The Face of Global Sex 2008

The Face of
Global Sex 2008
The path to
sexual confi dence
netw rk

---

---

Contents
Foreword
04
Overview
05
Introduction
06
Methodology
07

Main study findings
09
Regional variations on sexual confidence
10
Sexual confidence and age
14
Sexual confidence and socio-demographic variables
18
Sexual confidence and sources of sex education
24

The confident profile
26
Study conclusions
27
Results of the Durex Sexual Wellbeing Global Survey 2007
28
References
30

---

Foreword
The 2008 Face of Global Sex report It is clear that there is a strong link between sex
examines sexual confidence and
education and sexual confidence. This analysis
indicates that individuals who have no main source
provides a unique perspective
of sex education are significantly less likely to be
on the role of sex education in
sexually confident.
helping individuals make informed But the report also demonstrates how sex education
remains taboo in many societies. Approximately
choices about their sexual health.
20 per cent of the world’s population has never received
This has serious implications on
formal sex education. Furthermore, recent reports have
shown that many young people worldwide are less
their ability to avoid unwanted
than satisfied with the quality of the sex education
pregnancy, prevent STIs/HIV/AIDS, they are receiving.
reach sexual fulfilment and know
Scientific studies have highlighted that the most
where to find guidance on various
effective sex education programmes are the most
comprehensive ones. They have also identified that
sexual issues.
a lack of involvement from parents, and the less than
adequate resources that are sometimes made available
to healthcare professionals, play a big part in the creation
of educational gaps.
04
This report, like all the Durex Network activity, represents
SSL International’s continued commitment to sexual
health and corporate social responsibility for society
at large.
More importantly, these findings stimulate the
debate that is necessary to develop more effective
and sustainable solutions to the sexual health
problems our world faces.

Garry Watts
CEO, SSL International

---

Overview
Professor Carl Latkin
The 2008 Face of Global Sex report presents detailed
The study provided detailed information on sources
findings of a major and comprehensive global survey
of sex education information. The role of the Internet
from 26 countries (the Durex Sexual Wellbeing Global
in providing information has grown exponentially in
Survey). The study instrument, the Durex Sexual
the last decade. Given the vast amount of information
Confidence Scale, quickly assesses key domains of
available through the Internet, one important issue
sexual confidence. The survey includes questions on
to consider is how individuals ensure that they are
positive aspects of sexual health as well as asking
obtaining accurate and relevant information on sex
questions on avoiding STIs/HIV/AIDS and pregnancy.
via the web. In addition to tracking traffic on sexual
As we think about HIV, STIs and pregnancy prevention
health websites, it would be useful to analyze what sex
programs, it is important to examine positive attributes
information is sought on the web and how websites
of sexual health and how these can be promoted in
can provide the most useful materials to promote
diverse countries and communities. The study results
sexual health.
are fascinating. These findings show significant
It is interesting to note that several diverse countries
cultural and geographical variations in levels of
scored consistently high on sexual confidence. The
sexual confidence.
data from these countries suggest that it is feasible to
One key question raised by the study findings is
enhance sexual confidence. Future studies of sexual
how do we make discussions about sexual health
education in these high scoring countries may provide
more normative? That is, how do we facilitate the
insights into how to improve and maintain sexual
conversations and informational exchanges that will
confidence. There was also a set of countries that
lead to talking about sex, pregnancy and disease
scored lower on confidence in knowing how to prevent
prevention becoming acceptable? The results of this
pregnancies. These countries should be targeted for
05
study point to the important role of both peers and
sexual education initiatives. As citizens’ health and
parents in sex education. Based on these findings,
wellbeing are at stake, all countries should strive for
social marketing and school-based sex education
high rates of confidence in HIV prevention.
programs may now want to consider promoting
Proper use of condoms remains the most viable
conversations about sexual health and confidence
method of HIV prevention among sexually active
amongst peers and family members, as well as
individuals. Given that condoms are highly effective
disseminating accurate information.
in preventing HIV, low levels of confidence about
The finding of the strong association between earlier
preventing HIV and other sexually transmitted
age of sex education and greater sexual confidence
infections is of great concern. Thailand, which scored
is also of great importance. This finding suggests
low on confidence to know how to protect from STIs/
that providing younger students with sex education
HIV/AIDS, once had a highly ambitious and successful
may help to normalize sex and may help to establish
HIV prevention campaign, which included extensive
community level norms that promote the acceptability
social marketing. The results of this survey suggest
of discussing sex. It is likely that countries that provide
that countries need to maintain their active HIV and
earlier sexual education have less stigma and anxiety
STI prevention activities. One of the key components
about sex and about talking about sex. Moreover, if
of confidence in STIs/HIV/AIDS prevention is confidence
healthy norms of sexual confidence are established
in negotiating condom use.
at an early age, they are likely to be maintained and
The 2008 Face of Global Sex report has provided
enhanced throughout life.
invaluable information from 26 countries on four key
There were several key results from the survey on
domains of sexual health and wellbeing. Now we must
rural versus urban populations, level of education,
utilize this data to improve and maintain sexual health
and income. The study results suggest that rural
and wellbeing.
residents have consistently fewer sources of sex
education information. In many countries such as
India, the majority of the population lives in rural
areas. Policy makers and program planners should
address this geographic disparity through increased
rural venues for sex education.

