Second Australian Study Of Health Research Articles

Sexual Difficulties, Problems, and Help-Seeking in a National Representative Sample: The Second Australian Study of Health and Relationships.

The Australian Study of Health and Relationships is a large national population-representative survey of sexual behavior and attitudes conducted every decade. We describe experiences of sexual difficulties lasting at least a month among Australians surveyed in 2012-2013 and identify changes since the previous survey in 2001-2002. Computer-assisted telephone interviews were completed by 20,091 people aged 16-69 years (participation rate 66%) of whom 16,897 people had had sex with a partner in the previous year. We asked how long each difficulty lasted, whether it was a problem, and whether they sought treatment. Half (48%) the men and 68% of women reported at least one difficulty. Lack of interest in having sex was common (28% men, 52% women); 21% of men reported coming to orgasm "too quickly" and women reported inability to reach orgasm (25%) and trouble with vaginal dryness (22%). Women were more likely than men not to find sex pleasurable and to have physical pain during intercourse. Some differences by age group were also apparent. Many difficulties were not seen as problems, especially lacking interest and reaching orgasm too quickly. People with erection/dryness problems, or with pain in intercourse, were more likely to seek treatment, as were people with multiple difficulties. Between 2001-2002 and 2012-2013, there was little change for men, but among women rates of all sexual difficulties fell by 4-10 percentage points. This change accompanied a drop in frequency of sex among people in ongoing relationships and an increase in masturbation and use of pornography. One explanation might be that, over time, fewer women were agreeing to "service sex" when they were not in the mood. Overall, the drop in prevalence of women's sexual difficulties since a decade earlier suggests a change towards more egalitarian sexual relations.

Reproductive experiences and outcomes among a representative sample of women: the Second Australian Study of Health and Relationships

ObjectiveTo enumerate pregnancy outcomes for a representative sample of women in Australia surveyed in 2012–2013 (primary aim) and compare these with women surveyed in 2001–2002 (secondary aim). MethodsComputer‐assisted telephone interviews with over 10,000 women aged 16–69 years (participation rate 68.4%). Results are weighted for chance of selection and to reflect the population as a whole. ResultsOf women with experience of vaginal intercourse, 75.1% had ever been pregnant, 18.4% reported difficulties getting pregnant and 10.0% had had fertility treatment. Of those who had been pregnant, 91.3% had ever had a live birth, 34.3% a miscarriage, 22.8% an abortion and 2.3% a stillbirth; 0.9% had relinquished a child for adoption. The proportion first pregnant in their 30s was 11% among women aged 60–69 and 26% among those aged 40–49. Fewer older women reported difficulties getting pregnant. Of the 21,882 pregnancies reported, 70% led to live births and 10% were terminated. Compared with our 2001–2002 survey, fewer women reported ever having been pregnant. Giving up newborns for adoption has become very rare. ConclusionsFalling fertility since the 1960s reflects greater access to contraception and abortion and higher opportunity costs of childbearing. Implications for public healthThese findings on women's lifetime reproductive experiences complement routine annual data collections.

Identifying gaps in dual protection from sexually transmissible infections and unintended pregnancies among Australian women: an observational study.

Background Dual protection refers to the simultaneous prevention of sexually transmissible infection (STI) and unintended pregnancies. Optimal contraception and STI prevention strategies sometimes fail to align. Methods Using data from a large nationally representative population-based survey, we analysed the contraception and STI prevention behaviours at the last vaginal intercourse among 2420 heterosexually active women aged 16-34years who had participated in the Second Australian Study of Health and Relationships, 2012-13. Results At their last vaginal intercourse, most women (95%) used contraception and half (49%) used condoms, either as a sole multipurpose method or in conjunction with another type of contraception. Condom use was highest (72%) among women whose most recent partner was a casual or occasional partner, followed by women with a regular partner (59%) and women with a cohabiting regular partner (40%). One-third of the women (34%) used condoms as a sole method, and 14% used oral contraceptives together with a condom. Few women used implants or intrauterine devices (8%) and, among them, very few women also used condoms (<1%). Among the women who used a condom at their last vaginal intercourse, 49% reported both the correct use for STI prevention and consistent condom use during the previous 6months. Among women using condoms, correct and consistent use was also highest among women whose most recent partner was a casual or occasional partner (76%). Conclusions Although almost all women used contraception and half used dual protection, few benefited from the protective effects of using condoms together with highly effective contraception.

