Share this article on:

Temporal Trends in Sexual Behaviors and Sexually Transmitted Disease History Among 18- to 39-Year-Old Seattle, Washington, Residents: Results of Random Digit-Dial Surveys

Aral, Sevgi O. PhD, MSc, MA*; Patel, Divya A.†; Holmes, King K. MD, PhD‡; Foxman, Betsy†


Objectives: The objectives of this study were to describe sexual behaviors of Seattle residents in 2003–2004 and report changes since 1995.

Methods: We conducted a random digit-dial (RDD) survey among 18- to 39-year-old men and women in 2003–2004. We compared the results with the results of a 1995 RDD survey conducted in the same population. Questionnaire batteries and sampling methods were similar in the 2 surveys.

Results: Between 1995 and 2004, the median number of lifetime sex partners increased from 7 to 8. Vaginal douching declined from 70.6% to 25.9% (P = 0.004) among black women; from 8.3% to 5.9% (P <0.05) among Asian American women; and from 15.5% to 2.4% (P <0.05) overall. After adjustment, proportions of women who reported practicing vaginal douching (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.7–0.22), the proportion of respondents who reported a history of any sexually transmitted disease (OR, 0.70; 95% CI, 0.53–0.93) and a history of gonorrhea (OR, 0.48; 95% CI, 0.25–0.89) declined between 1995 and 2004. Conversely, the proportion of respondents who reported only same-sex partners (OR, 3.27; 95% CI, 1.33–9.88), condom use at first sex with their most recent sex partner (OR, 1.38; 95% CI, 1.06–1.78), and reported practice of anal sex (OR, 2.01; 95% CI, 1.21–3.48) increased between 1995 and 2004. Among blacks, proportions reporting an age difference of only 2 years with their partners declined from 64.3% to 25.9% (P <0.05), indicating increased age mixing.

Conclusions: Some risk behaviors declined whereas others increased between 1995 and 2004; several trends were divergent between the general population and minority populations. Our data hint at an increasing divergence in risk behaviors and morbidity between minority populations and the general population. Also, anal sex and number of sex partners have increased. These patterns have serious implications for the design, targeting, and implementation of prevention programs.

This article describes sexual behaviors of Seattle residents in 2003-2004, describes changes in sexual behaviors since 1995, and points to divergent trends between the general population and minority populations.

From the *Centers for Disease Control and Prevention, Atlanta, Georgia; the †University of Michigan, Ann Arbor, Michigan; and the ‡University of Washington, Seattle, Washington

The authors thank Patricia Jackson for her support in the preparation of this article.

This work was funded by the Department of Public Health, Seattle King County, the Center for Molecular and Clinical Epidemiology of Infectious Diseases (MAC-EPID) at the University of Michigan School of Public Health, and the University of Washington Center for AIDS and STD.

Correspondence: Sevgi O. Aral, PhD, Division of Sexually Transmitted Disease, National Centers for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E02, Atlanta, GA 30333. E-mail:

Received for publication February 9, 2005, and accepted June 15, 2005.

© Copyright 2005 American Sexually Transmitted Diseases Association