CSIRO PUBLISHING

Sexual Health, 2014, 11, 397–405

http://dx.doi.org/10.1071/SH14099

Attitudes toward sex and relationships: the Second

Australian Study of Health and Relationships

Richard O. de Visser A,I, Paul B. Badcock B,C, Judy M. Simpson D, Andrew E. Grulich E,
Anthony M. A. Smith B,H, Juliet RichtersF and Chris RisselG
A
School of Psychology, Pevensey 1, University of Sussex, Falmer BN1 9QH, UK.
B
Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street,
Melbourne, Vic. 3000, Australia.
C
Centre for Youth Mental Health, University of Melbourne, Orygen Youth Health Research Centre,
35 Poplar Road, Parkville, Vic. 3052, Australia.
D
Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney,
NSW 2006, Australia.
E
The Kirby Institute, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
F
School of Public Health and Community Medicine, University of New South Wales, Sydney,
NSW 2052, Australia.
G
Sydney School of Public Health, Charles Perkins Centre (D17), University of Sydney, Sydney,
NSW 2006, Australia.
H
Deceased.
I
Corresponding author. Email: rd48@sussex.ac.uk

Abstract. Background: Attitudes towards sex and relationships influence laws about what is and is not permissible and
social sanctions against behaviours considered unacceptable. They are an important focus for research given their links to
sexual behaviour. The aim of the present study was to describe attitudes towards sex and relationships, to identify correlates
of scores on a scale of sexual liberalism and to examine responses to jealousy-evoking scenarios among Australian adults.
Methods: Computer-assisted landline and mobile 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 expressed their agreement with 11 attitude statements, five of which formed a valid scale of liberalism, and
also responded to a jealousy-evoking scenario. Results: There was general agreement that premarital sex was acceptable
(87%), that sex was important for wellbeing (83%) and that sex outside a committed relationship was unacceptable (83%).
Respondents were accepting of homosexual behaviour and abortion and few believed that sex education encouraged earlier
sexual activity. More liberal attitudes were associated with: being female; speaking English at home; homosexual or
bisexual identity; not being religious; greater education; and higher incomes. Respondents who expressed more liberal
attitudes had more diverse patterns of sexual experience. Predicted sex differences were found in response to the jealousy-
evoking scenario — men were more jealous of a partner having sex with someone else and women were more jealous of a
partner forming an emotional attachment — but responses varied with age. Conclusion: Sexual attitudes of Australians
largely support a permissive but monogamous paradigm. Since 2002, there has been a shift to less tolerance of sex outside a
committed relationship, but greater acceptance of homosexual behaviour.

Additional keywords: abortion, Australia, extradyadic sex, homosexuality, jealousy, pornography.

Received 6 June 2014, accepted 23 August 2014, published online 7 November 2014

Introduction Attitudes are important for public health, because they

A society’s attitudes towards sex are important because they
influence regulation and laws about what is and is not
permissible and may therefore affect provision of sexual
health services, use of such services and stigmatisation.1–5
Individuals’ attitudes may also be shaped by policy and laws.
are key components of many influential models of behaviour
change and health promotion; changing attitudes is one way
to try to change people’s behaviour.6–9 For example, there is
considerable evidence that attitudes predict earlier initiation
of sexual activity among adolescents.10 Changes in attitudes

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CSIRO 2014 www.publish.csiro.au/journals/sh

