{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:17:54Z","timestamp":1778602674622,"version":"3.51.4"},"reference-count":34,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"unspecified","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22K17329"],"award-info":[{"award-number":["JP22K17329"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001459","name":"Ministry of Education - Singapore","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/501100001459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001350","name":"Ministry of Health -Singapore","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/501100001350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJPR22R3"],"award-info":[{"award-number":["JPMJPR22R3"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,3,18]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sexual behaviour data are essential for monitoring sexual behavioural trends and designing effective sexual health interventions. In Singapore and other Southeast Asian countries, where research has largely focused on key populations, this study aimed to characterise sexual behaviour patterns in the general adult population and their associations with socio-demographics, engagement with sex workers and sexually transmitted infection (STI) positivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide cross-sectional survey (September 2023 to July 2024) using voluntary response sampling among adults aged \u226521 years, collecting data on socio-demographics and sexual behaviours in the past year, 6 months and 3 months. Partner numbers and sexual activity frequency were modelled using a Lomax distribution across partnered activities (mutual masturbation, oral, vaginal sex and anal sex), and associations with socio-demographics, sex worker engagement and self-reported STI positivity were evaluated using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 2297 eligible participants, 51.5% were male (1183) and 95.6% were aged 21\u201360 years (2195). Individuals reporting same-sex partners were more likely to have five or more same-sex partners in the past year. The model-estimated prevalence of engaging with sex workers among individuals aged 21\u201360 years in Singapore was 4.7% (95% CI 3.7 to 6.2) for females and 18.1% (95% CI 16.1 to 20.4) for males, with higher odds among those with at least five partners in the past year (eg, vaginal sex AOR=7.40, 95%\u2009CI 4.03 to 13.58). Self-reported STI positivity was associated with having at least five partners in the past year (eg, vaginal sex AOR=5.03, 95%\u2009CI 1.44 to 17.61)\u2009and ever engaging with sex workers (eg, vaginal sex AOR=3.16, 95% CI 1.67 to 5.99), but not with barrier protection frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patterns varied by sex, sexual orientation and risk behaviours, underscoring the need for context-specific behavioural data to inform STI modelling and public health interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004042","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T15:50:41Z","timestamp":1778601041000},"page":"e004042","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Partnership-based sexual behaviours among adults in Singapore: a cross-sectional population survey"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3533-5762","authenticated-orcid":false,"given":"Janhavi","family":"A","sequence":"first","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Gan","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Endo","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"},{"name":"School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rayner Kay Jin","family":"Tan","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Howard","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"},{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiesha","family":"Prem","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Ho","sequence":"additional","affiliation":[{"name":"National University of Singapore Department of Communications and New Media, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0079-7390","authenticated-orcid":false,"given":"Shihui","family":"Jin","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1592-1745","authenticated-orcid":false,"given":"Borame L","family":"Dickens","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"2026051208501304000_4.2.e004042.1","doi-asserted-by":"publisher","DOI":"10.1177\/0022146516661597"},{"key":"2026051208501304000_4.2.e004042.2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jsxm.2020.10.008","article-title":"Benefits of sexual activity on psychological, relational, and sexual health during the COVID-19 breakout","volume":"18","author":"Mollaioli","year":"2021","journal-title":"J Sex Med"},{"key":"2026051208501304000_4.2.e004042.3","doi-asserted-by":"crossref","unstructured":"Hogben M , Leichliter J , Aral SO . An overview of social and behavioral determinants of STI. In: Cristaudo A , Giuliani M , eds. Sexually transmitted infections: advances in understanding and management [Internet]. Cham: Springer International Publishing, 2020: 25\u201345. Available: https:\/\/doi.org\/10.1007\/978-3-030-02200-6_3","DOI":"10.1007\/978-3-030-02200-6_3"},{"key":"2026051208501304000_4.2.e004042.4","unstructured":"United Nations Population Fund, United Nations Educational, Scientific and Cultural Organization . Sexual and reproductive health of young people in Asia and the Pacific [Internet]. 2015. 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