Abstract
Objectives
To explore the relationship between sexual orientation and specific sexual and risk behaviors, compare the number of sexual behaviors and attitudes among people of different sexual orientations, and test the mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors.
Methods
A total of 2288 participants completed a checklist of sexual behaviors, indicators of sexual risk behaviors, and a scale of attitudes toward sexual behaviors.
Results
Bisexual women engaged in a greater number of sexual behaviors and had more positive attitudes toward sexual behaviors than heterosexual women. Homosexual men engaged in a greater number of sexual behaviors than heterosexual men, and homosexual and bisexual men had more positive attitudes toward sexual behaviors than heterosexuals. Finally, we show the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors engaged in.
Conclusions
The importance of considering sexual orientation when analyzing sexual behaviors and attitudes is highlighted.
Keywords: Sexual orientation, sexual attitudes, sexual behaviors, sexual risk behaviors
Introduction
Numerous studies have compared sexual behaviors among people of different sexual orientations (Leri & DelPriore, 2021; Pham et al., 2021), and most of these have focused on sexual risk behaviors (Coble et al., 2017; Rotermann & McKay, 2020; Vasquez et al., 2017). In general, research shows that homosexual and bisexual people (HB people) initiate sexual relations earlier (Coble et al., 2017; Glick et al., 2012; Hipwell et al., 2013) and have more sexual partners (Coble et al., 2017; Leri & DelPriore, 2021; Vasquez et al., 2017; Ybarra et al., 2016) than heterosexuals. However, concerning condom use, the results are inconsistent. While some studies find that HB people use condoms less than heterosexuals (Rosario et al., 2014; Travers et al., 2022), others find that HB people use them more than heterosexuals (De Santis et al., 2015; Glick et al., 2012; Kim et al., 2019; Vasquez et al., 2017). These discrepant findings could be due to the measures used or may also be influenced by the gender of the participants. For example, while some studies ask whether the person or their partner used a condom the last time they had sex (e.g., Rotermann & McKay, 2020), others focus on the frequency of use during vaginal intercourse, oral sex and anal sex (e.g., Oswalt & Wyatt, 2013). On the other hand, while some studies focus exclusively on women (Kerr et al., 2013; Ybarra et al., 2016), men (De Santis et al., 2015; Vasquez et al., 2017), or separate the results according to gender (Oswalt & Wyatt, 2013), others do not control for the influence of this variable. More specifically, homosexual and bisexual men (HB men) have been found to use condoms more in anal sex than heterosexuals (De Santis et al., 2015; Glick et al., 2012; Vasquez et al., 2017).
In contrast to the numerous studies linking sexual orientation to sexual risk behaviors, some have linked sexual orientation to specific sexual behaviors and activities. In general, the findings indicate that a higher percentage of HB people than heterosexuals engage in behaviors, such as solo masturbation (Træen & Daneback, 2013), online sexual behaviors, such as sexting (Gámez-Guadix et al., 2017; Scandurra et al., 2022), or sex with more than one person at the same time (Thompson et al., 2021). Along with differences in sexual behaviors, studies have also revealed differences in sexual attitudes according to sexual orientation. Specifically, HB people have been found to have more permissive sexual attitudes than heterosexuals (Grollman, 2017; Lentz & Zaikman, 2021; Leri & DelPriore, 2021; Silva et al., 2021; Swami et al., 2017), with HB people showing more positive attitudes toward masturbation (Cowden & Koch, 1995), various types of online sexual activities (Byers & Shaughnessy, 2014), and threesomes (Thompson et al., 2021).
The differences in sexual behaviors and attitudes among people of different sexual orientations reinforce the relationship between sexual behaviors and attitudes found in different studies (e.g., Blanc, 2021; Blanc, Sayans-Jiménez, et al., 2018). For example, it has been found that people with more permissive or erotophilic sexual attitudes engage in a greater number of different sexual behaviors (Blanc, 2021; Blanc, Sayans-Jiménez, et al., 2018), do so more frequently (García-Vega et al., 2017), and have more sexual partners than those who are less permissive or erotophilic (Leri & DelPriore, 2021). More specifically, it has also been found that more permissive or erotophilic individuals engage in more online sexual behaviors than less permissive or erotophilic individuals (Byers & Shaughnessy, 2014; Scandurra et al., 2022).
