourse.
Across the lifespan, Americans report they are masturbating, alone or with a partner, engaging in oral sex and experimenting with same-gender sex more often than they owned up to in the 1980s, according to a study released Monday.
"The sexual repertoire of Americans has sort of expanded," said Michael Reece, director of Indiana University's Center for Sexual Health Promotion and a leading author of the National Survey of Sexual Health and Behavior, published in a special issue of the Journal of Sexual Medicine. Though vaginal intercourse is hardly on its way out, the practice has declined as other sexual acts have gained ground.
"We've always looked at these other sexual activities as foreplay, with the notion that 'that's not really sex,' " Reece said. But amid a din of messages selling safe sex, pregnancy prevention, female empowerment and sexual pleasure, acts once seen as the starter course have not only become an essential ingredient in our sexual diet -- they are frequently the main course.
The result is a sexual smorgasbord that by all appearances has become more satisfying to women. Though men were more likely to report orgasm during vaginal intercourse, women told researchers they were more likely to have orgasms from a variety of sex acts, including oral sex and vaginal intercourse.
The survey suggested some ongoing miscommunication between men and women when it comes to satisfaction. All told, 64% of women reported having achieved orgasm in the course of their most recent sexual "event." A higher proportion of men — 85% — reported that their partner had experienced orgasm during their most recent sexual encounter.
Some of those men may have been having sex with other men, but that explanation could not fully account for a 21-percentage-point gap between men's and women's responses, researchers said.
Former Surgeon General M. Joycelyn Elders, in an accompanying editorial, said the findings would help our "sexually dysfunctional society" address sex as a positive source of pleasure and health. In a country where 30% of healthcare spending is related to sexuality, she wrote, the national conversation about sex must shift from its focus "only as prevention of pregnancy and disease to a discussion about pleasure."
In all, 5,865 U.S. residents answered the survey, which was the first to gather data on sexual activity from Americans at such far ends of the age spectrum. The last such survey, conducted by the same researchers in 1992, asked people between the ages of 18 and 59 about their sexual activities. In contrast, the current study included adolescents as young as 14 and adults as old as 94.
The study showed that, despite widespread concern about early adolescent "hookups," "sexting" and "friends with benefits," most young teenagers are largely not having sex with anyone but themselves. Among 14- and 15-year-olds, about 1 in 10 said they were having sex with a partner. But 62% of boys and 40% of girls in this age group reported they had masturbated by themselves in the last year.
Men and women over 60 continued to be sexually active and adventurous in large numbers, with 38% of men and 25% of women between the ages of 60-69 reporting that they had received oral sex from a member of the opposite sex in the last year. Those numbers declined to 19% and 8% for men and women, respectively, in their 70s and beyond.
Not surprisingly, given that the study was underwritten by the condom manufacturer Trojan, condom use was a major focus of the survey. It found condom use was widespread among the sexually active: 1 in 4 acts of vaginal intercourse involved a condom, a ratio that rose to 1 in 3 among partners who were not cohabitating.