398 Sexual Health
towards some aspects of sexuality have occurred in recent
decades.11–13 A cross-temporal meta-analysis of 530 studies
involving over 250 000 respondents indicated that, during the
second half of the 20th century, changes in attitudes towards
sexuality were followed by changes in behaviour. The changes
in behaviour were also followed by changes in attitudes, such
that more liberal attitudes and behaviour appeared to be mutually
reinforcing (especially among women).14
Attitudes towards aspects of sexuality differ for men and
women. A recent meta-analysis and data from large-scale studies
of population-representative samples reveal that men express
greater approval of casual sex and premarital sex, but less
approval of male homosexual behaviour.12,15–17 Comparisons
of these data with the findings of an earlier meta-analysis suggest
that the effect sizes for most sex differences in attitudes have
become smaller, indicating that women’s and men’s attitudes are
becoming more similar.15,18
Studies of population-representative surveys indicate that
older people tend to have less permissive attitudes towards
sexuality.12,14,16,17 However, the observed age effects are not
always uniform. For example, data from the third British
National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
indicate that younger people were less accepting than older
adults of non-exclusivity in marriage.12 Other important
demographic correlates of sexual liberalism include greater
education and higher socioeconomic status.12,14,16
The First Australian Study of Health and Relationships
(ASHR1) was the largest population-representative study of
Australians’ attitudes towards various aspects of sexuality.19
It revealed broad agreement that sex is important to wellbeing,
that premarital sex is acceptable and that having an affair is
unacceptable.19 Few people felt that abortion or male or female
homosexual activity is always wrong. Demographic correlates
of scores on a scale of sexual permissiveness were similar
to those reported in other studies: being male, identifying as
bisexual or homosexual, speaking English at home, having
greater education, having higher-status occupations and
receiving higher incomes.19 Religious people who attended
services more frequently had less permissive attitudes, but the
attitudes of less observant religious people were not
significantly different from those of non-religious people.20 In
addition, people with more permissive attitudes reported more
diverse patterns of sexual experience.19
As noted above, ASHR1 revealed that most people believe
that having an affair is unacceptable.12,19 Sexual infidelity is a
commonly stated reason for relationship dissolution21 and
jealousy is considered an acceptable response to a partner’s
infidelity. Evolutionary models posit that relationship jealousy is
a hard-wired, sexually dimorphic phenomenon; men tend to be
more worried about a female partner’s sexual infidelity because
this could result in his providing resources to support a rival’s
child; and women tend to be more worried about emotional
infidelity because this may be followed by her partner diverting
resources to support another woman’s offspring.22,23 However,
the presence and size of sex differences varies between and
within cultures (e.g. the differences tend to be greater among
younger people), which has led some to propose Social
Cognitive models of jealousy that emphasise the importance
R. O. de Visser et al.
of attitudes in shaping individuals’ responses to jealousy-
evoking scenarios.23
ASHR1 assessed a relatively limited range of attitudes.
Additional items were added to the Second Australian Study
of Health and Relationships (ASHR2) to assess beliefs about
pornography24 and about the effects of sex education on young
people’s sexuality.25,26
Given the observed links between sexual attitudes and sexual
behaviour and the possibility of linked behaviour change,1–14 the
aim of the analyses reported here was to describe attitudes
towards sex among a representative sample of Australian
adults, to identify correlates of sexual liberalism and to
identify changes in attitudes over the 11-year period between
ASHR1 and ASHR2.
Methods
The methodology used in ASHR2 is described elsewhere in
this issue.27 Briefly, between October 2012 and November
2013, computer-assisted telephone interviews were completed
by a representative sample of 20 094 Australian residents aged
16–69 years from all states and territories. Ethical approval was
obtained from the researchers’ host universities. Respondents
were selected using dual-frame modified random digit dialling
(RDD), combining directory-assisted landline-based RDD
with RDD of mobile telephones. The overall participation
rate among eligible people was 66.2%.
To maximise the number of interviews with people who
had engaged in less-common and/or more-risky behaviours, all
respondents who had no sexual partners in the previous year,
who had more than one partner in the previous year or
who reported homosexual experience ever completed a long
form of the survey instrument, which collected detailed data
on their sexual attitudes, relationships and behaviours. Of the
large proportion of respondents who reported one partner in
the previous year and no homosexual experience, 20% were
randomly selected to complete the long-form interview and the
other 80% completed a short-form interview. As a consequence,
8577 completed the long-form interview and 11 517 completed
the short-form interview. Answers to questions that occurred
only in the long-form interview are reported after weighting to
reflect the sample as a whole.
Respondents used a five-point scale (Strongly agree/Agree/
Neither/Disagree/Strongly disagree) to indicate the extent of
their agreement with 11 statements, seven of which were used
in ASHR1 (Box 1; Table 1).19,20 These questions were only
asked of people who completed a long-form interview. Factor
analysis with varimax rotation of responses to the 11 attitude
statements revealed two factors, containing five and three
items respectively. Based on the interpretability of the first
factor, responses to the five items were used to form a valid
scale of sexual liberalism with good internal consistency
(Cronbach’s a = 0.81): ‘Sex before marriage is acceptable’;
‘Abortion is always wrong’; ‘Sex between two adult women
is always wrong’; ‘Sex between two adult men is always wrong’;
and ‘Sexual health education for adolescents increases the
likelihood of early sexual activity’. Respondents were also
asked: ‘What would upset or distress you more: imagining
Attitudes towards sex Sexual Health 399