Attitudes toward sexual behaviors have been found to mediate the relationship between gender and sexual behaviors, with men engaging in a greater number of sexual behaviors than women because they have more positive attitudes toward them (Blanc, 2021). Similarly, attitudes toward sexual behaviors could also mediate the relationship between sexual orientation and number of sexual behaviors, and HB people may engage in a greater number of sexual behaviors due to more positive attitudes toward them. Thus, differences in sexual behaviors among people of different sexual orientations could be due to differences in their sexual attitudes.
Despite the relationship between sexual orientation and sexual behaviors and attitudes found in different studies (e.g., Leri & DelPriore, 2021), relatively few studies in Spain have compared sexual behaviors and attitudes among people of different sexual orientations (Castro, 2016). Most of the studies have been conducted in the United States. And while studies comparing sexual risk behaviors (e.g., Blanc & Rojas, 2018), specific sexual behaviors (e.g., Blanc & Rojas, 2017), or sexual attitudes between men and women (e.g., Sierra et al., 2021) have been carried out, most have focused on heterosexuals. In addition, to date, no study has analyzed the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and sexual behaviors in any country.
Therefore, the objectives of this study were: (Aim 1) to explore the relationship between sexual orientation and various specific sexual behaviors (caressing in intimate areas, oral sex, partner masturbation, sexual fantasies, solo masturbation, cybersex, sexting, threesomes, and group sex); (Aim 2) to examine the link between sexual orientation and sexual risk behaviors (age of sexual debut, number of sexual partners, and frequency of condom use); (Aim 3) to analyze and compare the number of sexual behaviors engaged in and attitudes toward sexual behaviors among people of different sexual orientations, and (Aim 4) to test the mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors engaged in. Due to the previously reported differences between men and women in the behaviors and attitudes toward sexual behaviors found in some studies in Spain (e.g., Blanc, 2021; Blanc & Rojas, 2017, 2018), the gender variable will be controlled or included in all analyses. In addition, due to the discrepancy in the results of the previous studies, the results will be separated according to gender, and three sexual behaviors will be differentiated (vaginal intercourse, oral sex, and anal sex) for the indicators of sexual risky behaviors.
Materials and methods
Participants
A total of 2288 people between 18 and 35 years of age (M = 23.23; SD = 3.87), selected by convenience and snowball sampling, participated in the study. Of the sample, 60.3% were women (n = 1380), and 39.7% were men (n = 908). A total of 58.9% had completed vocational training or high school (n = 1358), 33.5% had completed university studies (n = 767), 6.7% had completed compulsory secondary education (n = 153), and 0.9% had no education or had completed primary education (n = 20). In addition, 74.9% identified as heterosexual (n = 1714: number of women = 1009; number of men = 705), 9.2% as homosexual (n = 210: number of women = 81; number of men = 129), and 15.9% as bisexual (n = 364: number of women = 290; number of men = 74).
Measures
Sociodemographic variables
We gathered information about gender, age, educational level, and sexual orientation (heterosexual, homosexual, bisexual, or other orientation).
Checklist of sexual behaviors (Blanc, Sayans-Jiménez, et al., 2018)
This checklist measures the number of sexual behaviors engaged in ever and includes the following nine sexual behaviors: caressing in intimate areas, oral sex, partner masturbation, sexual fantasies, solo masturbation, cybersex, sexting, threesomes, and group sex. Participants had to select whether they had engaged in each sexual behavior. If they had not engaged in the sexual behavior, they were assigned a score of 0, and if they had engaged in such a behavior a score of 1 (with scores ranging from 0 to 9). The reliability estimated by Kuder-Richardson 20 [(k/k − 1)*(1 − Σpq/σ2] was .717 and .767 for women and men, respectively, and .729, .792, and .741 for people with a heterosexual, homosexual, and bisexual orientation, respectively.