Meeting Sexual Partners Through Internet Sites and Smartphone Apps in Australia: National Representative Study.

BackgroundStudies have reported on the proportion of the population looking for potential sexual partners using internet sites and smartphone apps, but few have investigated those who have sex with these partners, arguably a more important target group for health promotion.ObjectiveThis study aimed to determine the proportion of people who have had sex with someone they met on an internet site or a smartphone app in the previous year.MethodsWe analyzed data from the 2012-2013 Second Australian Study of Health and Relationships, a nationally representative telephone survey of Australian residents aged 16-69 years (N=20,091). The participation rate for the telephone survey was 66.22%. The prevalence of looking for a potential partner, physically meeting, and having sex with someone first met through an internet site or a smartphone app was estimated. Multivariate logistic regression was used for men and women separately to determine demographic and behavioral factors associated with having had sex with someone met on an internet site or a smartphone app in the last year.ResultsOverall, 12.09% of respondents had looked for potential partners using these technologies and 5.40% had done so in the last year. In the last year, 2.98% had met someone in person and 1.95% reported having had sex with someone first met on an internet site or a smartphone app. The prevalence of all behaviors was greater in men than in women and in younger respondents than in older respondents. Among sexually active men, factors associated with having had sex with someone met using internet sites or smartphone apps included identifying as gay or bisexual (adjusted odds ratio, AOR: 15.37, 95% CI 8.34-28.35), having either 2-3 or >3 sexual partners in the last year (AOR: 9.20, 95% CI 9.20-34.68 and AOR: 35.77, 95% CI 18.04-70.94, respectively), having had a sexually transmissible infection (STI) test in the past year (AOR: 2.02, 95% CI 1.21-3.38), or an STI in the last year (AOR: 3.15, 95% CI 1.25-7.97). Among sexually active women, factors associated with having had sex with someone met on an internet site or a smartphone app were as follows: having either 2-3 or >3 sexual partners in the last year (AOR: 32.01, 95% CI 13.17-77.78 and AOR: 71:03, 95 % CI 27.48-183.57, respectively), very low and low income (vs very high AOR: 3.40, 95% CI 1.12-10.35), and identifying as lesbian or bisexual (AOR: 2.27, 95% CI 1.04-4.49).ConclusionsMore than a third of adults who had looked for potential partners using websites and apps each year had sex with such partners, and those who had done so were more sexually active, suggesting that dating and hookup websites and applications are suitable settings for targeted sexual health interventions.

Estimates of Australia’s non-heterosexual population

Background Demographers have studied minority populations for many years, but relatively little attention has been paid to sexual minority groups. Population estimates for sexual minorities would be useful as denominators for a range of health and socioeconomic indicators, to monitor representation in employment, assist budget planning and inform the marketing of goods and services. Aim The aim of this paper is to present some approximate estimates of the non-heterosexual adult population of Australia in mid-2016 by sex, broad age group and state and territory. Data and methods Data on sexual identity were sourced from three nationally representative surveys: the Household Income and Labour Dynamics in Australia survey, the second Australian Study of Health and Relationships and the ABS General Social Survey. Use was made also of 2016 ABS Census of Population and Housing (Census) data and Estimated Resident Populations. Prevalence rates of the non-heterosexual population aged 18+ were averaged over the three surveys and multiplied by ERP to obtain national population estimates. Census data on same-sex couples were used to distribute the national estimates by state and territory. Results Australia’s non-heterosexual population aged 18+ in 2016 is estimated to have been 592,000, representing about 3.2% of the adult population. New South Wales is home to the largest non-heterosexual population (about 204,000) and the Northern Territory the smallest (4,700), while the highest prevalence is in the Australian Capital Territory (5.1%). Conclusions Australia’s non-heterosexual population is a relatively small population, but its prevalence varies considerably by age and sex and between states and territories. Estimates of this population should prove useful for monitoring health and wellbeing and for a variety of planning and policy purposes.

Sex education: findings from the Second Australian Study of Health and Relationships.

In a national telephone-based survey, information on sexual behaviour and outcomes were collected from 20091 randomly selected Australians in 2012-13. Data were weighted and analysed to determine the proportion of those who had received school-based sex education and to examine the associations between sex education and sexual health outcomes, specifically a history of a sexually transmissible infection (STI), early pregnancy, contraception use at first sex, and level of STI knowledge. Just over half the respondents (53%; n=19836) reported receiving sex education that included information about condoms and contraception. Using logistic regression analysis after adjusting for age, education and non-English-speaking background, we found that sex education was strongly associated with increased odds of using contraception at first vaginal intercourse (odds ratio (OR)=1.57; 95% confidence interval (CI) 1.44-1.71; P<0.001) and higher levels of STI knowledge (OR=1.75; 95% CI 1.46-2.12; P<0.001).