Low income and low levels of education were both

associated with lower levels of sexual confidence.
Yet school is cited almost as frequently as friends
and peers as a major source of sex education among
Professor Carl Latkin
individuals with lower levels of education. These results
Department of Health, Behavior and
highlight the need for good school-based education.
Unfortunately, in many countries high quality school-
Society, Bloomberg School of Public
based sexual education is lacking.
Health, Johns Hopkins University

---

Introduction
06
The Durex Network has been using data collected by
responsible than were their own parents in providing
Durex global surveys to analyse specific sexual health
sex information, most [sexual health] communication
issues since 2004.
from parents to children is indirect.”
Previous reports have covered the factors influencing
In identifying which socio-demographic variables most
risk-taking in sexual activity and contraception use at
influence sexual confidence, the 2008 Face of Global
first sex. Papers on these and related topics have been
Sex report seeks to highlight which circumstances
presented at international conferences, including the
provide the best opportunities to gain sexual health
9th Congress of the European Federation of Sexology
knowledge.
and the 10th Congress of the European Society of
Region and area of residence, age, gender, virginity
Contraception in 2008.
status, income level, level of education and sources
The 2008 Face of Global Sex report sets out to
of sex education are all evaluated against scales
identify which variables are most associated with
of confidence on sex related issues. The analysis of
making people feel more confident on how to protect
these variables has made it possible to generate the
themselves from STIs, avoid unplanned pregnancy,
Durex Sexual Confidence Scale (DSCS), an innovative
ensure sexual fulfilment and know where to look for
statistical analysis tool that can be used as the basis
sexual guidance.
of reliable assessments of sexual confidence.
Analysis of data from the Durex Sexual Wellbeing Global The DSCS was based on responses to questions that
Survey has shown that people who fully agree there is
covered areas addressing STIs, pregnancy, fulfilment
enough sexual health information available are more
and guidance on sex.
likely to be confident on sexual issues.
Responses for each of the four questions were scored
This statement defines the close links that exist
from 0 to 60 points, where 60 was the highest possible
between information, knowledge and confidence when
score, and the DSCS was generated from the summation
it comes to sex. It also reminds us that far from being
of these scores into an overall 100-point scale.
blissful, ignorance may in fact cause people to take
Overall, the report findings highlight the impact of
higher levels of risk than they anticipate and prevent
sexual health information on confidence and the need
them from making the choice that is right for them.
for a more inclusive provision of sex education to take
Being able to source adequate sexual health
into account an individual’s personal circumstances.
information at the right time strongly influences
These findings are powerful and, by sharing them with
the building up of sexual confidence and, ultimately,
sexual health experts, we hope to further stimulate
sexual health choices.
debate and help formulate effective strategies to equip
According to a study published in the Journal of Sex &
people with the tools to take responsibility for their
Marital Therapy (King and Lorusso 1997), “For at least
sexual health and that of those around them.
six decades, children have relied on peers and literature
(or the media) as their primary source of information
[on sex]. Although some sex educators believe that
the generation of baby boomers has been more

