Added: Perlita Dahlberg - Date: 03.05.2022 16:16 - Views: 36415 - Clicks: 1832
Public policies promoting abstinence until marriage attempt to influence the sexual behavior of the more than 18 million American women who are currently single. Sexual behaviors, risk factors and reproductive health needs were examined among a nationally representative sample of 6, women aged 20—44 from the National Survey of Family Growth.
Paired t tests were used to assess differences among single, married and cohabiting women by selected demographic, behavioral and risk measures.
Thirty-six percent of women aged 20—44 are single, and nine in 10 single women are sexually experienced. Seventy percent of the latter women are currently sexually active; on average, they had intercourse in seven of the last 12 months. Because of the high level of sexual activity among single adult women, providers must address their reproductive health care needs and offer appropriate counseling and services. Government policies aimed at encouraging adult women to have sex only within marriage appear out of touch with the reality of the sexual behavior of single women.Who Wants Sex More, Men or Women?
However, demographic shifts in the United States make the behavior and needs of this group increasingly salient. The median age at first marriage rose from Sexual activity among single women puts them at risk of unplanned pregnancy, unplanned births and STDs, including HIV, and determines the extent of their need for sexual and reproductive health information and services. Additional emphasis on abstinence among adult women is evident in the program priorities for Title X, the only federal program that provides deated funding for family planning.
Title X plays an important role because it establishes standards in publicly funded family planning service provision. Given demographic trends and the growing policy interest in single women, it is important to understand the sexual behavior of single adult American women, including how it compares with that of married and cohabiting women. While marital and union status is often used as a differentiating variable in studies of sexual behavior, it generally is not the focus of these studies; as a result, information about the sexual behavior and reproductive health needs of single women is scattered across diverse studies.
First, earlier studies used various and noncomparable definitions of union status, particularly in how they identified and grouped women in cohabiting unions. Measures that group all unmarried women—whether cohabiting or single—do not accurately capture their experiences. Second, most studies that focused on union status as a differentiating characteristic gave little attention to identifying variation in sexual activity and reproductive health needs by social and demographic characteristics, such as age, income, education, and race or ethnicity.
Third, research based on data from the mids or earlier may no longer adequately describe the experiences and needs of single women. This article presents new, nationally representative data on current patterns of sexual behavior, by union status, among women aged 20— Our objectives are to assess the extent to which single women are sexually active and at risk of poor sexual and reproductive health outcomes, and therefore are in need of reproductive health services; to identify differences in these patterns between single women and married or cohabiting women; and to examine differences in these patterns among demographic subgroups.
We address a range of questions: What proportions of single women have had sexual intercourse, are currently sexually active and have had multiple partners in the past year? What proportions are at risk of unintended pregnancy and STDs?
What are their needs for sexual and reproductive health services, and do they have health insurance to help meet these needs? How do single women differ from cohabiting or married women regarding sexual behavior and need for information and services? Are some subgroups of single women at greater reproductive health risk than others?
Most of the data for this analysis were drawn from the National Survey of Family Growth NSFGthe latest cycle of a periodic survey of the noninstitutionalized population in the United States. The survey used a multistage, stratified, clustered sample de and interviewed men and women of reproductive age; methodological details are available elsewhere.
A month-to-month calendar was employed to elicit detailed responses about sexual activity and contraceptive use. Because of our focus on adult women, our sample was limited to 6, female respondents aged 20—44 at the time of interview. To examine trends in union status, we also used and NSFG data on 7, and 9, women, respectively, who were aged 20—44 at the time of interview.
These earlier surveys had comparable des to the NSFG. We recognize that this last category encompasses groups that may differ in behaviors and needs, but for our assessment of how women not in a union differ from others, this categorization is appropriate. Most of the measures for this analysis were drawn from the face-to-face interviews, and sensitive topics, such as of partners, thus may be underreported.
Sexual experience is a dichotomous measure indicating whether a woman had ever had vaginal intercourse. Several variables measured exposure to reproductive health risks and use of contraceptives. Having multiple sexual partners—a risk factor for STDs—was defined as having had two or more partners in the past year. A woman was considered to be at risk of unintended pregnancy if she was sexually active, fecund, not pregnant or postpartum, not trying to get pregnant and not using contraceptive sterilization; women using other forms of contraception were considered to be at risk of unintended pregnancy.
Data for both of these measures were collected for all women, regardless of sexual experience, since never having sex is one means of risk reduction. Among women with multiple partners in the past year, we assessed if they had used condoms during the month of interview, as well as their consistency of condom use in the past year always, sometimes, never. For women who were at risk of unintended pregnancy, we determined if they had used any contraceptive in the month of interview. Respondents were asked whether they had had private insurance, Medicaid coverage or other types of insurance during the entire 12 months preceding the survey.
Unfortunately, the NSFG has no other appropriate measure of access or barriers to health care. We first examined change in the distribution of women by current union status, according to age, across theand surveys. In the rest of the analyses, we used only data.
We assessed differences in distribution by union status according to age and race or ethnicity, as well as differences in sexual behavior and risk of unintended pregnancy or STDs among single, married and cohabiting women.
Among single women, we examined sexual behavior and risk by age, race or ethnicity, poverty status and education level. We also analyzed union status and contraceptive use among women who were at risk of unintended pregnancy or STDs. Finally, we looked at differences in insurance coverage among sexually active women. Standard errors and ificance were calculated using the svy series of commands in Stata 8. The proportion of women who are single differs ificantly by race or ethnicity Table 1 Nevertheless, similar proportions of Hispanic and white women in each of the older age-groups are single; these proportions stabilize at about one in four among women aged 30 or older.
