Prevalence of Sexual Choking Among Adults Aged 18 Years and Above: A Systematic Review of Quantitative Studies

<ns5:p>Background Sexual choking has become increasingly visible within contemporary sexual culture, particularly among adolescents and young adults. Although often portrayed as pleasurable or adventurous, it may involve important physical, neurological, mental health, and sexual health risks. Evidence relating to prevalence and associated outcomes remains fragmented across populations and study designs. Objective To synthesise quantitative evidence on the prevalence of sexual choking among adults aged 18 years and above and examine variation by age, gender, region, recall period, and study design, alongside reported health outcomes and methodological limitations. Methods MEDLINE, CINAHL, and APA PsycINFO were systematically searched from database inception to March 2026. Searches were limited to peer-reviewed English-language studies. Supplementary searches included Google Scholar and backward and forward citation chasing. Quantitative studies reporting prevalence estimates of sexual choking among adults were included. Screening, study selection, and quality appraisal followed PRISMA guidance and Joanna Briggs Institute critical appraisal criteria. Due to substantial heterogeneity, narrative synthesis was undertaken. Results Thirteen studies met the inclusion criteria, primarily from the United States (n = 10), with additional studies from Australia (n = 2) and Italy (n = 1). Lifetime prevalence of being choked during sex ranged from 11.0% to 67.0%, with the highest prevalence generally reported among women and younger university populations. Women more commonly reported being choked, whereas men more frequently reported choking a partner. Reported symptoms included breathing difficulty, difficulty swallowing, inability to speak, dizziness, altered consciousness, and loss of consciousness or fainting. Limited evidence additionally identified associations with psychological distress and changing sexual and contraceptive practices. Conclusion Sexual choking appears increasingly prevalent among young adults and may represent an emerging public health concern. Future research should prioritise longitudinal designs, standardised measurement approaches, and more diverse populations.</ns5:p>