Heterosexual AIDS Epidemic Unlikely, Survey of Sexual Behavior Suggests
From 1991 to 1993, researchers at the University of Chicago Irving B. Harris School of Public Policy Studies carried out a national survey of sexual behavior in adults, part of a major effort in the fight against HIV/AIDS.
- The survey found that the vast majority of Americans have very few sexual partners, and those they do have are of their own race, education level, and socioeconomic class.
- The researchers state that their data "on sexual networks and sexual behavior argue strongly that these sporadic aborted breakouts of the AIDS virus into the general population are the exception, not the rule . AIDS is, and is likely to remain, confined to exactly the risk groups where it began: gay men and intravenous drug users and their sexual partners. We are convinced that there is not and very unlikely ever will be a heterosexual AIDS epidemic in this country."
The products of this grant have received wide dissemination, with two major books already released, Sex in America: A Definitive Survey (Little Brown; Warner Books [paperback]) and The Social Organization of Sexuality: Sexual Practices in the United States (University of Chicago Press).
The Robert Wood Johnson Foundation (RWJF) supported the study with a grant of $859,195 between September 1991 and August 1993.
Prior to this survey, the only scientifically rigorous study ever completed on sexual behavior in the United States was the 1948 Kinsey report. No studies had collected detailed national data on sexual behaviors known to place individuals at risk of HIV infection.
While those groups at highest risk (e.g., homosexual men, drug users and prostitutes) had been well studied, almost no information existed on the risk behaviors of the general population. This information deficit severely limited the ability of the Centers for Disease Control and Prevention and others to forecast future HIV transmission and prevention patterns and to target effective prevention strategies.
In 1987, the National Opinion Research Center (NORC) at the University of Chicago, in conjunction with the National Institute of Child Health and Human Development, the Centers for Disease Control and Prevention, the National Center for Health Statistics, and other federal agencies began work on an expedited survey of a national sample of adults to provide preliminary national data and to serve as the initial phase of a much larger national survey.
However, beginning in 1989, political intrusion prevented the survey process from moving forward and seriously jeopardized behavioral research efforts related to the transmission of HIV. By September 1991, the Senate explicitly prohibited the National Institutes of Health from paying for the study. (Laumann, Edward O., John H. Gagnon and Robert T. Michael, A Political History of the National Sex Survey of Adults. Family Planning Perspectives, 26(1): 3438, 1994.)
RWJF and other foundations were approached to underwrite portions of the research.
Funders included: Henry J. Kaiser Family Foundation, $650,000; Rockefeller Foundation, $175,000; John D. and Catherine T. MacArthur Foundation, $100,000; Andrew Mellon Foundation, $150,000; New York Community Trust, $100,000; AmFar, $10,000; Ford Foundation, $165,000.The researchers, in consultation with the funders, widened the focus of the survey to study sexual behavior like any other social behavior, using established research methods.
The underlying objective was to help obtain needed information about adult sexual behavior to contribute to the design of effective preventive efforts in the fight against AIDS. Between February 14, 1992, and September 30, 1992, a roughly 90-minute face-to-face interview was conducted with English-speaking adults (ages 18 to 59) in a random sample of 3,432 households in the continental United States Black and Hispanic households were oversampled.
This was the first scientifically sound, nationally conducted sexual behavior survey of adults ever fielded. Preliminary analysis determined that it was indeed possible to collect useful data on sexual behavior, in response to questions raised during the congressional discussions. Two substantial books based on the findings have been published The data continue to be analyzed.
- A strong link exists between attitudes and sexual behavior. Three broad attitude categories were identified:
- Traditional, where people say their religious beliefs always guide their sexual behavior (31 percent).
- Relational, where people believe sex should be part of a loving relationship, not always reserved for marriage (45 percent).
- Recreational, where people view sex as independent of love (24 percent).
- Societal rules underlie sexual behavior: people date and marry people within their own race, education level, and socioeconomic status. Very few people met sexual partners by going outside their groups.
- The findings give no support to the idea of a promiscuous society or of a dramatic sexual revolution reflected in huge numbers of people with multiple casual sex partners. Nearly all Americans have a very modest number of partners over their adult lifetime and in the past year: 56 percent have had 1 to 4 partners over their lifetime and only 20 percent have had more than 10. The more educated people are, the more partners they have had over their life time. Of all people questioned, whether old or young, 83 percent had 0 or 1 sexual partner in the last year. The number of blacks or whites with more than 5 partners in the last year was small (6 percent and 3 percent, respectively).
- There is a steadily declining age at which teenagers first have intercourse; half in all racial and ethnic groups begin between 15 and 18; 80 percent have begun by age 20. Peer pressure is now a stronger and more important factor than it was in the past.