---

Methodology
The data that informs the 2008 Face
For nine of the countries included in the study (Brazil,
07
of Global Sex report was gathered
China, Greece, India, Mexico, Poland, Russia, South Africa
and Thailand), an online approach does not provide a
through the Durex Sexual Wellbeing
representative sample of the entire population, but only
Global Survey.
of the online community.
This survey was developed in 2006 and
For each country included in the study every effort
sought to understand how and why sex
was made to make the sample as representative as
possible of the general population. This was undertaken
is important for physical, emotional and
by weighting the data.
psychological health. Durex surveyed
These limitations, however, are mitigated by the
more than 26,000 adults in 26 countries
anonymity and ease of use provided by such a tool,
over a one-month period via a web-
which makes it easier to have larger sample sizes. As
enabled panel in each country, except
discussed in Williams and Bonner 2006, “Participants
Nigeria where, due to low Internet use,
who fill out a brief survey in the course of an Internet
search may do so anonymously and without investing
face-to-face interviews were conducted.
excessive time or effort in the process. Participation
rates and response veracity may therefore be improved.”
Respondents were of all ages, sexual
orientations, cultures and lifestyles,
The survey took approximately 25 minutes to complete
and covered three key areas: demographic and
making the data as representative as
background; overall health and wellbeing; and the
could be, bearing in mind the inherent
respondent’s sex life.
limitations of Internet-based data
This provided an unprecedented insight into all areas
collection.
of sexual wellbeing. The Durex Sexual Wellbeing Global
Survey gave us an understanding of how previous
experiences have impacted and influenced people’s
later lives, and what they believe could have given
them a better sexual experience.
From this, it was possible to build a clear picture of how
people see their sex lives today and how these differed
across the participating countries.
The quality of the data collected was such that we have
been able to look at it from many different perspectives.
This report identifies how variables associated with sex
information and education influence sexual confidence.

---

Data analysis
For the purpose of the present study, the statistical
Table 1 Analysis of sub-scale correlations
analysis was carried out by Miguel Fontes of the

HIV/AIDS Pregnancy Fulfilment Guidance
Johns Hopkins Bloomberg School of Public Health
and Peter Roach, Vice President of the Durex Network,
HIV/AIDS
1.0000
based on four specific statistical models:
Pregnancy 0.7261
1.0000
a) T-tests of statistically significant differences for
Fulfilment 0.5342
0.5121
1.0000
rates of sexual confidence among countries;
Guidance 0.5775
0.5489
0.6091
1.0000
b) T-tests of statistically significant differences

