Groups of middle-aged individuals have the lowest rates of sexually transmitted infections (STIs) compared to younger age groups, such as those in their 20s and 30s who have the highest rates of casual sexual intercourse with partners. It has been identified that various sexual behavior problems exist in these age groups, particularly due to a lack of sexual education among adolescents. The current study includes a wider range of age groups, including young adults and adolescents, and aims to focus on the sexual activity and related problems in older age groups. This study is the second nationally representative study on sexual behavior among Korean men and women. Educators should develop plans to improve social knowledge associated with sexual behaviors, enabling individuals to make better choices.
In the 20s age group, there has been an increase in the percentage of adolescents and young adults who have had sexual experiences compared to those in the previous 10 years. Our study focuses on the reported sexual experiences of individuals in their 20s and teenagers, which may reflect the conservative perspective of traditional Confucian Koreans regarding sexual intercourse before marriage. Most previous studies, although they were conducted among individuals who were already sexually active, did not include the baseline parameter for sexual intercourse behavior.
It can be inferred that among individuals aged 30 or above, the reported age of first sexual intercourse could potentially be lower compared to those in their 20s or younger, as individuals with no prior sexual experience were not included in the study. Recent research indicates a declining trend in the age of first sexual intercourse in Korea. Moreover, the average age at first intercourse in Korea was found to be higher than that of Western countries [18,19].
This might imply that sexually active adolescents, including casual sex partners and recent acquaintances, were having sexual relationships with their friends and partners. Interestingly, only half of these sexually active adolescents reported having current sexual partners, and among those who did, they had experienced sexual intercourse. It could be explained by factors such as the shorter life expectancy and different patterns of remarriage in men compared to women. Men tend to pair with younger women in marital relationships, similar to the age structure of relationships among adults. The gender disparity was reversed in the 60s age group, with women making up 83.1% and men 89.9%. This difference might be due to the increased unemployment rate, which affects intimacy and dating, and the increasing age of marriage in Korea. This is consistent with previous studies in other countries [16,22]. Among women who reported having a sexual partner, 70.7% had male counterparts in their younger or 30s age groups, compared to 85.6% of men.
Due to possibly increasing age, the prevalence of sexual problems showed a decrease in sexual activity in males aged 40 and above. It is also possible that other sexual health problems and lower libido might affect sexual activity, such as vaginal atrophy in older women. The difference in gender might be a reason why men have a more positive attitude and higher interest in sex, with respect to sexual activity. Consistent with our results, marital status and age are well-known determinants of sexual activity.
It is imperative to develop a program to promote the usage of condoms in the general population. The overall percentage of condom usage in Korea has declined compared to the previous decade [10,29]. Moreover, the current overall rate of consistent condom usage is lower than that in western countries [14,28]. Although individuals in the older age group are less likely to engage in sexual relationships with casual partners, their rates of condom usage were significantly lower than those in younger age groups. Additionally, while the rates of condom usage with casual partners among individuals in their 20s and 30s were higher than other age groups, this cannot be justified. Further research on the rates of condom usage in these groups is crucial. The identified vulnerable groups consist of males in their 20s and 30s who are in sexually active age ranges. Engaging in sexual relationships with casual partners is a concerning sexual behavior, as it exposes individuals to a high risk of sexually transmitted infections .
It is necessary to provide opportunities for groups among these education sex, therefore. The rate of sexual education has been low among those ages and there has been a rapid increase in the 40s and beyond, although this relationship has not been clearly ascertained. Recently, the number of STI patients beyond their 40s has decreased by more than 20% compared to 10 years ago, which probably includes photos or pictures that are repulsive and embarrassing. In our cohort of adolescents, only 0.4% received sexual education regarding STIs, which could have been avoided by students and teachers in the health curriculum. Despite the increase in sexual education in health classes, including mandated sexual education provided by health teachers, the emphasis on the health of Korean adolescents and the increase in interest in sexual education, only about 10% of Korean adults received sexual education on STIs.
The major strength of this study is that we used a multi-stratification sampling design to collect nationally representative data from a wider age group. We believe that our results adequately reflect contemporary patterns of sexual behaviors among Koreans and provide better insights for the formulation of sexual health practices and policies. Online surveys were chosen to minimize the sharing of sensitive personal information and to provide privacy and convenience for respondents due to the candid and honest nature of their sexual behaviors. Telephone and face-to-face interviews would be unsuitable for such a survey as they may be embarrassing for respondents and introduce bias. Compared to previous studies in Korea, our study stands out for its use of a multi-stratification sampling design and its ability to collect representative data from a wider age group.
The study had limited ability to incorporate those groups into the analysis. Another constraint is that this population-based design did not encompass sexual minorities such as homosexuals, lesbians, or individuals who identify as bisexual. Therefore, in order to investigate the sexual behaviors of older adults, a large-scale population-based study with an innovative research design should be undertaken. Additionally, the online survey respondents from the 60s age group may not accurately represent the entirety of this age group. However, they are less accessible for online surveys, which poses a risk of selection bias that may exclude most elderly individuals residing in hospitals or long-term care facilities. A limitation of the present study is the exclusion of individuals aged 70 years or older.