| Summary: | Women ages 60 and older vary in sexual behaviors. This study examined the prevalence of vaginal intercourse, outercourse, and receipt and performance of oral sex reported among 461 married/partnered women age ≥ 60 years in the United States and factors associated with these four sexual behaviors. Using data from the National Social Life, Health, and Aging Project, associations between participants’ socio-demographics, health indicators, sexual perceptions, communication, and sexual behaviors were examined. In the past year, 53.6% reported having vaginal intercourse, 56.0% outercourse, and 21.7% receiving and 20.6% performing oral sex. Women with depressive symptomology were less likely to report intercourse and outercourse (<i>p</i> < 0.05). Women endorsing pleasurable sex as necessary to maintain relationships were more likely to report all four behaviors (<i>p</i> < 0.01). Women who communicated openly with partners were more likely to report intercourse (<i>p</i> = 0.002), outercourse (<i>p</i> = 0.001), and performing oral sex (<i>p</i> = 0.025). Findings may inform strategies about positive sex perceptions and strengthening partner communication.
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