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CONTEXT: Public policies promoting abstinence until marriage attempt to influence the sexual behavior of the more than 18 million American women who are currently single. An analysis of these women’s behavior is needed to inform policies that are responsive to their sexual and reproductive health needs.

METHODS: Sexual behaviors, risk factors and reproductive health needs were examined among a nationally representative sample of 6,493 women aged 20–44 from the 2002 National Survey of Family Growth. Paired t tests were used to assess differences among single, married and cohabiting women by selected demographic, behavioral and risk measures.

RESULTS: Thirty-six percent of women aged 20–44 are single, and nine in 10 single women are sexually experienced. Seventy percent of the latter women are currently sexually active; on average, they had intercourse in seven of the last 12 months. A higher proportion of single women (22%) than of cohabiting (9%) or married women (2%) have had two or more partners in the past year, and half of single women are at risk of unintended pregnancy. Furthermore, single women and cohabiting women are more likely to lack health insurance than are married women (21–25% vs. 12%).

CONCLUSIONS: Because of the high level of sexual activity among single adult women, providers must address their reproductive health care needs and offer appropriate counseling and services. Government policies aimed at encouraging adult women to have sex only within marriage appear out of touch with the reality of the sexual behavior of single women.