Box 1. Ascertainment of attitudes towards sex and relationships

I’m now going to read several statements and I’d like you to tell me whether you: . . .
(Interviewer reads out responses 1 to 5 with numbers)
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. Don’t know
9. Refused

Statements
Sex before marriage is acceptable.
An active sex life is important for my sense of wellbeing.
If two people had oral sex, but not intercourse, you would still consider that they had had sex together.
Having an affair when in a committed relationship is always wrong.
Abortion is always wrong.
Sex between two adult women is always wrong.
Sex between two adult men is always wrong.
Pornography degrades the women shown in it.
Pornography degrades the men shown in it.
Pornography can improve sexual relations among adults.
Sexual health education for adolescents increases the likelihood of early sexual activity.
What would upset or distress you more: imagining your partner. . .
1. . . .forming a deep emotional attachment to another person?
2. . . .having sexual intercourse with another person?

Table 1. Agreement with sexual attitude statements among men and women
Data exclude results for 158 people who did not respond to all statements. Unless indicated otherwise, data show percentage responses in each group. P-values
are for comparisons of women versus men

Statement Men (n = 9947) Women (n = 9989) P-value

Agree Neither Disagree Agree Neither Disagree
Sex before marriage is acceptable 87.1 4.2 8.7 86.3 4.5 9.2 0.69
An active sex life is important for my sense of wellbeing 86.8 6.5 6.7 78.8 9.3 11.9 <0.001
If two people had oral sex, but not intercourse, I would still consider 68.3 5.8 25.9 68.2 6.8 25.0 0.36
that they had sex
Having an affair when in a committed relationship is always wrong 83.7 5.1 11.3 81.5 7.1 11.5 0.01
Abortion is always wrong 20.2 12.6 67.3 14.8 11.5 73.8 <0.001
Sex between two adult women is always wrong 16.7 11.7 71.6 12.9 12.2 74.9 0.002
Sex between two adult men is always wrong 26.5 10.9 62.6 13.4 12.1 74.4 0.001
Pornography degrades the women shown in it 41.6 16.9 41.5 49.0 20.7 30.3 <0.001
Pornography degrades the men shown in it 30.0 15.9 54.1 37.2 21.0 41.8 <0.001
Pornography can improve sexual relations among adults 65.6 16.7 17.7 53.7 23.4 22.9 <0.001
Sexual health education for adolescents increases the likelihood of 31.0 13.6 55.4 16.4 11.4 72.2 <0.001
early sexual activity

