Sexual behavior: Review national survey details

Understanding sexual behavior is an important piece of the family planning puzzle, and a new national report provides insights on current sexual practices.1

Researchers with the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) have issued the report, which uses data collected over a four-year period from the National Health and Nutrition Examination Survey (NHANES). The long-running survey is a program of studies designed to assess the health status of adults and children in the United States.

Results of the survey may have special significance for the study of sexual behavior, because information on sexual behavior and drug use for adults ages 20-59 was collected using the Audio Computer-Assisted Self-Interview (ACASI) method. The ACASI method, used for the first time in the NHANES survey, allows respondents to answer questions in complete privacy about socially sensitive questions related to drug use and sexual behavior.

Before 1999, many sexual behavior and drug use questions were asked in face-to-face private interviews. Studies have shown that more private methods of interviewing yield higher reporting of socially sensitive behaviors than with face-to-face interviews,2-5 says Cheryl Fryar, MSPH, an associate service fellow at NCHS and lead author of the report. "Survey planners attempted to minimize response errors by implementing ACASI for the socially sensitive behavior questions asked in the survey," says Fryar. The NHANES ACASI was conducted in a private room of a mobile examination center in English or Spanish.

What did they find?

The new report uses data collected over a four-year period (1999-2002) from the NHANES survey. A total of 6,237 adults, ages 20 to 59, provided information in the survey.

Here's what researchers found:

  • Approximately 96% of U.S. adults have had sex.
  • Sixteen percent of adults first had sex before age 15, while 15% abstained from sex until at least age 21.
  • Males were more likely than females to have had sex before the age of 15.
  • The proportion of adults who first had sex before age 15 was highest for non-Hispanic blacks (28%), compared to 14% for Mexican-Americans and non-Hispanic whites.
  • Six percent of blacks abstained from sex until age 21 or older, compared to 17% of Mexican-Americans and 15% of non-Hispanic whites.
  • One-quarter of all women and 17% of men reported having no more than one partner of the other sex in their lifetime.
  • Seventeen percent of all men and 10% of women reported having two or more sexual partners in the past year.
  • Black men (46%) and women (13%) were more likely to report having 15 or more partners in a lifetime than other racial or ethnic groups.

Substance use can be intricately connected with sexual risk taking, according to the authors of Contraceptive Technology.6 Asking questions about drug use can aid clinicians in assessing risks in family planning patients.

Here's what the new survey results found about drug use:

  • Twenty-one percent of adults 20-59 years old have tried cocaine or street drugs at some time in their lives.
  • Five and one-half percent of adults said they used cocaine or street drugs within the past 12 months.
  • Past year use of cocaine or street drugs increased as the age group became younger, with the youngest age group (20-29 years) having the highest prevalence.
  • Men (26%) were more likely to have ever tried cocaine or street drugs than women (17%).


  1. Fryar CD, Hirsch R, Porter KS, et al. Drug use and sexual behaviors reported by adults: United States, 1999–2002. Advance Data from Vital and Health Statistics; No. 384. Hyattsville, MD: National Center for Health Statistics. 2007.
  2. Rogers SM, Willis G, Al-Tayyib A, et al. ACASI to measure HIV risk behaviors in a clinic population. Sex Transm Infect 2005; 81:501-507.
  3. Turner CF, Villarroel MA, Rogers SM, et al. Reducing bias in telephone survey estimates of the prevalence of drug use: A randomized trial of telephone ACASI. Addiction 2005; 200:1,432-1,444.
  4. Newman JC, Des Jarlais DC, Turner CF, et al. The differential effects of face-to-face and computer interview modes. AJPH 2002; 92:294-297.
  5. Hewett PC, Mensch BS, Erulkar AS. Consistency in reporting of sexual behaviour by adolescent girls in Kenya: A comparison of interviewing methods. Sex Transm Infect 2004; 80(Suppl II):ii43-48.
  6. Hatcher RA, Trussell J, Nelson AL, et al. Contraceptive Technology: 19th revised edition. New York City: Ardent Media; 2007.