Compared with both married and cohabiting women, single women are ificantly less likely to be sexually experienced Table 2 And among sexually experienced women, single women are the least likely to be currently sexually active, and are sexually active for the fewest months in the year. On average, sexually experienced single women had intercourse in seven of the last 12 months, compared with 11 months for married or cohabiting women. These patterns of differences by union status hold across demographic characteristics. Among single women, sexual behavior varies ificantly by age, race or ethnicity, and education level.
The average of months that single women have been sexually active in the past year also declines ificantly with age, from eight months among those in their 20s to six months among those aged 40— College graduates also report fewer months of sexual activity over the last year than do high school graduates six vs. Household poverty status is not ificantly related to any of these measures.
The same is true in every demographic subgroup examined.
Within most subgroups, single women are less likely than cohabiting women to be at risk of unintended pregnancy. The proportions of single and cohabiting women at risk differ ificantly at ages 20—39, but not at age 40— Among blacks and whites, but not among Hispanics, single women are at greater risk of unintended pregnancy than are married women. It does not vary ificantly by race or ethnicity, but is lowest among those with the least education.
Among women who have multiple partners, consistent condom use is important for protection against STDs. Yet more than a quarter of single women with multiple partners had never used condoms over this period, and more than half had used them inconsistently. Overall, one in six women at risk had not used any method. We also assessed whether single women were disproportionately at risk of unintended pregnancy or STDs. In general, health insurance—whether private or Medicaid—provides coverage for needed reproductive health care services, including family planning, maternity care, and STD prevention and treatment services.
Cohabiting and single women also are ificantly more likely than their married peers to have Medicaid coverage and less likely to have private insurance. These findings suggest that sexually active single women are less able than married women to obtain the sexual and reproductive health services they may need. Much of the academic and policy discussion of changes in American fertility and family formation has focused on the shift away from formal marriage toward higher rates of cohabitation.
Nine in 10 single women are sexually experienced, and seven in 10 of these experienced women have had intercourse in the past three months. These high levels of sexual activity among single women highlight their need for reproductive health services and their potential risk for poor health outcomes. How can single adult women achieve healthy sexual relationships while limiting their risk of unintended pregnancy and STDs? Women who are not in a union merit special attention because, as indicated by ourtheir behaviors differ ificantly from those of married or cohabiting women.
It is particularly challenging for women in shorter term or sporadic relationships to maintain effective contraceptive use during all periods when they are at risk of unintended pregnancy, even when they wish to prevent pregnancy. Single women are more likely than married or cohabiting women to have multiple sexual partners, and this differential pattern by union status corroborates findings based on older data.
Moreover, four of five women with multiple partners are single, so the need for STD prevention services is concentrated among these women. Hence, it is critical to educate single women about their risk for STDs, to increase their use of barrier methods, and to improve their communication and negotiation skills with new partners. Additionally, compared with younger women who are single, older, formerly married women may have less experience with barrier methods and may need greater education and counseling about the importance and use of condoms.
Among single women, sexual experience, sexual activity, multiple partnerships and of months sexually active all vary by level of education. In contrast, household income shows little correlation with their sexual behavior.
This is somewhat surprising, given the body of research suggesting that income is related to union formation. About half of sexually experienced single women aged 40—44 are sexually active, and on average, these women have sex in only six months of the year. Do these patterns represent differences in personal preferences between older and younger women, or barriers to finding a partner?
Our findings suggest that other groups, beside single women, also merit special attention. One key finding is that a higher proportion of cohabiting women than of either married or single women are at risk of unintended pregnancy.
Indeed, the proportion does not differ between married and single women. Cohabiting women are as likely to be sexually active as married women, but less likely to have health insurance. Another high-need group identified in our analysis are single women aged 20— The needs of this relatively young group are often overlooked.
In some respects, this group is at greater risk than teenage females, because a higher proportion are sexually experienced, they are sexually active for more months in the year and they are less likely to receive health insurance coverage through their parents.
Compared with older women, 20—year-olds are more likely to be sexually active, have multiple partners and be at risk of unintended pregnancy. New policy and funding emphases on promoting abstinence among single women in their 20s brings attention to this group, but does little to meet their existing reproductive health needs. Proposed policies that promote abstinence until marriage are of special concern for black women, whose rates of marriage are particularly low; inonly three in 10 black women aged 20—44 were married, compared with more than half of white or Hispanic women.
Federal, state and private initiatives to promote marriage seek to address a range of issues perceived as barriers to marriage, especially among low-income minority populations. This study has a of limitations. First, self-reported data may be inaccurate or incomplete, especially for sensitive topics such as of sexual partners and sexual activity. Second, among single women, there is likely a range of unidentified relationship types that may be relevant for determining their risk of STDs or unintended pregnancy, as well as their need for reproductive health services. Finally, the data are cross-sectional and provide information about a limited time period prior to the survey.
Further research should consider how past unions and changes in union status influence current sexual behaviors and contraceptive use. The call for a national cultural transformation to sex only within marriage faces the challenge of altering the behavior of the majority of Americans. Bureau of the Census, Estimated median age at first marriage, by sex: to present, Sept. Chandra A et al.
Dailard C, New Bush administration policy promotes abstinence until marriage among people in their 20s, Guttmacher Policy Review, 9 4 DHHS, Announcement of anticipated availability of funds for family planning service grants, Federal Register69 —, Mosher WD et al. Santelli JS et al. Groves RM et al. Kelly JE et al. Turner C et al.Women want sex Dingle
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Sexual Behavior of Single Adult American Women