your partner forming a deep emotional attachment to another Correlates of the scale of sexual liberalism examined in this
person, or having sexual intercourse with another person?’ paper included a range of demographic characteristics, which
(Box 1).23 were recoded to facilitate analyses. Respondents’ ages were
400 Sexual Health
recoded into six groups (16–19, 20–29, 30–39, 40–49, 50–59
and 60–69 years). Languages spoken at home were recoded as
English or a language other than English. Sexual identity (in
answer to the question ‘Do you think of yourself as . . .’) was
coded as heterosexual, homosexual or bisexual; too few
respondents stated that they were ‘queer’, ‘other’ or
‘undecided’ to allow analyses of these groups. Respondents’
reports of their highest completed level of education were
recoded to distinguish between those who had not (yet)
completed secondary school, those who had completed
secondary school and those who had completed post-secondary
education. Respondents’ postcodes were used with the
Accessibility/Remoteness Index of Australia (ARIA) to
determine whether respondents lived in a major city, a regional
area or a remote area (i.e. areas with relatively unrestricted,
restricted and very restricted access to goods, services and
opportunities for social interaction respectively).28 To
approximate the gross annual household income quintiles
reported by the Australian Bureau of Statistics for 2009–10,29
respondents’ reported annual household income was grouped
into five categories: less than $28 000, $28 001–$52 000,
$52 001–$83 000, $83 001–$125 000 and more than $125 000.
Respondents’ reported occupations were coded into the nine
major categories of the Australian Standard Classification of
Occupations and then recoded to distinguish among
managerial/professional occupations, white-collar occupations
and blue-collar occupations.30
Further analyses examined the association between sexual
liberalism scale scores and various behaviour variables.
Respondents indicated whether they had a religious belief or
faith and whether they were current smokers, former smokers or
had never smoked. Reports of alcohol consumption frequency
and volume were used to determine whether respondents
exceeded Australian National Health and Medical Research
Council (NHMRC) guidelines at the time of ASHR1 (28
standard drinks a week for men and 14 for women).31
Respondents indicated whether they had ever injected illicit
drugs, first had vaginal intercourse before age 16 years, had ever
had heterosexual anal intercourse or had ever engaged in
homosexual activity. Finally, the main outcome variables
were compared with those of ASHR1 to identify significant
changes over time.
Data were weighted to adjust for the probability of each
respondent being selected for a landline or mobile phone
interview, a long-form interview and (for landline
participants) the number of in-scope adults in the household.
Data were then weighted to match the Australian population on
the basis of age, gender, area of residence (i.e. ARIA category)
and telephone ownership (i.e. mobile telephone only vs other),
resulting in an adjusted sample of 10 056 men and 10 038
women (total 20 094). The data were thus weighted to
account for the specifics of our sample design and the fact
that particular types of people were over- or under-represented.
The data presented therefore describe the Australian population
aged 16–69 years, subject to the biases noted elsewhere in this
issue.27
Weighted data were analysed using the survey estimation
commands in Stata Version 11.2.32 The data were analysed
using univariate logistic regression for dichotomous outcome
R. O. de Visser et al.
variables, including comparisons of ASHR1 and ASHR2.
Correlates of continuous outcomes were identified using
univariate linear regression. Responses to the jealousy-
evoking scenario were compared for men and women using
multinomial logistic regression. Percentages are presented
without standard errors or 95% confidence intervals. This
decision was made to maximise both readability and brevity
and is in keeping with the style of other studies of a similar scope
and intent.16,33,34 Further information about the precision of
estimates is found elsewhere in this issue.27 Due to the number
of participants in ASHR2, it is important to recognise that often
there is the statistical power to detect even small changes as
statistically significant, but these do not necessarily correspond
to significant differences in a public health sense.
Results
A weighted total of 19 936 respondents answered all the
attitude questions and were included in the analysis. Table 1
lists the proportion of men and women who ‘Agreed’ or
‘Strongly agreed’ (these categories were collapsed), ‘Neither
agreed nor disagreed’, and ‘Disagreed’ or ‘Strongly disagreed’
(also collapsed into one category) with each attitude statement.
Five-sixths (87%) of respondents were accepting of premarital
sex, with similar proportions of men and women agreeing that
sex before marriage was acceptable. Among neither men
(P = 0.23) nor women (P = 0.13) was age related to attitudes
towards premarital sex.
Five-sixths (83%) of respondents agreed that an active sex
life was important for their sense of wellbeing. However, women
were significantly less likely than men to agree with this
statement. Men and women aged 16–19 years were the least
likely to agree with this statement (both P < 0.001). Given that
younger people were less likely than older people to be sexually
active,35 these analyses were re-run: the observed significant age
effects held when the sample was restricted to respondents
with experience of partnered sex (both P < 0.001) and when it
was further restricted to respondents with experience of vaginal
intercourse (both P < 0.001).
Two-thirds (68%) of respondents agreed that oral sex
constituted having sex, with similar proportions of men and
women agreeing with this statement. Men and women aged
16–29 years were significantly less likely than older respondents
to agree that oral sex constituted having sex (both P < 0.001).
Five-sixths (83%) of respondents agreed that having an
affair when in a committed relationship was always wrong,
with men significantly more likely to express this attitude.
Among both men and women, increasing age was associated
with lower levels of agreement that it was always wrong to have
an affair (both P < 0.001).
Only 17% of respondents agreed that abortion was always
wrong, with women significantly less likely to agree. Men and
women aged 16–29 years were significantly more likely than
older men and women to believe that abortion was always wrong
(both P < 0.001).
Attitudes towards homosexual behaviour were generally
positive; only 15% of respondents believed that sex between