Indicators of sexual risk behaviors (Blanc & Rojas, 2018)
Those who indicated performing vaginal intercourse, oral sex, and/or anal sex were asked the following questions:
Age of sexual debut in vaginal intercourse, oral sex, and anal sex: at what age (years) did you have your first experience of sexual intercourse where you engaged in …?
The number of sexual partners in vaginal intercourse, oral sex, and anal sex: with how many different persons have you engaged in …?
Frequency of condom use during vaginal intercourse, oral sex, and anal sex: how often have you used a condom during…? Response options ranged from 1 (never) to 5 (always).
Scale of attitudes toward sexual behaviors (Blanc, Byers, et al., 2018, 2020)
This instrument measures attitudes toward specific sexual behaviors in different contexts (Please indicate how positively or negatively you feel about engaging in the following behaviors with a casual partner. Example: Oral sex with a casual partner). The Likert-type version was used with five response options from 1 (very negative) to 5 (very positive). This study excluded items that include sexual behaviors that are impossible to perform in sexual relations between two women and between two men (items referring to anal sex and vaginal intercourse). Therefore, to obtain the total score, the response to 18 items was considered, with scores ranging from 18 to 90, where a higher score indicates a more positive attitude toward sexual behaviors. Cronbach’s alpha coefficient for reliability was .901 and .908 for women and men, respectively, and .901, .898, and .894 for people with a heterosexual, homosexual, and bisexual orientation, respectively.
Procedure
The participants answered the questionnaire online. After reading the study information sheet, individuals had to give informed consent before participating. The questionnaire took ∼10 min to complete. The study was approved by the Bioethics Committee of the Junta de Andalucía.
Data analysis
For aim 1, the percentage of people who had engaged in each of the nine sexual behaviors was calculated, differentiating between gender and sexual orientation, while the relationship with sexual orientation was analyzed using chi-square, and Cramer’s V. These percentages were compared between the different sexual orientations. Pairwise comparisons were performed correcting p-values using the Bonferroni method. For aim 2, descriptive statistics (M and SD) of the age of sexual debut, number of sexual partners, and frequency of condom use in vaginal intercourse, oral sex, and anal sex were calculated, differentiating between gender and sexual orientation. To analyze the effect of sexual orientation and gender on these variables in each of the behaviors, two-factor ANOVAs were conducted in which sexual orientation and gender were included as independent variables, and age as a covariate. For aim 3, an analysis of the descriptive statistics (M and SD) of the number of sexual behaviors engaged in and attitudes toward sexual behaviors were carried out, differentiating between gender and sexual orientation. The number of sexual behaviors engaged in and attitudes toward sexual behaviors were treated as continuous variables. A multivariate analysis of covariance (MANCOVA) was conducted to test for statistically significant differences in the number of behaviors and sexual attitudes according to sexual orientation and gender. This MANCOVA included the number of sexual behaviors and attitudes toward sexual behaviors as dependent variables, sexual orientation and gender as independent variables, and age as a covariate. When statistically significant interaction effects were found, simple main effects analyses were conducted using the Bonferroni statistic. The effect size was calculated using partial eta squared (η2p). Finally, for aim 4, three simple mediation models were applied to analyze the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors: one for the total sample, one for women, and one for men. In the mediation models, sexual orientation (1 = heterosexual; 2 = homosexual and bisexual) was used as the independent variable (X), attitudes toward sexual behaviors as the mediating variable (M), and the number of sexual behaviors as the dependent variable (Y). In addition, age was included as a covariate. In the mediation analyses, 5000 bootstrapping samples were used, and a 95% confidence level was used to construct the intervals to determine whether the indirect effects were statistically significant. Indirect effects are significant when the confidence interval does not include the value 0. The analyses were conducted using SPSS version 25 and the PROCESS macro.