Tobacco smoking and sexual difficulties among Australian adults: a cross-sectional study.

Data for this study came from the Second Australian Study of Health and Relationships (2012-13), which includes a representative sample of 18427 sexually active Australian adults (aged 16-69 years). The main study and outcome measures were tobacco smoking and sexual difficulties. A multiple logistic regression analysis was conducted to adjust for potential confounders. Male heavy smokers (>20 cigarettes per day) were significantly more likely than non-smokers to have trouble keeping an erection [adjusted odds ratio (AOR) 4.14, 95% confidence interval (CI) 1.87-9.20; P<0.0001], lack interest in having sex (AOR 2.18, 95% CI 1.20-3.97; P=0.011), have anxiety about performance (AOR 2.46, 95% CI 1.24-4.86; P=0.010) and be unable to come to orgasm (AOR=2.81, 95% CI 1.23-6.42; P=0.015). Female smokers were also significantly more likely than non-smokers to not find sex pleasurable (AOR 1.48, 95% CI 1.05-2.07; P=0.025); and light female smokers were significantly more likely than non-smokers to be unable to come to orgasm (AOR=1.44, 95% CI 1.05-1.98; P=0.025). Current tobacco smoking was associated with sexual difficulties in both men and women. For women, even light smoking was associated with not finding sex pleasurable and being unable to come to orgasm.

A Profile of Pornography Users in Australia: Findings From the Second Australian Study of Health and Relationships

There are societal concerns that looking at pornography has adverse consequences among those exposed. However, looking at sexually explicit material could have educative and relationship benefits. This article identifies factors associated with looking at pornography ever or within the past 12 months for men and women in Australia, and the extent to which reporting an “addiction” to pornography is associated with reported bad effects. Data from the Second Australian Study of Health and Relationships (ASHR2) were used: computer-assisted telephone interviews (CASIs) completed by a representative sample of 9,963 men and 10,131 women aged 16 to 69 years from all Australian states and territories, with an overall participation rate of 66%. Most men (84%) and half of the women (54%) had ever looked at pornographic material. Three-quarters of these men (76%) and more than one-third of these women (41%) had looked at pornographic material in the past year. Very few respondents reported that they were addicted to pornography (men 4%, women 1%), and of those who said they were addicted about half also reported that using pornography had had a bad effect on them. Looking at pornographic material appears to be reasonably common in Australia, with adverse effects reported by a small minority.

Contraceptive practices among women: the second Australian study of health and relationships

ObjectiveTo document the use of contraception by a representative sample of Australian women aged 16–49 years and compare it with 2001–2002. MethodsWomen were asked about their use of contraception and method used or reason for non-use during computer-assisted telephone interviews in 2012–2013. Women were sampled by random digit dialling of landline and mobile phones (participation rate 67.2%). ResultsOf a weighted sample of 5654 heterosexually active women interviewed 81% were using a method of contraception including sterilisation; this amounts to 66% of all women aged 16–49. Of those who were not using a method, 42% were pregnant or wanted a baby, 25% said they or their partners were infertile, 5% were currently not having intercourse, 3% were past menopause and 25% were apparently at risk of unintended pregnancy. Of those who used a method, 33% used oral contraceptives, 30% condoms and 19% sterilisation as their primary method. Use of condoms, intrauterine devices, implants and emergency contraception has increased since 2002, and use of sterilisation has fallen. Method used varied by age group, location, occupational group, relationship status and parity. A third of women had ever used emergency contraception, with the highest rate among women in their 20s. ConclusionAustralian women have access to a wide range of effective contraceptive methods. ImplicationsGiven the high levels of use, most unintended pregnancies in Australia are likely to be attributable to method failure or inconsistent use.

