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Background: Definitions of sexual health from various organizations (e.g., WHO) address multiple dimensions of sexual health. We surveyed a U.S. sample of youth to assess their endorsement of these dimensions and aimed to understand the link between patterns of endorsement and age, gender and sexual behavior.
Methods: We sampled 4017 youth (15-25 years) via a representative probability-based survey, administered online. For those who were legal minors (n = 1197), parents provided consent; 53% agreed. Those 18 and older were contacted directly; 51% agreed to take the survey. Sexual health survey questions assessed endorsement of 7 dimensions on 4-point measures (very important – not at all important): emotional fulfillment, social connectivity, overall enjoyment, spiritual fulfillment, mutual benefits, mental and physical dimensions. Gamma was used to assess ordinal indices of association.
Results: Respondents described each dimension as important or very important to them, ranging from 94% for pleasure and 95% for emotional fulfillment to 76% for social connectivity and spiritual fulfillment. Importance of emotional, enjoyment, mutual and mental aspects of sexual health were all associated with oral, vaginal and anal sex at p < .01 (gammas = 0.12 – 0.39), with social aspects the only aspect unrelated to sexual activity. Female respondents (n = 2519) were more likely than males to describe all dimensions as important (gammas = 0.08 – 0.42, all p < .01). Endorsement varied by age, with older respondents more likely to endorse dimensions as important, with the largest effects for spiritual and physical dimensions (mean age difference for very important and not at all important were, respectively, 1.7 and 3.2 years, p < .001).
Conclusions: Understanding how aspects of sexual health are linked to our changing youth population helps elucidate which dimensions of sexual health may be (1) the most salient to youth and (2) the most amenable to intervention.