British sexual attitudes and behaviors are changing, survey reveals

Results of the nation’s largest scientific study of sexual health and lifestyles are reported in The Lancet

Results published in The Lancet this week give the most detailed picture yet of the British population's sex lives over the last 10 years as part of the third National Survey of Sexual Attitudes and Lifestyles (Natsal) survey.

Over 15,000 adults aged 16-74 participated in interviews between September 2010 and August 2012. Studying this  large representative sample of people living in Britain allowed the researchers to  produce key estimates on patterns of sexual behavior, attitudes, health and well being across the population.

Two previous Natsal surveys have taken place, in 1990 and 2000, making it one of the biggest and most comprehensive studies of sexual behavior undertaken in a single country.

The results from the latest survey take into account for the first time the views and experiences of older individuals up to the age of 74 and show that many people remain sexually active well into later life.

Results from the survey show that different aspects of sexual health affect people at different times throughout their lives, and that sexual health is an important component of our overall health and well being. They also reveal how sexual attitudes and  lifestyles have changed in the last sixty years.[divider]

Watch the video infographic

[divider]Study Principal Investigator Dame Anne Johnson, Professor of Infectious Disease Infection & Population Health at University College London, wrote:

By taking a robust scientific approach to assessing the sexual health and lifestyles of people from across Britain in 2010, and in previous Natsal surveys, we now have a much greater understanding of the role that sex plays over the course of a person's lifetime. This new information will help to guide the sexual health and education services that people may need at different stages of their lives.  Although our results show that we are improving the uptake of some services, there are other areas where people may need more support and advice on health and sexual problems.

Positive sexual experiences are related to health and well being throughout the life course, and it's time for this to be given wider recognition by health workers, educators, and society as a whole.  We need to do more to create an environment in which  it is easier for people to discuss sexual  well-being as an integral part of the conversation we have with people about our health.

Dr. Kaye Wellings, study co-leader and Professor of Sexual & Reproductive Health Research at the London School of Hygiene & Tropical Medicine, commented:

The Natsal studies, along with others, reveal major changes in sexual behaviour over the last century, including earlier onset of sexual activity, increasing numbers of older people who are sexually active, a closing of the gap between men and women, and weakened links between sex and reproduction.

These changes now need to be reflected in research, clinical practice, and education. We need to start thinking about sex differently – sexual health is not merely the absence of disease, but the ability to have pleasurable and safe sexual experiences, free from coercion. Improving the quality of peoples' sexual experiences and their relationships will not just improve the effectiveness of sexual health programs, but is also something that is important in its own right.

The study was funded by the Medical Research Council and The Wellcome Trust, with additional funding from the Economic & Social Research Council and the Department of Health. The researchers carried out the survey at  UCL (University College London), the London School of Hygiene and Tropical Medicine, and NatCen Social Research.

There are six papers and a framing paper published in a special issue of the The Lancet.[divider]

What the studies found

 This video infographic illustrates the dramatic changes in sexual lifestyles and attitudes over the past 60 years, based on responses of over 45,000 people in the third Natsal Survey. All papers are freely available in a special issue of The Lancet. Here are the links along with headline results:

Framing sexual health research: adopting a broader perspective — Introduction to the third Natsal study by lead authors Professor Dame Anne M Johnson and Professor Kaye Wellings

Changes in sexual attitudes and lifestyles in Britain through the life course and over time

  • Biggest changes in behavior seen amongst women
  • People have sex at an early age and continue into their 70s
  • Average frequency of sex reported by men and women declines
  • People are more accepting of same-sex relationships, but less tolerant of married people having sex outside of marriage

Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain

  • Chlamydia and human papillomavirus (HPV) remain common and broadly distributed in sexually-active young adults in Britain, while HIV and gonorrhoea are restricted to those with known high risk factors.
  • Uptake of chlamydia testing in young people is high, as is coverage of HPV catch-up immunisation, with lower rates of HPV 16/18 now being seen in young women.
  • Substantial increases in sexual health service attendance and HIV testing, especially in those at highest risk, are welcomed, but continued efforts to maintain integrated services and encourage testing are needed.
  • STIs persist both in those accessing and those not accessing services, and risky sexual behaviours remain the major drivers.

The prevalence of unplanned pregnancy and associated factors in Britain

  • One in six pregnancies among women in Britain are unplanned
  • One in 60 women experience an unplanned pregnancy in a year

Sexual function in Britain

  • At least four out of 10 men and women have had a recent sexual problem, but only one in ten are distressed or worried about their sex life
  • Lack of interest in sex was one of the most commonly reported problems for both men and women, affecting three in every 20 (15%) men, and with women twice as likely as men to say that this had been an issue in the last year.

Associations between health and sexual lifestyles in Britain

  • One in six men and women feel that their health affects their sex life, but few seek help from health professionals
  • Only a quarter of men (24%) and under a fifth of women (18%) who say that ill-health affected their sex life in the past year sought help from a health professional, usually a GP


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