Sexual behaviour and risk assessment in different age cohorts in the general population of Sweden (1989-2007).

AIM: The aim of this investigation was to study the development of sexual attitudes, behaviour and risk assessment in adolescents and young adults, 16-24 years, compared with older adults, 25-44 years, between 1989 and 2007. METHODS: We conducted mailed questionnaire surveys in random samples of the Swedish general population in 1989, 1994, 1997, 2000, 2003, and 2007 (total n = 16,773). Each sample consisted of 4,000-6,000 participants, stratified by age. The overall participation rate for men was 54% and for women was 70%. RESULTS: The likelihood of holding a restrained attitude to sexual intercourse outside of a stable relationship decreased significantly throughout the period of study, particularly for the 16-24 year olds. The odds ratio for more than two sexual partners and casual sexual intercourse without using a condom during the preceding 12 months increased significantly in the younger age group, particularly for young women. For women aged 16-24 years, the prevalence of several sexual partners and casual sexual intercourse without the use of a condom doubled between 1989 and 2007. In 2007 there was no difference in this respect between young men and young women. There were small changes in risk assessment associated with HIV infection during the study period. CONCLUSIONS: Sexual risk behaviour increased significantly for 16-24 year olds, and particularly young women, during the study period. To reduce the risk of uncontrollable spread of sexually transmitted infections in this age group, it is imperative that condom use in risky sexual contact is encouraged.

Risk of sexual dysfunction in a randomly selected nonclinical sample of the Swedish population.

OBJECTIVE: To investigate the risk of sexual dysfunction as a result of childhood sexual abuse or sexual assault in a randomly selected nonclinical sample of men and women. METHODS: In 1996, a randomly selected sample of 2,810 Swedish males and females completed a 322-item interview and questionnaire. Age-adjusted odds ratios (ORs) were calculated to assess risk of sexual dysfunction and analysis of variance was employed to test differences by gender and abuse or assault history in regard to seeking assistance for sexual dysfunction. RESULTS: For females with a history of childhood sexual abuse, an increased risk of anorgasmia for more than 12 months was found for women aged between 31 and 45 years (OR 1.21, P=.009). For females with a history of sexual assault; an increased risk for hypoactive sexual desire disorder was found for women who between the ages of 16 and 30 years (OR 1.51, P=.03), 31 and 45 years (OR 1.28; P=.02), 46 and 60 years (OR 1.21, P=.03), and 61 and 84 years (OR 1.62, P=.04); lubrication problems in the past year for women between 46 and 60 years (OR 1.28, P=.02) and for more than 12 months (OR 1.38, P=.02). No statistically significant increased risk of sexual dysfunction was found for males with a history of childhood sexual abuse. Males who reported a history of sexual assault as an adult had a significant increased risk of retarded ejaculation in the last 12 months if they were between the ages of 31 and 45 years (OR 2.00, P=.008) or 46 and 60 years (OR 2.11, P=.02). Women most often reported sexual dysfunction to their gynecologists (18%) or midwives (8.4%), whereas men reported their sexual dysfunction to their physicians (5.6%) or urologists (4.3%). CONCLUSION: Future research should focus on predictors of sexual dysfunction and resilience subsequent to childhood sexual abuse and sexual assault as an adult. LEVEL OF EVIDENCE: III.

The association between childhood and adolescent sexual abuse and proxies for sexual risk behavior: a random sample of the general population of Sweden.

OBJECTIVE: Several studies with small and "high risk" samples have demonstrated that a history of childhood or adolescent sexual abuse (CASA) is associated with sexual risk behaviors (SRBs). However, few studies with large random samples from the general population have specifically examined the relationship between CASA and SRBs with a comprehensive set of measures. DESIGN: The study was a cross-sectional retrospective survey of past and current sexual health and behavior. METHODS: A random sample of 4781 persons from the Swedish Post Address Register was obtained, which included 6,119,000 Swedish citizens in 1996. Of those persons, 2810 participants agreed to participate in the study. Participants were interviewed as well as administered a questionnaire regarding their sexual health and behavior. RESULTS: Using Mann-Whitney U tests, a history of CASA was found to be associated with younger age at first intercourse; younger age at diagnosis of first sexually transmitted infection (STI); greater frequency of unintended pregnancy; greater likelihood of participation in group sex; higher likelihood of not interrupting sexual intercourse despite the risk of pregnancy or risk of an STI; greater likelihood of exchanging sex for money or other necessities/drugs; more frequent substance use in the last 48 hours; and higher likelihood of adult sexual and physical assault. CONCLUSIONS: The findings of this study confirm previous research, which has reported an association between CASA and SRBs in smaller and high-risk samples. Clinicians working with adults with a history of CASA should be aware of the relationship between CASA and SRBs and be prepared to address such issues during therapy.