Decriminalization of Sex Work Is Not Associated with More Men Paying for Sex: Results from the Second Australian Study of Health and Relationships

It has been claimed that the decriminalization of sex work may result in its proliferation, but there is no evidence to prove or disprove this claim. We investigated whether decriminalization was associated with the prevalence of paying for sex. A representative national sample of 8074 Australian men interviewed by telephone reported whether they had paid for sex ever and in the last 12 months. Cross-sectional associations between paying for sex in the last 12 months and their jurisdiction’s legal approach to sex work (criminalized, licensed, or decriminalized), were examined with logistic regression analysis, controlling for demographic variables and relationship status. Overall, 2.2 % of the men reported paying for sex in the past year—a proportion that was not statistically different by state or territory (P = 0.26). The only variable that was associated with paying for sex was not having a regular sexual partner, or to a lesser extent, not living with a regular partner. Being aged 16–19 years was associated with lower odds of paying for sex. Being a male without a regular partner was associated with paying for sex. The legal approach to sex work in the respondent’s state of residence was not associated with having paid for sex.

P04.15 Sexual behaviour, sti testing and diagnosis down under: findings from the second australian study of health and relationships (ashr2)

Background In recent years, the number of sexually transmissible infections (STIs) has skyrocketed in Australia and cause a considerable burden on public health. The association between STIs and sexual behaviour is well-established in high-risk populations but information about the general population is less well-known. ASHR2 provides population-based data about the sexual health and practices of Australians. This analysis examines the associations between STIs and sexual behaviour. Methods Computer-assisted telephone interviews were conducted with a random sample of the Australian population aged 16–69. Participants were surveyed about their sexual behaviour and experiences with STIs. Responses were weighted based on study design, location, and the age and sex distribution of Australia. Univariate logistic regression was used to determine the associations between sexual behaviour, testing history and diagnosis. Results A total of 20 094 men and women were interviewed, with an overall participation rate of 66.2%. A higher proportion of women (17.3%) were tested than men (13.2%) in the past year. Men and women were more likely to have been tested in the past year if they identified as bisexual (or homosexual for men), were of Aboriginal and/or Torres Strait Islander origin, had >1 partner in the past year, had a previous STI and had ever injected drugs. In the year prior to being interviewed, 1.1% of men and 2.7% of women reported having an STI. Diagnosis was associated with having >1 partner in the past year, sex work as a worker and having ever injected drugs for both men and women. For men, diagnosis was also associated with sex work as a client (OR = 3.14 [95% CI: 1.78–5.56]) while diagnosis in women was associated with receiving sex education at school (OR = 1.59[95% CI: 1.14–2.21]). Conclusion Australian women are tested more frequently for STIs and are diagnosed more frequently despite sharing similar associations for STIs as men. Disclosure of interest statement No conflict of interest.

O19.1 Preexposure prophylaxis of hiv (prep): utilisation estimates in australia

Background Preexposure prophylaxis (PrEP) with daily oral Truvada® is recommended for people at high risk for HIV infection. The population-level benefit of PrEP requires higher levels of use than is currently observed. In Australia, homosexually active men (HM), particularly those who identify as gay or homosexual, contribute most to HIV transmission. We estimated how many HM are eligible for and likely to request PrEP. Method Using data from the Australian Bureau of Statistics (2013) and the second Australian Study of Health and Relationships (ASHR2, 2013), we estimated the number of HHMM nationally. PrEP eligibility was defined by the national PrEP guidelines. Input indicators from the 2013 Gay Community Periodic Surveys (GCPS) were applied to estimate the numbers of men eligible for PrEP based on each individual and any behavioural eligibility criteria. Using data from Treatment Options to Reduce Chances of HIV (TORCH) study, we estimated how many eligible HM are likely to request Truvada® for PrEP. Results We estimated 143,000 Australian men would identify as ‘gay/homosexual’ plus 95,000 as ‘other’ HAM. In GCPS, 15.7% of the HIV non-positive respondents reported sustained risk behaviour (≥6 sex partners in previous 6 months). Overall, 5.7% of HIV non-positive respondents satisfied behavioural eligibility criteria for PrEP, while having at least one episode of receptive condomless anal intercourse in the previous 6 months appeared the most common criterion (5%). Based on national eligibility criteria, 8,300 ‘gay/homosexual’ and 5,300 ‘other’ HM can be considered eligible for daily PrEP in Australia, and 44.9% of those are likely to uptake PrEP. Conclusions Our estimate of the number of HM eligible for PrEP in Australia is based on the current PrEP eligibility criteria, which target individuals at the highest risk for HIV infection. This estimation helps to predict service needed for PrEP prescribing nationally. Disclosure of interest statement Input indicators for these analyses were obtained from Australian Bureau of Statistics, Australian Study of Health and Relationships and Gay Community Periodic Surveys (all funded by the Australian state and federal governments) and from Treatment Options to Reduce Chances of HIV (TORCH) study funded by Gilead Sciences. Funding sources were not involved in research conducted.

