The paper analyses data from 59 countries worldwide to answer questions such as when people start to have sex, how many sexual partners they have and whether they practise safer sex. The authors explore what the patterns and trends mean for sexual health and they review the literature on preventive approaches to improve sexual health status.

A surprising finding is that it is the developed nations that report comparatively high rates of multiple partnerships, not those parts of the world which tend to have higher rates of HIV and AIDS, such as African countries. This has led the authors to suggest that social factors such as poverty, mobility and gender equality may be a stronger factor in sexual ill-health than promiscuity, and they call for public health interventions to take this into account.

Monogamy was found to be the dominant pattern in most regions of the world. Despite substantial regional variation in the prevalence of multiple partnerships, which is notably higher in industrialised countries, most people report having only one recent sexual partner. Worldwide, men report more multiple partnerships than women, but in some industrialised countries the proportions of men and women reporting multiple partnerships are more or less equal.

Trends towards earlier sexual experience were found to be less pronounced and less widespread than is sometimes supposed. In the majority of countries for which data were available, age at first intercourse had increased for women. In many developing countries, especially those in which first sex occurs predominantly within wedlock, the trend towards later onset of sexual activity among women has coincided with the trend towards later marriage, and this is particularly a feature of countries in Africa and south Asia.

Given the diversity of sexual behaviour revealed by the study, the authors call for a range of preventive strategies to be adopted to protect sexual health.

MEDICA.de; Source: London School of Hygiene & Tropical Medicine