How people conduct their sexual lives is shaped by many previously unrecognized factors, which in turn have profound consequences for their health and quality of life, according to a new book by University of Chicago scholars.

The book, Sex, Love, and Health, presents a storehouse of surprising and useful insights for individuals and policy leaders on the consequences of sexual experiences, ranging from physical and emotional satisfaction with sex partners and general life satisfaction to the challenges of unwanted pregnancy and sexually transmitted diseases.

“Because of the public consequences of these private acts, our society faces the need to create public policies to address these issues,” said Robert T. Michael, a co-editor of the book. This new book is a follow up to two previously published volumes, The Social Organization of Sexuality; Sexual Practices in the United States and Sex in America, both of which were published in 1994. Sex, Love, and Health in America, published by the University of Chicago Press contains a fresh analysis of data collected in the National Health and Social Life Survey, the nation’s most comprehensive survey on sexuality.

“We view sexual practices as an ongoing series of interactions whose content, pacing and partner choice are based not only on the character of the relationship between the people involved, but also on the social networks in which they live,” said Edward O. Laumann, one of the editors of the volume, which is made up of a series of individual reports from colleagues who have worked with the NHSLS data.

Laumann is the George Herbert Mead Distinguished Service Professor in Sociology at the University of Chicago. Michael, is the Eliakim Hastings Moore Distinguished Service Professor and Dean of the Irving B. Harris Graduate School of Public Policy Studies at the University. Here are their findings:

Abortion: One in six Americans men and women was responsible for a pregnancy that ended in an abortion. The first pregnancy (especially if it occurred in the teen years) and late pregnancies (especially at ages above the mid-30s) are the most likely to be aborted, with pregnancies in the 20s and early 30s being more likely to go to term. The reported rates of miscarriage are somewhat higher than the reported rates of abortion. While African-American women are much less likely to abort their first pregnancy, they have on average more conceptions and are more likely to have had an abortion over the lifetime. Opinions about abortion appear to influence the abortion choice, but marital status and mother's career opportunities play an important, independent role in that choice.

Teen pregnancy: Over the past half century there has been no trend in the birth rate among teenagers under age 18: about 10 percent of teenage women in each recent decade have had a baby by the time they turn 18. What has changed dramatically is the rate at which teen women engage in sex before age 18 (29 percent 40 years ago compared to 63 percent recently), but this has been offset by both a greater use of more effective contraceptives (25 percent used contraception at their first sex 40 years ago compared to 40 percent recently) and by an increase in the use of abortion (a tiny percentage 40 years ago compared to 27 percent of teenagers recently).

Child/adult sexual experiences: Roughly one in eight women and one in 16 men have had sexual experiences as children with an adult. People with such experiences tend to exhibit much higher levels of erotic behavior as adults. The women who have had that experience are more than three times as likely to have had more than 10 lifetime sex partners, twice as likely to have had a sexually transmitted disease, nearly three time as likely to report high sexual dysfunction as adults, and nearly four times as likely to be forced sexually as an adult.

Men who have had childhood sexual experiences with an adult as well as those who have had childhood sexual experiences with age mates (other children) are twice as likely to report low levels of overall happiness as adults, nearly twice as likely to be less satisfied with their current sexual partners, and nearly twice as likely to report high sexual dysfunction. The good news is that the vast majority of those with childhood sexual experiences appear to be quite resilient and have survived these experiences with no apparent harmful effects as adults so far as their sexuality and quality of life are concerned, Laumann said.

Consequences of the Sexual Revolution of the late 1960s: The study documents the considerable erosion of organized religion and middle class status in organizing people’s sexual lives in the wake of the Sexual Revolution. Before 1970, being raised Catholic or having a middle class mother played a substantial role in reducing a woman's likelihood of having sex before age 18. Now the principal factors affecting the decision not to have sex before age 18 are having an intact family (both biological parents present) when aged 14, late age of menarche, and not having had a sexual experience before the age of sexual maturity. The Sexual Revolution has seen a decline in the gender difference in age at first sex and a dramatic rise in the rates of premarital sex. 

