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    Peer Reviewed

    Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison.

    Michael RT; Wadsworth J; Feinleib J; Johnson AM; Laumann EO; Wellings K

    AMERICAN JOURNAL OF PUBLIC HEALTH. 1998 May; 88(5):749-54.

    A review of data from recent national probability sample surveys in the US and Britain was conducted to compare patterns of sexual behavior and the effects of such behaviors on public health policy related to sexually transmitted diseases (STDs). Although the two surveys were conducted independently and with different protocols, the general character of the information was similar. Overall, there was greater dispersion in sexual behavior in the US than in Britain. Consistently fewer respondents in Great Britain than in the US reported having two or more sexual partners in the year preceding the survey. Reported condom use was significantly higher among British men than US men. Lifetime STD rates were 2-3 times higher among US men than British men and this discrepancy was even larger among women. In both countries, there was a clear positive association between number of sexual partners and the likelihood of contracting an STD. British respondents were more tolerant than their US counterparts of premarital, extramarital, and homosexual sex. Two factors present in the US--the greater diversity of sexual behavior and the greater degree of absolute public opinion about improper sexual behaviors--may account for the resistance in the US to development of a public health policy such as exists in Britain that promotes safer sexual behavior. The failure in the US to mount an effective public health campaign about sex and STDs may, in part, explain the higher rate of STDs, including HIV/AIDS, in the US compared with Britain.
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