- Only one-third of Americans ages 18 to 59 have sex with a partner as often as twice a week. The frequency has little to do with people's race, religion, or education. Having more partners does not translate into having more frequent sex.
- Those having the most partnered sex and enjoying it most are married people. Young single people with many partners and a very satisfying sex life are mostly a media creation.
- Vaginal intercourse is the only sexual practice that is nearly universal. Oral sex is most frequent among young, better educated whites. Anal sex was much more prevalent than expected: about 25 percent of men and women have had anal sex in their lifetimes, and nearly 10 percent had anal sex in the last year.
- Masturbation is a more frequent sexual practice than commonly believed. Among Americans ages 18 to 59, about 60 percent of men and 40 percent of women report they masturbated within the past year. For those living with their sexual partner, nearly 85 percent of men and 45 percent of women reported having masturbated. Married people were significantly more likely to masturbate than people who were living alone.
- Findings contradict prevailing estimates of homosexuality. In self-reports, only 1.4 percent of women and 2.8 percent of men said they thought of themselves as homosexual or bisexual. However, these findings vary significantly by geography. More than 9 percent of men in the twelve largest cities identify themselves as gay, while 3 to 4 percent of men living in the suburbs and only 1 percent of men in rural areas identify themselves as gay.
- One in six Americans report having had a sexually transmitted disease; 1.5 percent report having had one in the past year; women are more likely than men to have had at least one sexually transmitted disease at some time in their lives. The key risk factor is unprotected sex with many sexual partners, not ethnicity, sex education, educational attainment, or social status.
- Those with highest risk for HIV transmission, based upon number of partners, are also the most likely to have been tested for HIV infections (35 percent) and to have changed their conduct (30 percent), suggesting that members of high-risk groups are aware of their risk of infection.
- Questions regarding forced or coerced sex reveal significant gender differences in perceptions. A large proportion of women (20 percent) say they have been forced to do something sexually that they did not want to do, but very few men (2 percent) report ever forcing a woman; 96 percent of the women knew the man who was forcing them.
The key study finding, namely that the vast majority of Americans have very few sexual partners, leads the authors to conclude " that AIDS is likely to remain confined to exactly the risk groups where it began: gay men and intravenous drug users and their sexual partners. We are convinced that there is not and very unlikely ever will be a heterosexual AIDS epidemic in this country."
Two publications were produced by the project. The Social Organization of Sexuality: Sexual Practices in the United States, written for a professional audience of social scientists, counselors, and health professionals, won the 1996 Liang Award from The University of Chicago Press. Sex in America (Little Brown, 1994; Warner Books, [paperback], 1995.) was written for the general public.
To date, these books have been reviewed in over 20 major periodicals, and the authors have given numerous interviews to print and broadcast media. Sixteen additional publications (including three under review) have been produced, and 34 presentations/talks before professional and academic audiences have been given.
In addition, in October 1994, the data set was made available to other researchers through NORC and Sociometrics, Inc.
GRANT DETAILS & CONTACT INFORMATION
Risks for Sexually Transmitted Diseases - A Pilot Study
University of Chicago Irving B. Harris School of Public Policy Studies (Chicago, IL)
Dates: September 1991 to August 1993
Robert T. Michael, Ph.D.
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Books and Reports
Laumann, Edward O., John H. Gagnon, Robert T. Michael, and Stuart Michaels. The Social Organization of Sexuality: Sexual Practices in the United States. Chicago: The University of Chicago Press, 1994.
Michael, Robert T., John H. Gagnon, Edward O. Laumann, and Gina Kolata. Sex in America. Boston: Little, Brown, 1994; New York: Warner Books, 1995. (Translated into Dutch, German and French.)
Anonymous. Abortion Review, 56(Summer): 1995.
Adelson, Joseph. Commentary, July 1995: 2630.
Anderson, William P. Jr. Christian Sociological Newsletter, 22(2): 1995.
Bullough, Vern L. Scientific American. August 1995.
Cherlin, Andrew, Stanley Presser and Lynn Chancer. Contemporary Sociology, July 1995: 293302.
Davis, Dona. Transcultural Psychiatric Research Review, 32: 178182, 1995.
DeLamater, John. Science, 270(October 20): 501503, 1995.
Gordon, M. Choice, 32(8): 1995.
"A.H." Psychotherapies, XV(1): 1995.
Ingall, Marjorie. Ms. Magazine, January/February, 1995: 4243.
Lewontin, R.C. New York Review of Books, XLII(7): 24ff, 1995.
Malinowsky, H. Robert. AIDS Book Review Journal, 19(August): 1995 (symposium subject).
McDonald, Kim A. Chronicle of Higher Education, March 3, 1995: A8ff.
Murray, David W. The Sciences, July/August 1995: 4449.
Pellauer, Mary D. Christian Century, June 21, 1995: 642644.
Reiss, Ira. Journal of Sex Research, 32(1):4449, 1995.
