Lifestyle and exercise

Survey reveals US sex habits

“America reveals its sexual secrets,” said_ The Guardian_ , reporting on the publication of the most comprehensive survey of American sex lives in 20 years. The study of nearly 6,000 Americans between the ages of 14 and 90 aims to provide a ‘contemporary snapshot’ of sexual behaviours, condom use and sexual health.

As The Guardian reports, it is likely that some of these findings apply to the UK.

The main findings indicate that there is great variability in the “sexual repertoires” of US adults, with adults of all ages engaging in healthy and varied sex lives.

Probably one of the survey’s most important findings is that condoms are only used in one in four acts of vaginal intercourse, and in one in three acts of vaginal intercourse among singles.

Encouragingly, the highest rate of condom use was among the 14-17-year-old age group, suggesting a changing attitude towards safe sex in this generation. Adults above the age of 40 have the lowest rate of condom use, which suggests that the promotion of condoms remains a public health priority.

Where did the story come from?

The survey was carried out by a multidisciplinary team from Indiana University in the US. The initial findings have been published in nine separate research articles in the peer-reviewed Journal of Sexual Medicine .

The survey was funded by Church & Dwight Co, maker of sexual health products, including condoms, vibrating rings and pregnancy testing kits.

The Guardian and The Daily Mail reported the study.

Why was the survey carried out?

The survey is thought to be the largest national study of its kind in the US, involving 5,865 adolescents and adults between 14 and 94 years old. The aim was to provide a ‘contemporary snapshot’ of sexual behaviours, condom and contraceptive use and sexual health in the US.

The authors say that the US faces significant challenges in terms of the population’s sexual and reproductive health, particularly the impact of HIV, high rates of other sexually transmitted infections and high numbers of unplanned pregnancies. Because of this, up-to-date information about sexual behaviour and condom use is urgently needed by health professionals, as well as being of interest to scientists and the general public.

They point out that the first large-scale systematic study of human sexual behaviour, by Dr Alfred Kinsey, was published over 60 years ago. Since then, there have been many studies of different aspects of sexual behaviour. The authors argue that up-to-date data reflecting changes in social attitudes is needed.

What did the research involve?

Participants were randomly selected using several different methods that aimed to produce a nationally representative sample of adolescents and adults in the US. Participants received a brief recruitment message giving some information about the survery and inviting them to take part. The participants then carried out the survey online.

As the authors point out, this approach had some limitations. It was “quantitative rather than qualitative” in nature, meaning that the context and background to the respondents could not be assessed in any detail. As it was not based on in-depth interviews, it lacks the “rich contextual insights” provided, for example, by the Kinsey Report.

What did the survey find on sexual health?

In terms of sexual health, probably one of the survey’s most important findings is that condoms are only used in one in four acts of vaginal intercourse, and in one in three acts of vaginal intercourse among singles. The researchers suggest that efforts to promote condom use among sexually active individuals should remain a public health priority.

The main findings for condom use are:

  • Condoms are used twice as often among casual sexual partners as among relationship partners across all age groups.
  • Adults over the age of 40 have the lowest rate of condom use; the highest rates of use was among 14-17 year olds.
  • Condom use is higher among black and Hispanic Americans than among other racial groups.
  • Adults using a condom were just as likely to rate sexual intercourse positively in terms of arousal, pleasure and orgasm than when having intercourse without one.

What did the survey find on sexual behaviour?

There was great variability in the “sexual repertoires” of US adults, with 41 different combinations of sexual activity described, comprised of five basic acts:

  • penile vaginal intercourse
  • solo masturbation
  • mutual masturbation
  • oral sex
  • anal sex

The report suggests that while vaginal intercourse is still the most common sexual behaviour, many “sexual events” do not involve intercourse and include only partnered masturbation or oral sex. It also suggests that many older adults continue to have active sex lives, with a range of different behaviours and partner types: for example, between the ages of 60 and 69 years, 38% of men and 25% of women indicate they had been given oral sex by a partner of the opposite sex in the past year.

At any given point in time, most adolescents (14-15 years) were not engaging in partnered sexual behaviour. While 40% of 17-year-old males reported vaginal intercourse in the past year, only 27% reported the same in the past 90 days.

Key findings:


  • About 85% of men reported that their partner had an orgasm during their most recent sexual event, but only 64% of women reported having had an orgasm the last time they had sex.
  • Men were more likely to orgasm when sex included vaginal intercourse, but for women, variety appeared to be important, as they were significantly more likely to orgasm if they gave oral sex, received oral sex, had vaginal intercourse or received anal sex. Both men and women were more likely to orgasm if they engaged in a greater number of sexual behaviours.

Sexual repertoires

  • Vaginal intercourse is still the most common sexual act among adult men and women but many people have sexual events that do not include intercourse. The next most common sexual repertoires consisted of giving and receiving oral sex with vaginal intercourse, and giving and receiving oral sex along with partnered masturbation and vaginal intercourse.
  • Of the five basic acts identified, more than 6% of men aged 25-29 claimed to have engaged in all five during their last sexual event. For women, 16% aged 18-24 engaged in four or five of the five basic acts the last time they had sex, as did 8% of the women aged 50-59 years.

Oral sex

  • About 88% of men aged 30-39 performed oral sex on a woman, 69% of them in the last year. Nearly 20% of boys aged 16-17 years performed oral sex on a woman.
  • More than half of all women surveyed said they had received oral sex from a male partner the previous year.
  • 23% of women aged 16-17 and over half those aged 18-49 said they had given a male partner oral sex.


  • Between 28 and 69% of men in each age group reported having masturbated alone during the past month.
  • More than half of women aged 18-49 said they had masturbated alone in the previous 90 days.
  • Nearly a quarter of all women said they had engaged in mutual masturbation with a male partner in the previous month.

Anal sex

  • 21% of the women in the 25-29 and 30-39 age groups had experienced anal sex in the last year.
  • About 20% of girls aged 18-19 had had anal sex at least once.

Same-sex activity

  • 7% of adult women and 8% of men identified themselves as gay, lesbian or bisexual.
  • 15% of women in their 30s reported having performed oral sex on another woman at least once.
  • 13% of men over 40 said they had performed oral sex on another man. 


This large, representative survey is one of the most comprehensive studies of US sexual behaviour and condom use in almost two decades.

Its findings are important for health professionals and policy makers responsible for and involved in promoting sexual health and sex education, as well as interesting for the public. However, it should be noted that, unlike Kinsey’s research, the findings are not based on in-depth interviews but on internet research and therefore may be less reliable.

Though the survey was of a sample of the US population, it seems likely that the main findings that many sexually active adults do not use condoms and engage in a wide variety of sexual behaviours also applies to the UK.

NHS Attribution