Sexual activity by marital status and age: a comparative perspective

Abstract

This paper presents an analysis of trends in sexual activity by marital status and age, and their associations with contraceptive use. Understanding levels of, and trends in, sexual activity is important for assessing the needs for family planning services and for analysing commonly used family planning indicators. Data were taken from 220 Demographic and Health Surveys (DHSs) and 62 Multiple Indicator Cluster Surveys (MICSs) to provide insights into sexual activity by marital status and age in a total of 94 countries in different regions of the world. The results show the sensitivity of the indicator with respect to the definition of currently sexually active, based on the timing of last sexual intercourse (during the last 4 weeks, 3 months, or 1 year). Substantial diversity in sexual activity by marital status and age was demonstrated across countries. The proportion of married women reporting recent sexual activity (sexual intercourse during the last 4 weeks) ranged from 50% to 90%. The proportion of unmarried women reporting recent sexual activity did not exceed 50% in any of the 94 countries with available data, but showed substantial regional differences: it appeared to be rare in Asia and extremely varied within Africa, Europe and Latin America and the Caribbean. Among married women, sexual activity did not vary much by age group, while for unmarried women, there was an inverted U-pattern by age, with the youngest age group (15–19 years old) having the lowest proportion sexually active. The proportion of women who reported currently using contraception and reported not being sexually active varied by the contraceptive method used and was overall much greater among unmarried women. The evidence presented in this paper can be used to improve family planning policies and programmes to serve the diverse needs, for example regarding method choice and service provision, of unmarried women.

Adding It Up: Investing in Sexual and Reproductive Health 2019

“…This represents a departure from prior Adding It Up reports (which classified unmarried women as sexually active if they had had sex in the three months prior to the survey) and aligns with the definition of sexually active used by the United Nations Population Division. b, 46 Women whose current pregnancy was unintended and women with postpartum amenorrhea after an unintended pregnancy are included in this definition because their experience indicates that they wanted to avoid becoming pregnant at some point in the last year. These groups help to complete the picture of the total number of women wanting to avoid pregnancy in a given year.…”

“…the levels in Asia are likely to be underestimated. 46 In Asia, as well as in Northern Africa, never-married women are often excluded from fertility and health surveys. Moreover, when people are asked about sexual activity in a face-to-face survey interview (a key source of data for these estimates), they tend to underreport it.…”

Adding It Up: Investing in Sexual and Reproductive Health 2019—Methodology Report

“…72 A study on recent sexual activity in 94 LMICs found that roughly 50-94% of married women reported sexual activity in the past month. 73 Despite this variation, we retained this definition of sexual activity for married women to align with other estimates in the field.…”

“…74 The level of sexual activity is likely to be underestimated among unmarried women in certain contexts due to underreporting as a result of the stigma around nonmarital sex. Findings from Ueffing et al 73 show large variation in reported timing of sexual intercourse among unmarried women by regions, and by countries within regions, as seen in Figure 4.1 We made adjustments and estimates for these probable underestimates of sexual activity among unmarried women; more details can be found in sections 4.3.c and 4.3.d. • Infecundity.…”

“…Because of the stigma attached to nonmarital sex, the level of sexual activity-and therefore risk for unintended pregnancy-is likely to be underestimated among unmarried women, especially for countries in Asia and Northern Africa, where social acceptance of sexual activity outside of marriage for women is particularly low. 73 Unmarried women are largely excluded from national surveys in Asia and Northern Africa, and where they are included, underreporting of their sexual activity is likely to be extensive. Therefore, to estimate contraceptive need and use among all sexually active women, we used data for unmarried women in countries in Eastern Asia, Southeast Asia, Oceania, Western Asia and Northern Africa from the UN Population Division's model-based estimates, which estimated sexual activity among unmarried women in countries with low or underreported sexual activity.…”