Sadock, Virginia A., M.D. Journal of the American Medical Association, February 22, 1995: 675676.
Stone, Laurence. London Review of Books, August 3, 1995.
Udry, Richard J. American Journal of Sociology, 101(1): 224225, 1995.
Wasserman, Stanley. Chance: A Magazine of the American Statistical Association, 8(2): 1995.
Wellings, Kaye. Burton-on-Trent Burton Mail, February 25, 1995.
Whitehead, Barbara Dafoe. The Times Literary Supplement (London), No. 4810, June 9, 1995: 12.
- Sept. 19 USA Today with Kim Painter for Karen Peterson
- Sept. 21 US News and World Report with Joanie Scrof
- Sept. 26 Chicago Tribune with Peter Gorner
- Sept. 28 Time with Wendy Cole
- Sept. 29 Washington Post with Barbara Vobetta
- Sept. 30 Scripps Howard with Robin Rosse
- Oct. 3 St. Louis Post Dispatch with Bill Smith
- Oct. 4 Chicago Sun Times with Gary Wisby
- Oct. 5 Wall Street Journal with Lauri McGinley
- Oct. 6 Detroit News with Carol Stevens
- AP Radio with Sandy Kosel
- (taped) CNN Radio News Center in Atlanta with Aleen McDonnell
- Newsday with Jack Sirica
- (taped) ABC Radio News, N.Y. with Joan Harris
- Standard News Radio Network D.C., with Bill Freeman
- BBC World Service News
Binson D, Stuart M, Stall R, Coates TJ, Gagnon JH and Catania JA. "Prevalence and Social Distribution of Men Who Have Sex with Men: United States and Its Urban Centers," Journal of Sex Research, 32: 245254, 1996.
Browning C and Laumann EO. "Sexual Contact Between Children and Adults: A Life Course Perspective." American Sociological Review, 62: 540560, 1997.
Joyner K, Laumann EO and Michael RT. "Teenage Sex and the Sexual Revolution," Social Forces. Under review.
Laumann EO, Masi CM and Zuckerman EQ. "Circumcision in the United States: Prevalence, Prophylactic Effects and Sexual Practice," Journal of the American Medical Association, 277(13): 10521057, 1997. Abstract available online.
Laumann EO, Michael RT, Wadsworth J, Feinleib J and Johnson AM. "Private Sexual Behavior, Public Opinion, and Public Health Policy Related to Sexually Transmitted Diseases: A US-British Comparison." American Journal of Public Health, 88(5): 749754, 1998. Abstract available online.
Laumann EO, Michael RT and Gagnon JH. "A Political History of the National Sex Survey of Adults." Family Planning Perspectives, 26(1): 3438, 1994.
Laumann EO, Gagnon JH, Michaels S, Michael RT and Schumm LP. "Monitoring AIDS and Other Rare Population Events: A Network Approach." Journal of Health and Social Behavior, 34(1): 722, 1993. Abstract available online.
Gagnon JH. "Epidemics and Researchers: AIDS and the Practice of Social Studies" pp. 2740 in Social Analysis in the Time of AIDS, Gilbert Herdt and Shirley Lindenbaum, eds. Newbury Park, Calif.: Sage, 1992.
Gagnon JH and Parker R (eds.). Conceiving Sexuality: Approaches to Sex Research in a Post Modern Era. Routledge, Inc., 1994.
Laumann EO. "On the Concept of Community" pp. 8391 in Assessing the Social and Behavioral Sciences Base of HIV/AIDS Prevention and Intervention: Workshop Summary and Background Papers. Washington: National Academy Press, 1995.
Laumann EO and Youm Y. "Social, Attitudinal and Behavioral Determinants of Sexually Transmitted Infections: In Search of the Core Group," in Social Aspects of Sexually Transmitted Infection, Edward Hook and William Cockerham (eds.). Chapel Hill, N.C.: University of North Carolina Press, 1996. Forthcoming.
Laumann EO, Gagnon JH and Michael RT. "Network theory in Research on Sexual Behavior" in Behavioral Research on the Role of Condoms in Reproduction Health, Willard Cates, Jr. and Arthur A. Campbell, (eds.). Washington, D.C.: NICHD, 1993.
Michael RT and Willis RJ. "Innovation in Family Formation: Evidence on Cohabitation in the U.S." in The Family, The Market and the State in Aging Societies, J. Ermisch, (ed.). Oxford: Oxford University Press, 1994.
Michaels S. "The Prevalence of Homosexuality in the United States," in Textbook of Homosexuality and Mental Health: A Comprehensive Textbook. Cabaj RP and Stein TS (eds.). Washington: American Psychiatric Press, 1996.
Report prepared by: Mary Cotton
Reviewed by: Molly McKaughan
Program Officer: James Knickman