The National Survey of Sexual Health and Behavior is a decade-long nationally representative study of human sexual behavior. The research has been conducted in the United States by researchers from the Center for Sexual Health Promotion in the School of Public Health at Indiana University in Bloomington. Time magazine called the NSSHB "the most comprehensive survey of its kind in nearly two decades and the first to include teenagers." [1] Former U.S. Surgeon General Dr. Joycelyn Elders has written the following about NSSHB findings: "These data are important for keeping the nation moving forward in the area of sexual health and well being. In the absence of scientific data available to construct an accurate and up-to-date view, opinions in the field of sexual science can vary widely from person to person." [2]
There have been a total of seven waves of the NSSHB, all conducted between 2009 and 2018. More than 30 scientific articles have been published from these data. [3] Articles based on the first wave of the study, the 2009 NSSHB, were initially released in a supplement to the October 2010 issue of Journal of Sexual Medicine . [4] Since the NSSHB's inception in 2009, there have been a total of six additional waves of data collection. The NSSHB was the first U.S. nationally representative probability survey of sexual behavior in the United States conducted since the 1992 National Health and Social Life Survey. In Fall 2018, the researchers were honored with Indiana University's Outstanding Faculty Collaborative Research Award Lecture. [5]
The 2009 NSSHB surveyed nearly 6,000 individuals between the age of 14 and 94, living in the United States. Findings showed a wide variety of sexual behavior. According to one of the lead investigators, Debby Herbenick, PhD, of Indiana University in Bloomington, "Adult men and women rarely engage in just one sex act when they have sex." [4] In addition to Dr. Herbenick, the original core NSSHB team included Drs. Michael Reece, J. Dennis Fortenberry, Brian Dodge, Stephanie Sanders, and Vanessa Schick. [5] Significant findings include use of condoms in about 25% of instances of vaginal sex by adults, about 33% if they were single, with teenagers using condoms 70 to 80% of the time. Only a low level of sexual activity among the approximately 800 teenagers surveyed was found with incidence increasing with age. It was discovered that about one third of women reported pain during intercourse. A discrepancy was discovered between men's perception that their female partner had experienced orgasm, about 85%, and women's self-reporting of 64%. [4]
The NSSHB has been supported by funding from Church and Dwight, maker of Trojan condoms. The sponsor offered limited input on the survey development, mostly with respect to gathering information on how often Americans use condoms, settling with a formulation which requested information on whether condoms were used or not during the last 10 sexual encounters of each respondent. [4]
With respect to condom use results were encouraging especially with respect to teenagers. Ethnic populations impacted by HIV/AIDS showed a higher rate of condom use than then general population as did dating adults. Discrepancies remain between the level of condom use considered optimal for public health and reported rate of use particularly by people over 40. [4]
Women reported less satisfaction with sexual activity than men with less pleasure, less arousal, and fewer orgasms. This was hypothesized by one of the researchers as being related to the greater incidence of pain also reported by women. [4]
In the 2012 NSSHB, researchers found that pain during vaginal intercourse was reported by 30% of women and 7% of men. Additionally, pain during anal intercourse was reported by 72% of women and 15% of men. [6]
In a publication from the 2016, the researchers found that although most sexually active adults between ages 18 and 50 were aware that Zika could be transmitted by mosquitos, only about 40% identified sexual intercourse as a possible route of transmission. [7]
In a 2018 NSSHB publication, it was found that about 60% of Americans who reported on a recent sexual event reported having ejaculated somewhere outside of the vagina at least once. Looking at the most recent sexual event, findings showed a lack of concordance between the percentage of people indicating they used "withdrawal" at their most recent sexual event compared with where they said they ejaculated. [8]
Anal sex or anal intercourse is generally the insertion and thrusting of the erect penis into a person's anus, or anus and rectum, for sexual pleasure. Other forms of anal sex include anal fingering, the use of sex toys, anilingus, pegging, as well as electrostimulation and erotic torture such as figging. Although anal sex most commonly means penile–anal penetration, sources sometimes use anal intercourse to exclusively denote penile–anal penetration, and anal sex to denote any form of anal sexual activity, especially between pairings as opposed to anal masturbation.
Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone to acts with another person in varying patterns of frequency, for a wide variety of reasons. Sexual activity usually results in sexual arousal and physiological changes in the aroused person, some of which are pronounced while others are more subtle. Sexual activity may also include conduct and activities which are intended to arouse the sexual interest of another or enhance the sex life of another, such as strategies to find or attract partners, or personal interactions between individuals. Sexual activity may follow sexual arousal.
Orgasm or sexual climax is the sudden release of accumulated sexual excitement during the sexual response cycle, characterized by intense sexual pleasure resulting in rhythmic, involuntary muscular contractions in the pelvic region. Orgasms are controlled by the involuntary or autonomic nervous system and experienced by both males and females; the body's response includes muscular spasms, a general euphoric sensation, and, frequently, body movements and vocalizations. The period after orgasm is typically a relaxing experience after the release of the neurohormones oxytocin and prolactin, as well as endorphins.
