BACKGROUND

Convenience sample data indicate that substantial portions of adults have engaged in sexual behaviors sometimes described as rough; little is known about these behaviors at the population level.

AIM

To describe, in a U.S. probability sample of Americans aged 18 to 60 years, (i) the prevalence of diverse sexual behaviors, described here as dominant and target behaviors; (ii) the age at first pornography exposure as well as prevalence, range, and frequency of pornography use; (iii) the association between past year pornography use frequency and dominant/target sexual behaviors; and (iv) associations between lifetime range of pornography use and dominant/target sexual behaviors.

METHODS

A confidential cross-sectional online survey was used in this study.

OUTCOMES

Lifetime engagement in dominant behaviors (eg, spanking, choking, name calling, performing aggressive fellatio, facial ejaculation, penile-anal penetration without first asking/discussing) and lifetime engagement in target behaviors (eg, being spanked, being choked, being called names during sex, having their face ejaculated on, receiving aggressive fellatio, or receiving penile-anal penetration without having discussed) were assessed; lifetime pornography use, age at first porn exposure, past-year frequency of porn viewing, and lifetime range of pornography were also assessed.

RESULTS

Women as well as men who have sex with men were more likely to report target sexual behaviors: having been choked (21.4% women), having one's face ejaculated on (32.3% women, 52.7% men who have sex with men), and aggressive fellatio (34.0% women). Lifetime pornography use was reported by most respondents. After adjusting for age, age at first porn exposure, and current relationship status, the associations between pornography use and sexual behaviors was statistically significant.

CLINICAL IMPLICATIONS

Clinicians need to be aware of recent potential shifts in sexual behaviors, particularly those such as choking that may lead to harm.

STRENGTHS & LIMITATIONS: Strengths include U.S. probability sampling to provide population level estimates and the use of Internet-based data collection on sensitive topics. We were limited by a lack of detail and context related to understanding the diverse sexual behaviors assessed.

CONCLUSION

Clinicians, educators, and researchers have unique and important roles to play in continued understanding of these sexual behaviors in the contemporary United States. Herbenick D, Fu T-C, Wright P, et al. Diverse Sexual Behaviors and Pornography Use: Findings From a Nationally Representative Probability Survey of Americans Aged 14 to 60 Years. J Sex Med 2020;17:623-633.