Comparison of age-specific patterns of sexual behaviour and anal HPV prevalence in homosexual men with patterns in women

ObjectivesAnal human papillomavirus (HPV) is highly prevalent in men who have sex with men (MSM) of all ages, whereas cervical HPV declines with age. We explore the hypothesis that different...

Corrigendum to: Heterosexual experience and recent heterosexual encounters among Australian adults: The Second Australian Study of Health and Relationships

Background Current information about numbers of other-sex partners, experiences of different heterosexual behaviours and the recent heterosexual experiences among a representative sample of Australian adults is needed. It is not known whether these practices have changed between 2001–02 and 2012–13. Methods: Computer-assisted telephone interviews were completed by a representative sample of 9963 men and 10 131 women aged 16–69 years from all states and territories. The overall participation rate among eligible people was 66.2%. Results: Men reported more sexual partners than women, although the lifetime number of heterosexual partners reported by women increased significantly between 2001–02 and 2012–13. In 2012–13, 14.7% of men and 8.6% of women reported two or more sexual partners in the last year. Reporting multiple partners was significantly associated with being younger, being bisexual, living in major cities, having a lower income, having a blue-collar occupation and not being married. The proportion of respondents reporting ever having had oral sex or anal intercourse increased significantly since the last survey. At the last heterosexual encounter, 91.9% of men and 66.2% of women had an orgasm, oral sex was reported in only approximately one in four encounters and anal intercourse was uncommon. Conclusion: There were increases between 2001–02 and 2012–13 in partner numbers among women and in the lifetime experience of oral and anal sex. The patterns of heterosexual experience in Australia are similar to those found in studies of representative samples in other countries.

Corrigendum to: Knowledge about and experience of sexually transmissible infections in a representative sample of adults: the Second Australian Study of Health and Relationships

Background Sexually transmissible infections (STIs) present a substantial public health burden, and are related to modifiable sexual behaviours. Methods: Computer-assisted telephone interviews were completed by a population-representative sample of 20 094 men and women aged 16–69 years. The overall participation rate among eligible people was 66.2%. Respondents were asked questions regarding their knowledge about, self-reported history of, and testing for STIs. Results: STI knowledge was better in women, the young, people of higher socioeconomic status, those with a variety of indicators of being at high STI risk and those with a history of receiving sex education in school. Approximately one in six men and women reported a lifetime history of an STI. A history of STI testing in the last year was reported by ~one in six (17%) women and one in eight men (13%) and higher rates of testing in women were reported in most high-risk groups. The highest rates of STI testing (61%) and HIV testing (89%) were reported in homosexual men. Conclusion: Knowledge of STI-related health consequences and transmission is improving in Australians, and rates of STI testing were relatively high but were higher in women than in men. Further increases in testing rates in both sexes will be required to facilitate the early diagnosis and treatment of STIs, which is a cornerstone of STI control.

Design and methods of the Second Australian Study of Health and Relationships.

Background This paper describes the methods and process of the Second Australian Study of Health and Relationships. A representative sample of the Australian population was contacted by landline and mobile phone modified random-digit dialling in 2012-13. Computer-assisted telephone interviews elicited sociodemographic and health details as well as sexual behaviour and attitudes. For analysis, the sample was weighted to reflect the study design and further weighted to reflect the location, age and sex distribution of the population at the 2011 Census. Interviews were completed with 9963 men and 10131 women aged 16-69 years from all states and territories. The overall participation rate among eligible people was 66.2% (63.9% for landline men, 67.9% for landline women and 66.5% for mobile respondents). Accounting for the survey design and adjusting to match the 2011 Census resulted in a weighted sample of 20094 people (10056 men and 10038 women). The sample was broadly representative of the Australian population, although as in most surveys, people with higher education and higher status occupations were over-represented. Data quality was high, with the great majority saying they were not at all or only slightly embarrassed by the questionnaire and almost all saying they were 90-100% honest in their answers. The combination of methods and design in the Second Australian Study of Health and Relationships, together with the high participation rate, strongly suggests that the results of the study are robust and broadly representative of the Australian population.

Experiences of sexual coercion in a representative sample of adults: the Second Australian Study of Health and Relationships.

