SEXUAL REPERTOIRES OF HETEROSEXUALS - IMPLICATIONS FOR HIV SEXUALLY-TRANSMITTED DISEASE RISK AND PREVENTION

Objective: To provide a quantitative and population-based analysis of sexual repertoires among heterosexuals. Design: The French National Su rvey of Sexual Behaviour (ACSF), conducted between September 1991 and February 1992 on a representative sample of the population aged 18-69 years. Methods: Sexual practices of the last heterosexual encounter we re investigated among 4261 individuals; we measured the combinations o f different practices and their correlations with age, and calculated frequencies for the main repertoires and their correlations with the i nterpartner relationship. Results: Vaginal penetration and caressing w ere almost systematic, self-masturbation and anal penetration were rar e, while mutual masturbation and orogenital practices had intermediate levels of occurrence. Examination of the correlations revealed (1) a very high correlation between practices which are reciprocal or symmet rical, (2) a strong association between genito-manual and genito-oral practices, (3) an association between anal penetration and fellatio, a nd (4) no clear correlation between any set of practices and vaginal s ex or condom use. A small number of repertoires accounted for the vast majority of encounters. Younger people tended to have a more diversif ied repertoire. Repertoire types and diversity were strongly correlate d to the pattern of interpartner relationship, independently of age. C onclusions: Reciprocity seems a standard feature of the heterosexual r epertoire. The absence of a negative correlation between Vaginal or an al penetration and other practices argues against promotion of the lat ter as substitute for the former. By contrast, the independence betwee n condom use and any specific repertoire argues for its promotion as a universal means of protection.