Sexual behavior in Germany

A sexual history and consultation in the practice setting can contribute to counteracting the spread of sexually transmitted infections. This is the result of a representative survey that questioned 2524 persons about their sexual practices and sexual contacts outside their main relationships, as well as about contraceptive measures, whose results Julia Haversath and coauthors summarize in the current issue of Deutsches Ärzteblatt International.

Some 13 percent of survey participants reported having unprotected sexual intercourse outside their primary relationship, but only 2 percent reported that they always used condoms. Such clandestine external sexual contacts are regarded as a transmission route for sexually transmitted infections (STIs). The authors point out that only one in four persons who reported having unprotected sex outside their primary relationship admitted to having had a medical examination in that context. On this background, the authors think that in the practice setting, the exploration of high risk behaviors and provision of information on how to prevent STIs is crucial. Whenever a patient reports having had sex with several partners, they should be explicitly instructed about transmission routes and use of condoms or femidom. Especially in view of the fact that about half of the survey participants reported having had experiences with oral sex, it is recommended that they receive instruction about the little known orogenital transmission route of infections.

In this representative survey, most women (82 percent) and men (86 percent) described themselves as exclusively heterosexual. 57 percent of survey participants reported that they were in a stable relationship at the time and expressed their satisfaction with this. 40 percent of participants in stable relationships were in monogamous relationships, 2 percent had open relationships, and 1 percent reported having sex with outside parties (threesomes). 56 percent had not sought any agreement on contacts with outside parties.

Of the women of reproductive age (≤ 50 years), 51 percent reported that they were taking oral contraception. 17 percent used other kinds of contraception. 5 percent did not use contraception as they wanted to have children. 27 percent did not think about contraception. 7 percent of women had taken interceptives (the "morning after pill") for the purpose of postcoital contraception; 3 percent had taken such drugs more than once.

17 percent of survey participants reported ever having had sex with a person other than their stable partner during a relationship. More men (21 percent) than women (15 percent) admitted to having had sexual partners outside their relationships. Persons who had had external sexual encounters reported a mean of 3.65 other partners in addition to their primary partner. 8 percent of men reported having had sex with an average of 4 female prostitutes.

The authors think that it is of vital importance for doctors to have knowledge of their patients' general sexual behavior. They consider this an important basis for dealing adequately with problems possibly arising from such behaviors.