Sexual Behavior in Men and Women Aged 20-59 Years in the United States According to the National Health and Nutrition Examination Survey
Ray M Merrill* and Steven B Ko
ABSTRACT
Early initiation of sexual activity and patterns of sexual partnerships are important predictors of sexual health outcomes, yet few population-based studies have examined their links to sexual orientation and demographics. This study examined self-reported age at first sexual intercourse, age at menarche, and number of sexual partners to assess associations with sexual orientation, partner stability, and sexually transmitted infections (STIs). Analyses included 7,843 U.S. adults aged 20-59 years who participated in the National Health and Nutrition Examination Survey (NHANES) (1999-2004). The mean age at first sexual intercourse was 17.38 years, with men reporting significantly younger ages than women. Earlier sexual debut was associated with being previously married, non-Hispanic Black, having lower education, substance use, and lower socioeconomic status, whereas individuals from other racial groups reported older ages at first sex. Individuals who reported having sex with both men and women had the youngest median age at first sexual intercourse. Those who initiated sex earlier had significantly more lifetime partners, with men reporting 1.8 times the number of partners as women. Previously married and nevermarried individuals, non-Hispanic Black participants, and substance users reported higher numbers of sexual partners. Multiple sexual partners were also associated with sexual orientation, demographic characteristics, and STIs. Among those in same-sex relationships, early sexual debut was linked to a higher number sexual of partners, and no men in this group reporting only one partner. Herpes and genital warts were more prevalent among those with earlier sexual debut and more sexual partners. However, no significant association was observed between age at first sexual intercourse and overall STI prevalence.