two adult women was always wrong and only 20% believed
that sex between two adult men was always wrong. Women
Attitudes towards sex
were significantly less likely to agree with both statements.
Older respondents had less positive attitudes towards female
homosexual behaviour (men, P = 0.03; women, P < 0.001) and
male homosexual behaviour (men, P = 0.01; women, P < 0.001).
Overall, 45% of respondents agreed that pornography
degraded the women shown in it and 34% agreed that
pornography degraded the men shown in it, but men were
significantly less likely than women to agree with either
statement. Among men (P < 0.003) and women (P < 0.001),
there was a U-shaped association with age, indicating that
respondents aged 16–19 years and respondents aged
60–69 years were significantly more likely than other
respondents to believe that pornography degraded women.
Slightly different patterns emerged for the attitude that
pornography degraded men; among men, respondents aged
60–69 years were less positive about pornography (P < 0.001)
and among women, the U-shaped association with age described
above was found again (P < 0.001). Most respondents (60%)
felt that pornography could improve sexual relations, with men
significantly more likely than women to express this view
(P < 0.001). Men aged 30–59 years (P = 0.01) and women
aged 30–49 years (P < 0.001) expressed the most favourable
attitudes towards the potential relationship benefits of
pornography use.
Only 24% of respondents believed that sexual health
education increased the likelihood of early sexual activity.
Men were twice as likely as women to express this belief
(P < 0.001). Among men (P < 0.003), there was a U-shaped
association with age, indicating that respondents aged
16–29 years or 60–69 years were significantly more likely
than other men to believe that sexual health education
increased the likelihood of early sexual activity (P = 0.003).
Among women, those aged 16–29 years were significantly
more likely than other respondents to express this belief
(P < 0.001).
Table 2 shows that women had significantly higher scores
on the scale of sexual liberalism than men (P < 0.001), but the
effects of other variables were similar for men and women.
For both sexes, those aged 16–19 years or 60–69 years
had less liberal attitudes than those aged 30–59 years (both
P < 0.001). More liberal attitudes were expressed by men and
women who spoke English at home (both P < 0.001), had
homosexual or bisexual identities (both P < 0.001), higher
levels of education (both P < 0.001), higher incomes (both
P < 0.001), white-collar or managerial/professional occupations
(both P < 0.001) or no religious belief or faith (both P < 0.001).
More liberal attitudes were expressed by men who were
former smokers (P < 0.001) and women who were former or
current smokers (P < 0.001), men (P = 0.05) and women
(P = 0.001) who consumed alcohol in excess of the 2001
NHMRC guidelines and men and women who had ever
injected illicit drugs (both P = 0.001). More liberal attitudes
were also expressed by men and women who first had
vaginal intercourse before the age of 16 years (men, P = 0.07;
women, P = 0.001), had more than one sexual partner in the
past year (both P < 0.001), had ever had heterosexual anal
intercourse (both P < 0.001) or reported homosexual
experience (both P < 0.001). Sexual liberalism was not related
to region of residence (men, P = 0.46; women, P = 0.40).
Sexual Health 401
Table 3 displays significant sex differences in heterosexual
participants’ responses to the question ‘What would distress
you more: imagining your partner forming a deep emotional
attachment to another person, or having sexual intercourse with
another person?’. Whereas a majority of men selected their
partner’s sexual involvement with someone else, women were
most likely to select their partner’s emotional involvement
with someone else (P < 0.001). Among men, there was a U-
shaped association with age indicating that respondents aged
16–19 years or 60–69 years were significantly more likely than
other men to select sexual involvement as most distressing
(P < 0.001); indeed, only 51% of men aged 20–39 years did
so. Among women, there was a similar non-linear association
with age; only among women aged 20–49 years did a majority
indicate that their partner forming a deep emotional attachment
with someone else would be most distressing (P = 0.002).
Table 4 compares the proportion of ASHR1 and ASHR2
respondents aged 16–59 years who agreed with the seven
attitude statements common to both studies. There was a
significant increase in the proportion of women who agreed
that sex before marriage was acceptable (P = 0.04) and a non-
significant increase among men (P = 0.06). Significantly fewer
men agreed that an active sex life was important for their
wellbeing (P = 0.02), but the decline among women was not
significant (P = 0.22). Among men and women, there were
similar significant decreases in the proportions that believe
that oral sex counted as ‘having sex’ (P < 0.001 for both). For
neither men (P = 0.31) nor women (P = 0.09) were there
significant changes in the proportions of respondents who
agreed that abortion was always wrong. There were
significant increases in the proportions of men (P < 0.001)
and women (P < 0.001) who agreed that having an affair was
always wrong. Significantly fewer men and women believed that
male homosexual behaviour or female homosexual behaviour
was always wrong (P < 0.001 for all).
Discussion
The data presented here indicate that Australian adults have
permissive attitudes towards pre marital sex, believe that an
active sex life is important for their wellbeing and believe that
having an affair is always wrong. Few believe that homosexual
behaviour is wrong or that abortion is always wrong. Although
many express a belief that pornography degrades the women and
men depicted, a majority believe that pornography can improve
sexual relationships. Only one-quarter of respondents believe
that sexual health education increases the likelihood of sexual
activity among young people.
Correlates of responses to single items and scores on the
sexual permissiveness scale were generally similar to those
found in other a studies of population-representative samples
(including ASHR1).12–17,20 Young people tended to have more
permissive attitudes towards various aspects of sexuality,
but they were the least permissive in some domains; 16–19-
year-olds were the most likely to believe that sexuality education
increased the likelihood of sexual activity among young
people and were the least tolerant of having an affair when in
a relationship; the latter finding was also observed in Natsal-3.12
The data from ASHR, Natsal, and the US National Social Life,
402 Sexual Health R. O. de Visser et al.

