Despite the World Health Organization's definition of sexual health as a state of well-being, virtually no public health research has examined sexual well-being outcomes, including sexual satisfaction. Emerging evidence suggests that sexual well-being indicators are associated with more classic measures of healthy sexual behaviors. We surveyed 2168 university students in the United States and asked them to rate their physiological and psychological satisfaction with their current sexual lives. Many respondents reported that they were either satisfied (approximately half) or very satisfied (approximately one third). In multivariate analyses, significant (P < .05) correlates of both physiological and psychological satisfaction included sexual guilt, sexual self-comfort, self-esteem (especially among men), relationship status, and sexual frequency. To enhance sexual well-being, public health practitioners should work to improve sexual self-comfort, alleviate sexual guilt, and promote longer term relationships.

Despite the literature's focus on (hetero)sexual initiation, we know little about the degree to which young people are satisfied by their first vaginal intercourse experience, let alone the factors that predict satisfaction. We analyzed data from a cross-sectional survey of 1986 non-Hispanic White and Black 18-25 year old respondents from four university campuses. Respondents were asked to rate the degree to which their first vaginal intercourse was physiologically and psychologically satisfying. Both Black and White women were significantly less likely than Black and White men to experience considerable or extreme satisfaction at first vaginal intercourse, particularly physiological satisfaction. Among all four gender-race groups, being in a committed relationship with one's sexual partner greatly increased psychological satisfaction, particularly among women. Experiencing less guilt at first sexual intercourse was also strongly associated with psychological satisfaction for women. Developing sexual relationships with partners they care for and trust will foster satisfaction among young people at first vaginal intercourse. Our findings highlight strong gender asymmetry in affective sexual experience.

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