Modes of sexual expression: The book characterizes many ways in which people can express themselves sexually, including numbers of sex partners, frequency of partnered sex, autoeroticism, and seeking venues of sexual provocation such as visiting nude bars, X-rated movies and phone sex. It shows that one can accurately describe men’s and women’s sexual profiles in one of only several possible patterns. About half of the men and women are comfortable monogamists (with partnered sex less than once a week, little masturbation and no seeking extra venues for sexual stimulation). The remaining half of the population who had at least one sex partner in the past year distribute into several sexual profiles, including enthusiastic polygamists (15 percent of men), venturesome cohabitors (35 percent of men), autoerotic singles (23 percent of women), and enthusiastic cohabitors (18 percent of women).

AIDS/HIV: About 30 percent of the American people reported that they had changed their behavior in some way in response to the AIDS epidemic of the 1980s. The common behaviors changed were (1) reducing the number of partners, (2) greater use of condoms and (3) greater care in selecting partners. Across the population, those who are at greater risk of contracting AIDS are more likely to adopt new behaviors that might reduce their chances of contracting the disease. However, there are some high-risk groups, including for example, young unmarried men, who fail to report any effective behavior change.

Sexually transmitted infections (STIs): About one in six Americans contract a STI in their lifetime. (This rate is much lower than the actual rate because many STIs are asymptomatic and thus undiagnosed because people are unaware that they have been infected.) While men as a group are much more likely than women to have had a STI because they have had more sex partners on the average than women have, women have about twice the likelihood of contracting a STI at any given level of risk exposure–that is, women reporting a comparable number of sex partners to men are twice as likely to contract an infection. Contrary to the impression generated from the Centers for Disease Control's reports on STI rates of infection suggesting that minorities and the poor are more apt to have STIs, in fact, it is the better educated people who are more likely to report having had a viral STI than people with less than a high school education.

?For several bacterial STIs, it is well known that African Americans have 15 to 30 times higher rates than whites. An explanation for this puzzle is found in the strong segregation between groups of highly sexually active African Americans and whites–the core groups. White core group members practically never choose black core group members as sex partners, and vice versa. A core group is a small subset of people within each racial group, usually about five to 10 percent who have many partners in the past year.

The sexual activities of core groups are the principal way by which an STI can be maintained in a population over time. Without them, STIs would die out because of their inability to spread from one person to another within a population at a fast enough rate.The result of the strict segregation of the white and black core groups is that an infection seeded in one racial group has no pathway to the other that would result in the spread of the infection from one group to the other. Because of the different ways the two racial groups choose sex partners, African-American women who have had only one sex partner in the past year are five times more likely to have that partner drawn from the black core group and thus much more likely to be exposed to contracting an STI, compared to white women with only one partner in the past year.

British/American similarities and differences in sexual attitudes and practices: The British and Americans have almost identical sexual practices, beliefs and attitudes, when one only compares averages. But Americans manifest much greater extremes in their sexuality than the British, who tend to cluster closely around their averages. Thus, there are many more virgins in the U.S. at the age of 20 than in Britain, as well as many more persons who have had large numbers of sex partners. There are many more Americans than British who hold extreme attitudes with respect to acceptable sexual behavior with the result that it is much harder to build consensus in the U.S. on what specific public policies should be adopted regarding sex education in the schools, abortion, AIDS intervention efforts and homosexuality.

?The book also discusses a number of other major issues in American sexuality, including the surprising consequences of male circumcision, the wide-spread prevalence and risk of sexual dysfunction (43 percent of women and 31 percent of men reported having had a substantial sexual problem of at least two months duration in the past twelve months), love and happiness in different types of sexual partnerships (comparing the relative advantages of marriage with other kinds of partnerships), and race/ethnic differences in sexual practices.

The National Health and Social Life Survey is a nationally representative probability sample of 1,511 men and 1,921 women between the ages of 18 and 59 living in households throughout the United States. The survey was conducted in 1992 by the National Opinion Research Center at the University of Chicago.

• Additional Contacts:
  Peter Schuler
  (773) 702-4195
  pm-schuler@uchicago.edu

  Mark Heineke
  (773) 702-7897
  mah@press.uchicago.edu

• Photos Available:
  Edward O. Laumann and Robert T. Michael
  300 dpi jpeg

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