Table 2. Correlates of scores on a five-item scale of sexual liberalism

Data show mean scores, with 95% confidence intervals in parentheses. Higher scores indicate more liberal attitudes

Correlate Men (n = 9947) Women (n = 9989)

Overall 3.62 (3.58–3.66) 3.83 (3.80–3.87)
Age (years)
16–19 3.53 (3.42–3.65) 3.73 (3.61–3.86)
20–29 3.62 (3.52–3.71) 3.85 (3.76–3.94)
30–39 3.70 (3.61–3.79) 3.89 (3.81–3.98)
40–49 3.64 (3.57–3.71) 3.93 (3.86–3.99)
50–59 3.68 (3.61–3.74) 3.77 (3.71–3.84)
60–69 3.49 (3.43–3.56) 3.71 (3.65–3.77)
Language spoken at home
English 3.67 (3.64–3.71) 3.89 (3.86–3.92)
Other 3.07 (2.89–3.24) 2.95 (2.77–3.13)
Sexual identity
Heterosexual 3.60 (3.57–3.64) 3.82 (3.78–3.86)
Homosexual 4.30 (4.21–4.40) 4.41 (4.30–4.52)
Bisexual 4.10 (3.95–4.25) 4.00 (3.69–4.31)
Education
Lower secondary 3.40 (3.33–3.48) 3.67 (3.61–3.75)
Secondary 3.61 (3.56–3.66) 3.80 (3.73–3.86)
Post-secondary 3.71 (3.65–3.76) 3.90 (3.85–3.94)
Region of residence
Major city 3.65 (3.61–3.69) 3.85 (3.81–3.90)
Regional 3.59 (3.53–3.64) 3.79 (3.73–3.84)
Rural 3.44 (3.25–3.63) 3.91 (3.64–4.18)
Household income
<$28 000 3.48 (3.38–3.59) 3.80 (3.72–3.88)
$28 001–$52 000 3.53 (3.44–3.61) 3.63 (3.54–3.73)
$52 001–$83 000 3.55 (3.47–3.63) 3.79 (3.72–3.87)
$83 001–$125 000 3.64 (3.57–3.72) 3.93 (3.86–4.01)
>$125 000 3.80 (3.74–3.87) 4.01 (3.95–4.08)
Occupational classification
Blue collar 3.50 (3.44–3.55) 3.63 (3.53–3.73)
White collar 3.65 (3.57–3.73) 3.79 (3.74–3.84)
Manager/professional 3.74 (3.68–3.79) 3.97 (3.92–4.03)
Religion or faith
No 3.88 (3.84–3.92) 4.05 (4.01–4.09)
Yes 3.33 (3.28–3.38) 3.59 (3.54–3.65)
Smoking status
Never smoked 3.58 (3.53–3.63) 3.74 (3.69–3.79)
Former smoker 3.72 (3.66–3.77) 4.00 (3.94–4.05)
Current smoker 3.60 (3.54–3.67) 3.93 (3.86–4.01)
Alcohol consumption
Below 2001 NHMRC guidelines 3.62 (3.59–3.66) 3.82 (3.78–3.85)
Exceeds 2001 NHMRC guidelines 3.65 (3.54–3.77) 4.15 (4.05–4.25)
Ever injected illicit drugs
No 3.62 (3.58–3.65) 3.83 (3.79–3.86)
Yes 3.80 (3.67–3.93) 4.10 (3.92–4.28)
First vaginal intercourse before age 16 years
No 3.62 (3.59–3.67) 3.86 (3.79–3.87)
Yes 3.75 (3.67–3.83) 4.06 (4.00–4.12)
More than one sexual partner last year
No 3.59 (3.55–3.63) 3.80 (3.77–3.85)
Yes 3.82 (3.77–3.87) 4.14 (4.08–4.20)
Ever had heterosexual anal intercourse
No 3.53 (3.49–3.57) 3.80 (3.76–3.84)
Yes 3.89 (3.84–3.95) 4.01 (3.94–4.08)
Homosexual experience
No 3.59 (3.55–3.62) 3.76 (3.73–3.80)
Yes 4.16 (4.11–4.22) 4.27 (4.23–4.31)
Attitudes towards sex Sexual Health 403

