Sexual risk-taking in the general population of Sweden (1989–2007)
Claes HerlitzDalarna Research Institute, Myntgatan 2, SE-791 51 Falun, Sweden. Email: claes.herlitz@dfr.se
Sexual Health 6(4) 272-280 https://doi.org/10.1071/SH08095
Submitted: 16 December 2008 Accepted: 17 September 2009 Published: 13 November 2009
Abstract
Background: The aim of the study was to assess changes in sexual attitudes and sexual behaviour related to HIV/sexually transmissible infections (STI) during a long period of intensive efforts by the Swedish authorities to curb the spread of HIV. Methods: We conducted mailed questionnaire surveys in random samples of the Swedish general population in 1989, 1994, 1997, 2000, 2003 and 2007 (total n = 16773). Each sample consisted of some 4000–6000 participants aged 16–44 years, stratified by age: 16–17, 18–19, 20–24, 25–34 and 35–44 years. The overall participation rate was 61.6% (for men, 53.5%; for women, 69.9%). Results: Between 1989 and 1994, the proportion of participants holding a restrictive view on sexual intercourse outside a stable relationship decreased significantly. The surveys since 1994 do not show any change in that respect. The prevalence of several sexual partners increased significantly throughout the period of study. The prevalence of casual sexual intercourse without the use of a condom also increased significantly from 1989 until 2003, but decreased slightly between 2003 and 2007. This change in sexual behaviour was more prominent in women than among men. The prevalence of several sexual partners and casual sexual intercourse without the use of a condom was significantly higher for the younger than for the older age cohorts. Conclusions: The study demonstrates the need for a continuous preventive campaign against HIV/STI in the general population in Sweden, particularly among young people.
Additional keywords: casual sexual contacts, multiple sexual partnerships, sexual attitudes, sexually transmissible infections.
Acknowledgements
This study was funded by the Swedish Medical Research Council, the Swedish National Institute of Public Health, and the Swedish National Board for Health and Welfare. The author is grateful to Margareta Forsberg for very helpful comments on the manuscript and to Jan Ifver for valuable statistical assistance.
[1]
[2]
[3]
[4]
[5] Herlitz C, Steel J. A decade of HIV/AIDS prevention in Sweden: changes in attitudes associated with HIV and sexual risk behaviour from 1987 to 1997. AIDS 2000; 14 881–90.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[6]
[7]
[8] Visser RO, Smith AMA, Rissel CE, Richters J, Grulich AE. Sex in Australia: heterosexual experience and recent heterosexual encounters among a representative sample of adults. Aust N Z J Public Health 2003; 27 146–54.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Johnson A, Mercer C, Erens B, Copas AJ, McManus S, Wellings K, et al. Sexual behaviour in Britain: partnerships, practices, and behaviours. Lancet 2001; 358 1835–42.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[10]
[11]
[12]
[13]
[14]
[15]
[16] Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull 1990; 108 339–62.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[17]
[18]
[19] ASCF Investigators AIDS and sexual behaviour in France. Nature 1992; 360 407–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[20] Smith AMA, Rissel CE, Richters J, Grulich AE, de Visser RO. The rationale and methods of the Australian study of health and relationships. Aust N Z J Public Health 2003; 27 106–17.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[21] Davis PB, Yee RL, Chetwynd J, McMillan N. The New Zealand partner relations survey: methodological results of a national telephone survey. AIDS 1993; 7 1509–16.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[22] Bogaert AF. Volunteer bias in human sexuality research: evidence of both sexuality and personality differences in males. Arch Sex Behav 1996; 25 125–40.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[23] Purdie DM, Dunne MP, Boyle FM, Cook MD, Najman JM. Health and demographic characteristics of participants in an Australian national sexuality survey. Comparison with population norms. J Epidemiol Community Health 2002; 56 748–53.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[24] Dunne MP, Martin NG, Bailey JM, Heath AC, Bucholz KK, Madden PA, et al. Participation bias in a sexuality survey: psychological and behavioural characteristics of responders and non-responders. Int J Epidemiol 1997; 26 844–54.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[25]
[26] Magnusson C. Adolescent girls’ sexual attitudes and opposite-sex relations in 1970 and 1996. J Adolesc Health 2001; 28 242–52.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[27]
[28] Weinberg MS, Lottes IL, Aveline D. AIDS risk reduction strategies among United States and Swedish heterosexual university students. Arch Sex Behav 1998; 27 385–401.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[29]
[30]
[31] Copas AJ, Wellings K, Erens B, Mercer CH, McManus S, Fenton KA, et al. The accuracy of reported sensitive sexual behaviour in Britain: exploring the extent of change 1990–2000. Sex Transm Infect 2002; 78 26–30.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[32] Dehne KL, Riedner G. Sexually transmitted infections among adolescents: the need for adequate health services. Reprod Health Matters 2001; 9 170–83.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[33] Genuis SJ, Genuis SK. Managing the sexually transmitted disease pandemic: a time for re-evaluation. Am J Obstet Gynecol 2004; 191 1103–12.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[34] Cohen MW. Adolescent sexual activity as an expression of nonsexual needs. Pediatr Ann 1995; 24 324–9.
| CAS | PubMed |
[35]
[36] Mindel A, Sawleshwarkar S. Condoms for sexually transmissible infection prevention: politics versus science. Sex Health 2008; 5 1–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[37]
[38] Cassell JA, Mercer CH, Imrie J, Copas AJ, Johnson AM. Who uses condoms with whom? Evidence from national probability sample surveys. Sex Transm Infect 2006; 82 467–73.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[39]
[40] Marston C, King E. Factors that shape young people’s sexual behaviour: a systematic review. Lancet 2006; 368 1581–6.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[41] Potts M, Halperin DT, Kirby D, Swidler A, Marseille E, Klausner JD, et al. Reassessing HIV prevention. Science 2008; 320 749–50.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[42] Oakley A, Fullerton D, Holland J, Arnold S, France-Dawson M, Kelley P, et al. Sexual health education interventions for young people: a methodological review. BMJ 1995; 310 158–62.
| CAS | PubMed |
[43]
[44]
[45]
[46]