Sexual intercourse is a sexual activity typically involving the insertion and thrusting of the male penis inside the female vagina for sexual pleasure, reproduction, or both. This is also known as vaginal intercourse or vaginal sex. Sexual penetration has been known by humans since the dawn of time, and has been an instinctive form of sexual behaviour and psychology among humans. Other forms of penetrative sexual intercourse include anal sex, oral sex, fingering and penetration by use of a dildo, and vibrators. These activities involve physical intimacy between two or more people and are usually used among humans solely for physical or emotional pleasure. They can contribute to human bonding.
Group sex is sexual activity involving more than two people. Participants in group sex can be of any sexual orientation or gender. Any form of sexual activity can be adopted to involve more than two participants, but some forms have their own names.
A sex toy is an object or device that is primarily used to facilitate sexual pleasure, such as a dildo, artificial vagina or vibrator. Many popular sex toys are designed to resemble human genitals, and may be vibrating or non-vibrating. The term sex toy can also include BDSM apparatus and sex furniture such as sex swings; however, it is not applied to items such as birth control, pornography, or condoms. Alternative terms for sex toy include adult toy and the dated euphemism marital aid. Marital aid also has a broader meaning and is applied to drugs and herbs marketed to enhance or prolong sex.
Vaginismus is a condition in which involuntary muscle spasm interferes with vaginal intercourse or other penetration of the vagina. This often results in pain with attempts at sex. Often it begins when vaginal intercourse is first attempted. Vaginismus may be considered an older term for pelvic floor dysfunction.
Dyspareunia is painful sexual intercourse due to somatic or psychological causes. The term dyspareunia covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the female type, which is more common than the male type. In females, the pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.
Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Non-infectious causes of cervicitis can include intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms. Cervicitis affects over half of all women during their adult life.
A vibrator, sometimes described as a massager, is a sex toy that is used on the body to produce pleasurable sexual stimulation. There are many different shapes and models of vibrators. Most modern vibrators contain an electric-powered device which pulsates or throbs. Vibrators can be used for both solo play and partnered play by one or more people. Devices exist to be used by couples to stimulate the genitals of both partners. They can be applied to erogenous zones, such as the vulva, vagina, penis, scrotum, anus, or rectum for sexual stimulation, for the release of sexual frustration and to achieve orgasm. Vibrators may be recommended by sex therapists for women who have difficulty reaching orgasm through masturbation or intercourse.
Women who have sex with women (WSW) are women who engage in sexual activities with women, whether they identify as straight, lesbian, bisexual, pansexual, have other sexualities, or dispense with sexual identification altogether. The term WSW is often used in medical literature to describe such women as a group for clinical study, without needing to consider sexual self-identity.
Adolescent sexuality is a stage of human development in which adolescents experience and explore sexual feelings. Interest in sexuality intensifies during the onset of puberty, and sexuality is often a vital aspect of teenagers' lives. Sexual interest may be expressed in a number of ways, such as flirting, kissing, masturbation, or having sex with a partner. Sexual interest among adolescents, as among adults, can vary greatly, and is influenced by cultural norms and mores, sex education, as well as comprehensive sexuality education provided, sexual orientation, and social controls such as age-of-consent laws.
The sexuality of US adolescents includes their feelings, behaviors and development, and the place adolescent sexuality has in American society, including the response of the government, educators, parents, and other interested groups.
Intravaginal ejaculation latency time (IELT) is the time it takes to ejaculate during vaginal penetration. Average IELT varies between people and tends to decrease with age.
Debby Herbenick is an American author, research scientist, sex educator, sex advice columnist, children's book author, blogger, television personality, professor, and human sexuality expert in the media. Herbenick is a Provost Professor at the Indiana University School of Public Health (IUSPH) and lead investigator of the National Survey of Sexual Health and Behavior (NSSHB), which Time called "the most comprehensive survey of its kind in nearly two decades."
Sexual activities involving men who have sex with men (MSM), regardless of their sexual orientation or sexual identity, can include anal sex, non-penetrative sex, and oral sex. Evidence shows that sex between men is significantly underreported in surveys.
Penile-vaginal intercourse or vaginal intercourse is a form of penetrative sexual intercourse in human sexuality, in which an erect penis is inserted into a vagina. Synonyms are: vaginal sex, cohabitation, coitus, intimacy, or (poetic) lovemaking. It corresponds to mating or copulation in non-human animals.
Genital trauma is trauma to the genitalia.
Risky sexual behavior is the description of the activity that will increase the probability that a person engaging in sexual activity with another person infected with a sexually transmitted infection will be infected, become unintentionally pregnant, or make a partner pregnant. It can mean two similar things: the behavior itself, and the description of the partner's behavior.
The orgasm gap or pleasure gap is the disparity in sexual satisfaction—specifically the unequal frequency in achieving orgasm during sexual encounters—between heterosexual men and women. Across every demographic that has been studied, women report the lowest frequency of reaching orgasm during sexual encounters with men. Researchers believe that multiple causes contribute to the orgasm gap. Orgasm gap researcher Laurie Mintz argues that the primary reason for this form of gender inequality is due to "our cultural ignorance of the clitoris" and that it is commonplace to "mislabel women's genitals by the one part that gives men, but not women, reliable orgasms."