Table 3. Heterosexual interviewees’ response to the attitude statement ‘What would upset or distress you more: imagining your partner . . .’
Unless indicated otherwise, data show percentage responses in each group. Unadjusted odds ratios (OR) and 95% confidence intervals (CI) are for women
versus men from multinomial logistic regression

Scenario Men (n = 9337) Women (n = 9443) OR (95% CI)

‘. . . forming a deep emotional attachment to another person?’ 37.1 50.3 1.86 (1.63–2.12)
‘. . . having sexual intercourse with another person?’ 56.8 41.5 1
Don’t know 6.2 8.2 1.82 (1.44–2.32)

Table 4. Prevalence of agreement or strong agreement with attitude statements among men and women: comparison of the first Australian Study
of Health and Relationships (ASHR1) and the Second Australian Study of Health and Relationships (ASHR2)
People aged 60–69 years have been removed from the ASHR2 sample for comparison. Unless indicated otherwise, data show percentage responses in each
group. Unadjusted odds ratios (OR) and confidence intervals (CI) are for ASHR2 versus ASHR1

Statement Men Women

ASHR1 ASHR2 Unadjusted ASHR1 ASHR2 Unadjusted
(n = 9432) (n = 8463) OR (95% CI) (n = 9283) (n = 8678) OR (95% CI)
Sex before marriage is acceptable 86.2 87.0 1.08 (0.88–1.31) 83.7 86.3 1.22 (1.01–1.48)
An active sex life is important for my sense 88.2 85.2 0.77 (0.62–0.96) 79.5 77.6 0.89 (0.74–1.07)
of well being
If two people had oral sex, but not intercourse, 72.3 65.7 0.73 (0.63–0.85) 71.9 65.7 0.75 (0.64–0.87)
I would still consider that they had sex
Having an affair when in a committed 77.5 84.9 1.63 (1.38–1.91) 77.7 82.3 1.33 (1.13–1.58)
relationship is always wrong
Abortion is always wrong 18.9 20.4 1.10 (0.92–1.31) 17.3 15.0 0.84 (0.69–1.03)
Sex between two adult women is always 21.4 15.6 0.68 (0.57–0.82) 25.1 12.1 0.41 (0.34–0.50)
wrong
Sex between two adult men is always wrong 36.9 24.9 0.57 (0.49–0.66) 26.6 12.8 0.40 (0.33–0.49)