Results
Sexual behaviors (aim 1)
Table 1 shows the percentage of people who have engaged in each of the sexual behaviors, differentiating between gender and sexual orientation. In women, the percentage who have engaged in oral sex is significantly higher in heterosexuals and bisexuals than in homosexuals. The percentage who reported having engaged in solo masturbation is higher in bisexuals than in heterosexuals. Finally, the percentage of women who have engaged in cybersex, sexting, and threesomes is higher in homosexuals and bisexuals than in heterosexuals. In men, the percentage who have engaged in partner masturbation is higher in homosexuals than in heterosexuals and bisexuals. Finally, the percentage of men who have engaged in cybersex, sexting, and threesome, is higher in homosexuals and bisexuals than in heterosexuals, and the percentage who have engaged in sex group is higher in homosexuals than in heterosexuals.
Table 1.
Percentage of People Who Have Engaged in Each of the Sexual Behaviors, Differentiating between Gender and Sexual Orientation, Chi-Square Test, Cramer’s V, and Contrasts of Proportions.
| Sexual behavior | Gender | Heterosexual % (n) | Homosexual % (n) | Bisexual % (n) | χ 2 | Cramer’s V |
|---|---|---|---|---|---|---|
| Caresses in intimate areas | Women | 94.4% (952)a | 88.9% (72)a | 92.8% (269)a | 4.333 | .056 |
| Men | 89.5% (631)a | 92.2% (119)a | 85.1% (63)a | 2.544 | .053 | |
| Oral sex | Women | 88.3% (891)a | 77.8% (63)b | 89.3% (259)a | 8.500* | .078 |
| Men | 87.4% (616)a | 91.5% (118)a | 86.5% (64)a | 1.867 | .045 | |
| Partner masturbation | Women | 87.9% (887)a | 82.7% (67)a | 85.9% (130)a | 2.373 | .041 |
| Men | 82.6% (582)a | 91.5% (118)b | 77.0% (57)a | 8.596* | .097 | |
| Sexual fantasies | Women | 87.5% (883)a | 86.4% (70)a | 90.3% (262)a | 1.932 | .037 |
| Men | 87.1% (614)a | 89.9% (116)a | 89.2% (66)a | 0.981 | .033 | |
| Solo masturbation | Women | 85.7% (865)a | 88.9% (81)a,b | 92.8% (269)b | 10.279** | .086 |
| Men | 90.9% (641)a | 93.8% (121)a | 91.9% (68)a | 1.173 | .036 | |
| Cybersex | Women | 26.6% (268)a | 42.0% (34)b | 41.4% (120)b | 28.564** | .144 |
| Men | 32.5% (229)a | 57.4% (74)b | 51.4% (38)b | 35.328** | .197 | |
| Sexting | Women | 55.2% (557)a | 69.1% (56)b | 68.6% (199)b | 20.511** | .122 |
| Men | 59.4% (419)a | 79.1% (102)b | 74.3% (55)b | 22.247* | .157 | |
| Threesome | Women | 4.4% (44)a | 11.1% (9)b | 11.0% (32)b | 21.008** | .123 |
| Men | 10.6% (75)a | 33.3% (43)b | 25.7% (19)b | 50.889** | .237 | |
| Group sex | Women | 0.8% (8)a | 1.2% (1)a | 1.7% (5)a | 1.987 | .038 |
| Men | 3.3% (33)a | 12.4% (16)b | 6.8% (5)a,b | 20.398** | .150 |
Note. Each letter (a, b) denotes a subset of sexual orientation categories whose column proportions do not differ significantly from each other at the .05 level. Groups that share the same letter are not significantly different. If 2 groups have “a,” they are not different; if one has “a” and the other “b,” they are different. If a group has “a, b,” they are not different from groups who have “a” nor from groups who have “b.”
*p < .05; **p < .01.
Indicators of sexual risk behaviors (aim 2)
Table 2 shows the means and standard deviations of the age of sexual debut, number of sexual partners, and frequency of condom use in vaginal intercourse, oral sex, and anal sex, differentiating between gender and sexual orientation.
Table 2.