Background It is important to have current reliable estimates of the prevalence, correlates and consequences of sexual coercion among a representative sample of Australian adults and to identify changes over time in prevalence and consequences. Computer-assisted telephone interviews were completed by a representative sample of 20094 Australian men and women aged 16-69 years. The participation rate among eligible people was 66.2%. Sexual coercion (i.e. being forced or frightened into sexual activity) was reported by 4.2% of men and 22.4% of women. Sexual coercion when aged ≤16 years was reported by 2.0% of men and 11.5% of women. Correlates of sexual coercion were similar for men and women. Those who had been coerced reported greater psychosocial distress, were more likely to smoke, were more anxious about sex and more likely to have acquired a sexually transmissible infection. Few people had talked to others about their experiences of sexual coercion and fewer had talked to a professional. There were no significant differences between the First and Second Australian Study of Health and Relationships in whether men or women had experienced coercion, talked to anyone about this or talked to a counsellor or psychologist. Sexual coercion has detrimental effects on various aspects of people's lives. It usually occurs at the ages at which people become sexually active. There is a need to reduce the incidence of sexual coercion, better identify experiences of sexual coercion, and provide accessible services to minimise the detrimental effects of sexual coercion.

First vaginal intercourse and oral sex among a representative sample of Australian adults: the Second Australian Study of Health and Relationships.

Background Current information about the characteristics of Australian adults' first vaginal intercourse and contraception or precautions used on that occasion is needed, as well as whether these characteristics have changed between 2001-02 and 2012-13. Computer-assisted telephone interviews were completed by a representative sample of 20094 men and women aged 16-69 years. The overall participation rate among eligible people was 66.2%. Respondents indicated their age at first vaginal intercourse and first oral sex. Those who reported vaginal intercourse were asked the age of their partner, their relationship to their partner, the duration of this relationship, and what contraception or precautions (if any) were used. There was a significant decline in the median age of first vaginal intercourse for both men and women among those born between the 1940s and the 1960s, but no further decline since. There has also been a significant increase in the use of protection at first vaginal intercourse, from less than 20% of men and women in the 1950s to over 90% in the 2000s. For men and women, first vaginal sex before age 16 years was significantly associated with a greater number of lifetime and recent sexual partners, and a greater likelihood of having had a sexually transmitted infection. Given the earlier age at first vaginal intercourse, sex education should begin earlier so that all young people have information about contraception and disease prevention before they begin their sexual careers.

Sexual identity, sexual attraction and sexual experience: the Second Australian Study of Health and Relationships.

Background Behavioural and other aspects of sexuality are not always consistent. This study describes the prevalence and overlap of same-sex and other-sex attraction and experience and of different sexual identities in Australia. Computer-assisted telephone interviews were completed by a representative sample of 20094 men and women aged 16-69 years recruited by landline and mobile phone random-digit dialling with a response rate (participation rate among eligible people) of 66.2%. Respondents were asked about their sexual identity ('Do you think of yourself as' heterosexual/straight, homosexual/gay, bisexual, etc.) and the sex of people with whom they had ever had sexual contact and to whom they had felt sexually attracted. Men and women had different patterns of sexual identity. Although the majority of people identified as heterosexual (97% men, 96% women), women were more likely than men to identify as bisexual. Women were less likely than men to report exclusively other-sex or same-sex attraction and experience; 9% of men and 19% of women had some history of same-sex attraction and/or experience. Sexual attraction and experience did not necessarily correspond. Homosexual/gay identity was more common among men with tertiary education and living in cities and less common among men with blue-collar jobs. Many gay men (53%) and lesbians (76%) had some experience with an other-sex partner. More women identified as lesbian or bisexual than in 2001-02. Similarly, more women reported same-sex experience and same-sex attraction. In Australia, men are more likely than women to report exclusive same-sex attraction and experience, although women are more likely than men to report any non-heterosexual identity, experience and attraction. Whether this is a feature of the plasticity of female sexuality or due to lesser stigma than for men is unknown.

Introduction to the special issue on the Second Australian Study of Health and Relationships.

Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia. Centre for Social Research in Health, University of New South Wales, John Goodsell Building, Sydney, NSW 2052, Australia. Research Department of Infection & Population Health, University College London, Mortimer Market Centre off Capper Street London, London WC1E 6JB, UK. Corresponding author. Email: M.Pitts@latrobe.edu.au