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Let's talk about sex: results from the third National Survey of Sexual Attitudes and Lifestyles

26 November 2013

Largest scientific study of sexual health and lifestyles in Britain reveals changing sexual attitudes and behaviour.
Natsal infographic

Results published today in The Lancet 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).

Led by the London School of Hygiene & Tropical Medicine in partnership with University College London (UCL) and NatCen Social Research, 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 behaviour, attitudes, health, and wellbeing 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 behaviour 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 timesthroughout their lives, and that sexual health is an important component of our overall health and wellbeing. They also reveal how sexual attitudes and lifestyles have changed in the last sixty years.

Study co-Principal Investigator, Professor Kaye Wellings, of the London School of Hygiene & Tropical Medicine, said: “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 programmes, but is also something that is important in its own right.”

Natsal 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.

Published across a series of six papers in The Lancet, key findings include:

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

  • Biggest changes in behaviour 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

Sexual health programmes making good progress, but sexually transmitted infections and risky sex still an issue

  • 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

First population prevalence estimates of unplanned pregnancy in Britain since 1989

  • 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 ten 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 twenty (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

  • 1 in 6 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

Lifetime prevalence, associated factors, and circumstances of non-volitional sex in women and men in Britain

  • One in ten women and roughly one in 70 men in Britain have reported that they have experienced non-volitional sex (sex against their will)
  • Of those who reported having had sex against their will, fewer than half (42.2% of women and 32.6% of men) had told anyone about it, and fewer still had reported it to the police (12.9 % of women and 8% of men)