Descriptive Statistics of Age of Sexual Debut, Number of Sexual Partners, and Frequency of Condom Use in Vaginal Intercourse, Oral Sex, and Anal Sex, Differentiating between Gender and Sexual Orientation.
| Gender | Heterosexual | Homosexual | Bisexual | ||
|---|---|---|---|---|---|
| M (SD) | M (SD) | M (SD) | |||
| Age of sexual debut | Vaginal intercourse | Women | 16.41 (2.01) | 16.80 (1.85) | 16.33 (1.98) |
| Men | 16.83 (2.21) | 16.45 (2.07) | 16.04 (2.22) | ||
| Oral sex | Women | 17.08 (2.22) | 17.62 (2.59) | 16.42 (2.00) | |
| Men | 16.97 (2.32) | 16.53 (2.64) | 16.28 (2.26) | ||
| Anal sex | Women | 19.76 (3.16) | 21.12 (3.04) | 18.48 (2.45) | |
| Men | 19.52 (3.23) | 17.86 (2.89) | 18.00 (3.03) | ||
| Number of sexual partners | Vaginal intercourse | Women | 5.13 (3.60) | 5.25 (3.48) | 5.86 (3.86) |
| Men | 5.81 (3.72) | 4.00 (3.98) | 4.04 (3.13) | ||
| Oral sex | Women | 4.03 (3.21) | 4.56 (3.20) | 5.37 (3.66) | |
| Men | 5.15 (3.68) | 7.93 (3.66) | 5.41 (3.78) | ||
| Anal sex | Women | 1.59 (1.16) | 1.73 (0.92) | 2.19 (2.05) | |
| Men | 2.32 (2.22) | 6.71 (3.87) | 4.15 (3.84) | ||
| Frequency of condom use | Vaginal intercourse | Women | 3.51 (1.02) | 2.85 (1.53) | 3.60 (1.15) |
| Men | 3.49 (1.09) | 3.82 (1.33) | 4.18 (1.03) | ||
| Oral sex | Women | 1.38 (0.84) | 1.32 (0.71) | 1.44 (0.84) | |
| Men | 1.33 (0.80) | 1.58 (1.06) | 1.45 (0.94) | ||
| Anal sex | Women | 2.01 (1.50) | 1.27 (0.67) | 2.20 (1.56) | |
| Men | 2.34 (1.59) | 3.92 (1.01) | 3.80 (1.55) |
Age of sexual debut
For the age of initiation of vaginal intercourse, there is no effect of sexual orientation [F(2,1790) = 1.905; p = .149], gender [F(1,1790) = 0.444; p = .505], or interaction effect [F(2,1790) = 2.970; p = .052].
For the age of initiation of oral sex, there is the effect of sexual orientation [F(2,2004) = 5.351, p = .005, η2p = .005], and gender [F(1,2004) = 7.897, p = .005, η2p = .004]. The interaction effect between gender and sexual orientation is not statistically significant [F(2,2004) = 2.628, p = .072]. Multiple a posteriori comparisons revealed differences between heterosexuals and bisexuals (p = .003).
A statistically significant interaction effect was found between gender and sexual orientation (Figure 1) for the age of onset of anal sex [F(2,943) = 7.306, p < .001, η2p = .015]. Simple effects analyses show statistically significant differences between men and women who are heterosexual (p = .026) and homosexual (p < .001). Simple effects analyses also show that in women, there are differences between heterosexual and bisexual women (p = .016) and between homosexual and bisexual women (p = .008). In men, differences were found between heterosexuals and homosexuals (p < .001).
Figure 1.
Age of sexual debut, differentiating between gender and sexual orientation.
Number of sexual partners
A statistically significant interaction effect was found between sexual orientation and gender (Figure 2) for the number of sexual partners in the three behaviors of vaginal intercourse [F(2,1790) = 10.503, p < .001, η2p = .012], oral sex [F(2,2004) = 13.520, p < .001, η2p = .013], and anal sex [F(2,943) = 41.683, p < .001, η2p = .081].
Figure 2.
Number of sexual partners, differentiating between gender and sexual orientation.
For the number of partners in vaginal intercourse, the analyses of the simple effects show statistically significant differences between men and women in heterosexuals (p = .002) and bisexuals (p = .001). In women and men, there are differences between heterosexuals and bisexuals (p < .001 and p = .012).
