Sexual behaviour

Sexual behaviour

The objective of the study was to explore the relative contribution of secular trends and public health policies to changes in sexual behaviour. Three random probability surveys of the sexual behaviour of people aged 18-69 years were conducted in 1970, 1992 and 2006 in France. Data of the 2006 survey (n = 12 364) were compared with those from two surveys carried out in 1970 (n = 2625) and 1992(n = 20 055). Over the last decades, median age at first intercourse has decreased by 4 years for women (22.0 in the 1930s vs. 17.6 in the 2000s) and 1 year for men (18.1 vs. 17.2). Lifetime number of sexual partners increased for women (1.8 in 1970 vs. 4.4 in 2006), but not for men (11.8 vs. 11.6). At the same time, the proportion of respondents, especially women, who reported nonpenetrative sexual practices and considered sexual intercourse essential to well being was on the increase. These changes are mainly attributed to an increase in women's social status. A marked increase in condom use was observed following the first HIV prevention campaigns in the 1980s. Public health interventions that are synergistic with trends in social norms are likely to be more effective than those that run counter to them. In France, sexual health and HIV prevention policies aimed at harm limitation appear to have chimed with secular trends. The evidence of greater diversification of sexual practices offers potential to increase the range of safer sex messages used in public health interventions.

For abstract access click here:

Editors’ note: This fascinating retrospective analysis of trends in sexual behaviours in France over almost three quarters of a century reveals dramatic changes, particularly among women. The gap between age at first sex between men and women has fallen from 4 years to 4 months while use of any contraceptive method rose steadily from 37% in the early 1940s to 92.9% by 2005. Lifetime numbers of sexual partners remained stable for men of all ages but increased for women from 1.8 in 1970 to 4.4 in 2006. Condom use at first sex was below 10% for those starting sex before 1960 but rose to more than 80% by the mid-1990s. Although it is difficult to sort out whether changes in sexual behaviour were the result of public health interventions or the result of changes in the broader social context, the fact that condom use at first sex became normalised was likely the result of a focus on the routinization of condom use in HIV public education campaigns. From the HIV perspective, the findings about increasing nonpenetrative sexual practices are striking: lifetime reported masturbation increased three-fold for women aged 20-49 years from 19% in 1970 to 62% in 2006 and for men from 71% to 92%. Lifetime experience of oral sex increased from 51% to 91% for women and 55% to 94% for men. This suggests that the UNAIDS term ‘abstinence from penetrative sex’ as an HIV prevention strategy could have public health significance equivalent to condom promotion among young people in some settings.