Health and Aging Project (NSHAP) suggest that age differences
in sexual attitudes may be due to age, per se, and/or to cohort
effects,12,17,19 One important cohort effect for the current study
may have been the sexual revolution of the 1960s and 1970s.
Changes in reproductive technologies, attitudes and behaviours
gradually led to changes in laws, policy and sex education that
are more accepting of sexual diversity.36–38 Taken together with
cross-temporal analyses,14 our data suggest that the observed
changes in attitudes are likely to be followed by further
consolidation of current behaviours and/or greater liberalism
in behaviour.
As expected, when asked to indicate whether a partner’s
sexual or emotional involvement with someone else would be
more distressing, a majority of heterosexual men selected sexual
involvement, whereas heterosexual women were most likely
to select emotional involvement. However, the sex differences
hypothesised according to evolutionary theory were not always
clear and strong.22,23 Indeed, among men aged 20–39 years
(prime child-rearing ages for which the evolutionary theory
should be most valid), only 51% reported that a partner’s
sexual involvement would be most distressing. Furthermore,
only among women of usual reproductive age (20–49 years) did
a majority indicate that the partner’s emotional involvement with
someone else would be most distressing.
In ASHR1, scale scores indicated that men had more liberal
sexual attitudes than women. The ASHR2 data revealed that
women were more liberal. However, direct comparisons
between the two results should be made with caution,
because the composition of the two scales was different. The
scale used in ASHR2 did not contain the item ‘Films these days
are too sexually explicit’: this item produced the largest sex
difference in ASHR1, with men expressing much more liberal
attitudes than women. Furthermore, for the one new item in the
scale (‘Sexual health education for adolescents increases the
likelihood of early sexual activity’), women had significantly
more permissive attitudes than men. Therefore, it is likely
that the apparent change in liberalism is due to the different
composition of the two scales. This interpretation is supported
by the observation that in the comparisons between ASHR1 and
ASHR2 reported in Table 4, the direction of change was the
same for men and women and most commonly of a similar
magnitude. Nevertheless, women had more permissive attitudes
to termination of pregnancy, extradyadic sex and homosexual
behaviour.
In contrast to the patterns described above, opposite
significant sex differences were found for attitudes towards
pornography. Women’s responses to the three items relating
to pornography indicated that they are less permissive in this
domain. Factor analysis indicated that these items could not be
included in a single scale comprised of all attitude items. These
findings provide further evidence for caution when interpreting
the apparent reversal of sex differences in sexual liberalism.
Other changes in attitudes between ASHR1 and ASHR2
are easier to interpret. There was a significant increase in the
proportion of women who agreed that sex before marriage was
acceptable and a non-significant increase among men. These
changes mean that the significant sex difference observed in
ASHR1 (whereby men were significantly more accepting of
404 Sexual Health
premarital sex) was not observed in ASHR2. In addition, there
were significant decreases in the proportions of men and women
who believed that oral sex counted as ‘having sex’, suggesting
that the age differences on this point found in previous
research are consistent cohort effects.39,40 Significantly fewer
men and women believed that male homosexual activity
or female homosexual activity was always wrong. In the
context of these changes, it is interesting to note that there
were significant increases in the proportions of men and women
who agreed that having an affair was always wrong. Therefore, it
appears that Australians are less concerned about the morality
of particular sexual practices, but are becoming more concerned
about the morality of infidelity in monogamous relationships.
This matches the shift suggested by the sociologist Anthony
Giddens two decades ago.41
The data presented here show that the sexual attitudes of
Australians support a permissive but monogamous paradigm.
Since 2002, there has been a shift to less tolerance of extradyadic
sex, but greater acceptance of homosexual behaviour. Given
that attitudes tend to predict subsequent behaviour,6–10 the
observed changes in attitudes between ASHR1 and ASHR2
suggest that there may be continued increases in the prevalence
of premarital sexual activity37 and a greater prevalence of oral
sex and earlier engagement in this behaviour.35 The changes in
attitudes towards homosexual behaviour suggest that there may
be less stigmatisation of gay men and lesbians.42 The patterns of
attitudes and behaviour observed in ASHR2 (and similar studies
in other countries) have implications for government policies
and for sexuality education.
Conflicts of interest
None declared.
Acknowledgements
This study was funded by the National Health and Medical Research Council
(grant no. 1002174). The authors are indebted to David Shellard and the
staff of the Hunter Valley Research Foundation for managing data collection
and undertaking the interviews for this study; and to the Social Research
Centre for producing weights for the data. The authors also thank the 21 139
Australians who took part in the two phases of the project and so freely
shared the sometimes intimate aspects of their lives. Professor Anthony
Smith died during the course of this project and we intend this work to be a
tribute to, and further example of, the extraordinary contribution his work has
made to the sexual health and wellbeing of Australians.
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