For the number of partners in oral sex, the simple effects analyses show statistically significant differences between men and women for both heterosexuals (p < .001) and homosexuals (p < .001). In women, there are statistically significant differences between heterosexual and bisexual women (p < .001) and between homosexual and bisexual women (p = .019). In men, differences were found between heterosexuals and homosexuals (p < .001) and between homosexuals and bisexuals (p < .001).
For the number of partners in anal sex, simple effects analyses revealed statistically significant differences between men and women for all sexual orientations: heterosexual (p < .001), homosexual (p < .001), and bisexual (p < .001). In women, there are statistically significant differences between heterosexuals and bisexuals (p = .004). In men, differences were found between heterosexuals and homosexuals (p < .001), heterosexuals and bisexuals (p < .001), and between homosexuals and bisexuals (p < .001).
Frequency of condom use
A statistically significant interaction effect was found between sexual orientation and gender (Figure 3) for the frequency of condom use during the three behaviors of vaginal intercourse [F(2,1790) = 7.811, p < .001, η2p = .009], oral sex [F(2,2004) = 3.197, p = .041, η2p = .003], and anal sex [F(2,943) = 30.331, p < .001, η2p = .060].
Figure 3.
Frequency of condom use, differentiating between gender and sexual orientation.
For the frequency of condom use during vaginal intercourse, analyses of simple effects revealed statistically significant differences between men and women—both homosexuals (p = .007) and bisexuals (p = .001). In women, there are statistically significant differences between heterosexual and homosexual women (p < .001) and between homosexual and bisexual women (p < .001). In men, differences were found between heterosexuals and bisexuals (p < .001).
For the frequency of condom use during oral sex, simple effects analyses revealed statistically significant differences between men and women for homosexuals (p = .028). In men, differences were found between heterosexuals and homosexual (p = .011).
For the frequency of condom use during anal sex, simple effects analyses revealed statistically significant differences between men and women across all sexual orientations: heterosexual (p = .008), homosexual (p < .001), and bisexual (p < .001). In women, there are statistically significant differences between heterosexual and homosexual women (p = .027) and between homosexual and bisexual women (p = .005). In men, differences are found between heterosexuals and homosexuals (p < .001) and between heterosexuals and bisexuals (p < .001).
Number of different sexual behaviors and attitudes toward sexual behaviors (aim 3)
Table 3 shows the means and standard deviations of the scores on the number of different sexual behaviors engaged in and attitudes toward sexual behaviors, differentiating between gender and sexual orientation. Again, the MANCOVA results show that there is an interaction effect (Figure 4) between gender and sexual orientation [Wilk’s Λ = 0.995, F(4, 4558) = 2.934, p = .020, η2p = .003].
Table 3.
Descriptive Statistics of the Scores on the Number of Different Sexual Behaviors Engaged in and Attitudes toward Sexual Behaviors, Differentiating between Gender and Sexual Orientation.
| Gender | Heterosexual M (SD) |
Homosexual M (SD) |
Bisexual M (SD) |
|
|---|---|---|---|---|
| Number of sexual behaviors | Women | 5.31 (1.62) | 5.48 (2.03) | 5.74 (1.71) |
| Men | 5.43 (1.87) | 6.41 (1.89) | 5.88 (2.01) | |
| Attitudes toward sexual behaviors | Women | 67.15 (10.87) | 69.74 (10.55) | 72.85 (9.66) |
| Men | 69.44 (11.07) | 73.58 (10.76) | 73.23 (12.15) |
Figure 4.
Number of different sexual behaviors engaged in and attitudes toward sexual behaviors, differentiating between gender and sexual orientation.
Concerning sexual behaviors, analyses of simple effects revealed differences between men and women only in people with a homosexual orientation (p < .001). In women, statistically significant differences were found between heterosexual and bisexual women (p < .001). In men, differences are found between heterosexuals and homosexuals (p < .001).
In attitudes toward sexual behaviors, simple effects analyses revealed statistically significant differences between men and women in heterosexuals (p < .001) and homosexuals (p = .012). In women, there are statistically significant differences between heterosexual and bisexual women (p < .001). In men, differences are found between heterosexuals and homosexuals (p < .001) and between heterosexuals and bisexuals (p = .011).
The mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors engaged in (aim 4)
Figure 5 shows the mediation analyses for the total sample, women, and men. The indirect (mediation) effect of sexual orientation on the number of sexual behaviors is statistically significant in all three cases. The only difference is the direct effect (c′) that is statistically significant for men but not women. This indicates that while there is a total mediation effect of attitudes toward sexual behavior in the relationship between sexual orientation and the number of sexual behaviors in women, in men this mediation is only partial.
Figure 5.
Mediation models to analyze the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors.
Discussion
The higher incidence of sexually transmitted infections in HB people compared to heterosexuals has prompted studies exploring the link between sexual orientation and sexual risk behaviors (e.g., Pham et al., 2021; Travers et al., 2022). In addition, some research has also related sexual orientation with specific sexual behaviors (Thompson et al., 2021) and with sexual attitudes (Leri & DelPriore, 2021). However, in Spain, few studies have compared sexual behaviors and attitudes among people of different sexual orientations. In addition, the fact that HB people engage in more sexual behaviors (Scandurra et al., 2022; Thompson et al., 2021) while having more permissive sexual attitudes (Silva et al., 2021) than heterosexuals could be because such attitudes mediate the relationship between sexual orientation and number of sexual behaviors. However, the mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and number of sexual behaviors has not been tested in any country.
The first objective of the study was to explore the link between sexual orientation and specific sexual behaviors. In line with previous studies (Scandurra et al., 2022; Thompson et al., 2021), the percentage of HB people, both men and women, who have engaged in cybersex, sexting, and threesomes are higher than heterosexuals. In Spain, Gámez-Guadix et al. (2017) also found that HB people engaged in sexting more than heterosexuals. Moreover, consistent with other studies (Træen & Daneback, 2013), it has been found that a higher percentage of bisexual women have engaged in solo masturbation than heterosexual women.
The second objective of this study was to explore the link between sexual orientation and sexual risk behaviors. Regarding the age of initiation of oral sex, it is evident that bisexuals initiate earlier than heterosexuals. Regarding the age of initiation of anal sex, bisexual women initiate earlier than heterosexual and homosexual women. Pham et al. (2021) also found that bisexual people initiated sexual intercourse earlier than heterosexuals, although they did not specify which sexual behaviors. For anal sex, homosexual men have been found to initiate earlier than heterosexual men. Other studies (Coble et al., 2017; Glick et al., 2012; Hipwell et al., 2013) have also found that HB people initiate sex earlier than heterosexuals, but they did not specify which sexual behaviors. Overall, these results show that bisexuals initiate oral sex earlier than heterosexuals, and bisexual women and homosexual men initiate anal sex earlier than heterosexuals.
Regarding the number of partners, in line with the current study, in Spain, Blanc and Rojas (2018) found that men heterosexuals had more partners in oral sex than women, while Castro (2016) found, in a sample of university students of different sexual orientations, that men had more partners in anal sex than women. Castro (2016) also found that HB men had more partners in anal sex that heterosexual men. Likewise, the results are similar to other studies carried out in other countries (e.g., Kerr et al., 2013; Oswalt & Wyatt, 2013). Overall, these results suggest that bisexual women and homosexual men have more sexual partners in oral and anal sex than heterosexuals.
Regarding the frequency of condom use, in anal sex, men used condoms more frequently than women across all sexual orientations. Other studies (e.g., Rotermann & McKay, 2020) have also shown that men use condoms more frequently than women. In Spain, Castro (2016) found that HB men used condoms in anal sex more than heterosexual women. On the other hand, heterosexual and bisexual women reported using condoms more frequently in vaginal intercourse and anal sex than homosexual women. In vaginal intercourse, bisexual men used condoms more frequently than heterosexual men, and in anal sex, as in previous studies (De Santis et al., 2015; Glick et al., 2012; Vasquez et al., 2017), HB men used condoms more frequently than heterosexual men. In this line, homosexual men used condoms more frequently than heterosexual men in oral sex. These results can show differences in risk according to sexual orientation.