for sources of sexual education among groups of

individuals by income, gender, area of residence
All correlations reached statistical significance
and education;
(p-value<0.05). In addition, for the Cronbach’s alpha
c) Linear multivariate regression between levels
test, the scale reliability coefficient reached 0.8464.
of sexual confidence and main sources of
These two results are indicative that the combined
sexual education;
overall scale is a reliable statistical tool for the
d) Difference in levels of sexual confidence for
purposes of this world analysis.
HIV/AIDS prevention, unwanted pregnancy,
sexual fulfilment, and sexual guidance.
The 100-point scale was used as the main dependent
variable of all regression analyses produced by this
For c and d above, a sexual confidence scale was
study. The final regression model also included
generated based on the responses received to four
eight independent variables: a) gender; b) age of
different types of questions:
respondent; c) income; d) virginity status; e) education
1. Agreement on being confident to know
level; f) area of residence (urban, suburban, and rural);
how to protect yourself from STIs/HIV/AIDS
g) age at first formal sex education; and h) main
2. Agreement on being confident to know
sources of sexual education.
how to avoid pregnancy
08
3. Agreement on being confident to know
how to have a happy and fulfilling sex life
4. Agreement on being confident to know
where to go for help/advice/guidance on sex
The Durex Sexual
Confidence Scale (DSCS)
For all of these questions, points were allocated to
each of the seven categories included in the final
Likert scale, ranging from complete disagreement
to complete agreement. A scale of 60 points was
subsequently generated for each question. The final
summation of the four sub-scales resulted in the
DSCS, an overall scale ranging from zero to 240 points.
However, for ease of interpretation, a 100-point scale
was generated by dividing the final results by 240.
Checks for reliability of the scale were also performed
by examining the correlation factors among all four
sub-scales included in the final overall scale and
calculating the scale reliability coefficient using
Cronbach’s alpha test.
Table 1 presents the correlation values among
all four sub-scales.

---

Main study
findings
To identify which variables associated
with sex education and information
influence sexual confidence, the study
first looked at sexual confidence
variations at global region level.
Age at first formal sex education was
then analysed in association with levels
of sexual confidence.
The study subsequently evaluated the
influence of variables including gender,
virginity status, income, education and
area of residence, on main sources of
sex education.
Correlations between levels of sexual
confidence and sources of sex education
09
were then explored to inform how the
latter influences the former.
Finally, a ‘confident profile’ was identified
as a summation of the most influential
factors to achieve a higher degree of
sexual confidence.

---

Regional variations on
sexual confidence
The Durex Sexual Confidence Scale has shown
Avoiding pregnancy
interesting variations of levels of confidence by
global regions.
Similar findings appeared when respondents were
asked about their confidence in how to avoid pregnancy
Protection from STIs/HIV/AIDS
(Fig. 2). In most cases, Asian countries’ confidence
levels reached a score of 70 per cent whereas Western
The study found that most Asian countries fell well
countries’ confidence levels ranged from 75 to
behind Western countries when it came to being
85 per cent. Singapore’s score was 68 per cent,
confident about protecting themselves against
while South Africa’s score was 85 per cent.
STIs and HIV/AIDS (Fig. 1). Thailand and Hong Kong
achieved a 65 per cent score of confidence in this area,
the lowest out of all countries surveyed, with South
Africa scoring the highest at 87 per cent and Spain,
Mexico, Switzerland, Brazil and Canada achieving
an 85 per cent score.
10
Fig. 1
Level of confidence in knowing how to protect from STIs/HIV/AIDS
90%
80%
70%
60%
50%
40%
0%
o
A
d
e
y
a
a
a
e
c
d
d
g
n
si
r
e
c
frica
xic
azil
US
s
t
r
i
a
UK
l
a
Italy
y
s
s
i
a
on
Spain
u
an
o
Indi
Chin
u
ee
Me
erland
Br
s
t
r
alia
R
Japan
Canada
u
A
ealan
Fr
Nigeria
P
Gr
A
German
Mala
Thailan
w Z
Singapo
Hong K
South A
Switz
Netherlands
Ne
Fig. 2
Level of confidence in knowing how to avoid pregnancy
90%
80%
70%
60%
50%
40%
0%
o
A
d
y
e
d
e
a
a
g
d
UK
n
c
s
ia
r
e
frica
azil
xic
US
s
t
r
i
a
nc
l
a
Italy
s
s
i
a
y
on
Spain
Br
u
ee
a
erland
s
t
r
alia
u
r
a
o
R
Chin
Japan
Indi
Canada
Me
u
A
ealan
F
Nigeria
P
Gr
A
German
Mal
Thailan
w Z
Hong K
Singapo
South A
Switz
Netherlands
Ne

---