The third objective of this study was to compare the number of sexual behaviors engaged in and attitudes toward sexual behaviors between people of different sexual orientations. We found that bisexual women engaged in a greater number of sexual behaviors and had more positive attitudes toward sexual behaviors than heterosexual women. In a recent study, Leri and DelPriore (2021) also found differences in sexual attitudes between bisexual and heterosexual women. In men, homosexuals engaged in a greater number of sexual behaviors than heterosexuals, and HB men had more positive attitudes toward sexual behaviors than heterosexuals. In general, these results are in accordance with previous studies (Lentz & Zaikman, 2021; Leri & DelPriore, 2021; Silva et al., 2021), suggesting that HB people engage in a wider variety of sexual behaviors and have more positive attitudes toward sexual behaviors than heterosexuals. These results are consistent with the differential psychosocial stress hypothesis, which proposes that HB people should have more permissive sexual attitudes than their heterosexual counterparts because they experience more psychosocial stress due to the stigma (Leri & DelPriore, 2021).
Our final objective was to explore the possible mediating effect of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors engaged in. This mediating effect was confirmed for both men and women. However, although this mediation effect is total for women, in men, it is only partial. Thus, homosexual and bisexual women could engage in a greater number of sexual behaviors than heterosexual women because they have more positive attitudes toward sexual behaviors. Unlike women, in men, the mediating effect could be partial because, as has been found in other studies (Blanc, Sayans-Jiménez, et al., 2018), in men the relationship between sexual attitudes and the number of sexual behaviors engaged in is lower than in women. Therefore, in men, other variables, in addition to these attitudes, could be influencing their sexual behavior.
Strengths and limitations
These results support the relevance of considering not only gender but also sexual orientation when analyzing sexual behaviors and attitudes. Furthermore, our findings highlight the importance of distinguishing between different sexual behaviors when exploring the age of sexual debut, number of sexual partners, and frequency of condom use. However, it is also worth bearing in mind that one of the limitations of our study is that the participants were not selected through probability sampling. This limitation could influence, to some extent, the generalizability of the results. However, being aware of this limitation, we attempted to mitigate its impact by using a sample of considerable size. Another limitation is how sexual orientation has been measured. Participants were asked to self-identify with different options that may be rigid. If the Kinsey rating had been administered, greater diversity could have been found in the sexual orientation of the participants. The greater diversity could have explained some results.
Conclusions
Despite the limitations, the findings of the present study indicate that bisexual women have reported engaging in a greater number of different sexual behaviors, their age of onset for oral and anal sex is lower, and they have had more sexual partners in vaginal intercourse, oral sex, and anal sex compared with heterosexuals, and in some cases also with homosexuals. Moreover, their attitudes toward sexual behaviors are more positive than those of heterosexual women. In the case of men, the percentage of HB people who have engaged in cybersex, sexting, and threesomes is higher than in heterosexuals. In addition, the number of sexual partners for anal sex is higher in HB people than in heterosexuals. In this line, attitudes toward the sexual behaviors of HB men are more positive than those of heterosexual men. Finally, it is important to highlight the mediating role of attitudes toward sexual behaviors in the relationship between sexual orientation and the number of sexual behaviors, especially in women.
Practical implications
It should also be noted that these results suggest the need to emphasize the use of condoms in sexual prevention programs, especially for women and heterosexual men when engaging in vaginal intercourse and anal sex. In the sexual prevention programs, condom use should also be promoted in oral sex because the frequency of use is very low in this sexual behavior. On the other hand, the results presented here indicate the importance of considering attitudes toward sexual behaviors if we wish to modify certain sexual behaviors, especially in the case of women. Therefore, in the clinical setting, sex therapists should give great weight to attitudes toward sexual behaviors. For example, if they want to promote certain sexual behaviors in couple relationships, they should encourage positive attitudes toward them.
Funding Statement
The author(s) reported there is no funding associated with the work featured in this article.
Ethical approval
The study was approved by the Bioethics Committee of the Junta de Andalucía.
Informed consent
The informed consent was obtained from all participants.
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
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