Sexual attitudes and lifestyles in Britain: Highlights from Natsal-3

Sexual attitudes and lifestyles in Britain: Highlights from Natsal-3 We interviewed 15,162 men and women aged 16-74 between September 2010 and August 2012. They provided us with valuable information about their experiences, behaviours, and views which will shape our understanding of sexual health in Britain. Here we present highlights from our initial findings. The full articles can be found in The Lancet (www.thelancet.com/themed/natsal) and details of the study methodology are on the Natsal website (www.natsal.ac.uk). More results will be published in the coming months, so please check the Natsal website for updates. Natsal Changes in sexual behaviour Percentage of the population who have ever had same-sex experience (people aged 16-44) Percentage who had sexual intercourse with someone of the opposite sex before age 16 Natsal-1 Natsal-2 Natsal-3 1990-1991 1999-2001 2010-2012 This is the third Natsal survey that has been carried out in Britain: the first survey was undertaken in 1990–1991 and the second survey in 1999-2001. Age at interview 6% 8% 7% 31% 16-24 29% 4% 5% 5% Over the 1990s, we saw an increase in the number of opposite-sex partners people reported, and more people reporting same-sex experience. Over the last decade, we have only seen further increases for women, so the gender gap is narrowing. 26% 25-34 25% 10% 16% 27% 35-44 18% 4% 2% 5% 8% 27% 45-54 15% Average (mean) number of opposite-sex partners, lifetime (people aged 16-44) 17% 55-64 10% 100% of population Any same-sex experience Same-sex experience with genital contact Key 15% 65-74 4% Natsal-1 1990-1991 8.6 3.7 Median (middle) On average over the past two Natsal-1 2 number of Natsal-2 Natsal-2 9 12.6 6.5 occasions of sex decades there has 1999-2001 Natsal-3 3 in the past 4 weeks (people aged 16-44) been a decrease in how often people say they have sex. 11.7 Natsal-3 2010-2012 7.7 The bars represent the interquartile range: 50% of the population were in this range, 25% were below the lower value, and 25% were above the higher value. Different types of sex with people of the opposite-sex, past year Given/received oral sex Anal sex Other genital contact 0000 Vaginal sex 1 Age at interview I Age at interview 1 Age at interview 1 Age at interview 74% 16-24 75% 71% 16-24 71% 19% 16-24 17% 71% 16-24 73% 89% 25-34 91% 80% 25-34 80% 17% 25-34 16% 76% 25-34 77% 91% 35-44 89% 80% 35-44 75% 15% 35-44 13% 74% 35-44 73% 85% 45-54 81% 71% 45-54 63% 14% 45-54 8% 66% 45-54 62% 8% 55-64 4% 3% 65-74 |4% 75% 55-64 59% 52% 55-64 35% 56% 55-64 41% 57% 65-74 37% 30% 65-74 19% 37% 65-74 28% People continue to have sex at all ages, but the frequency and range of sexual practices decrease with age. While most people have had vaginal sex in the past year, other practices are less common, especially anal sex. Sex and health Percentage reporting a health condition that affected their sex life in the past year Overall, more than 60% of people reported having sex recently and over 60% of people said they were satisfied with their sex life. People in poorer health were less likely to have had sex recently, and less likely to say that they were satisfied. This was true even after taking age and whether people were in a relationship into account. However, ill health does not necessarily mean the end of an active or satisfying sex life: more than one in three people in bad or very bad health had had sex recently, and around half were satisfied with their sex lives. 1 in 6 Percentage reporting recent sexual activity (in past four weeks) Health status Health status Very good or good Fair, bad or very bad Of those, percentage who had sought help or advice from a healthcare Very good or good Fair, bad or very bad 100%- 100% - 24% 18% 80%- 80%- professional 60%- 60% - Almost one in six people said they had a health condition that affected their sex life in the past year, 40%- 40%- 20%- 20%- yet less than one in four of these men and one in five of these women said that they had tried to get help or advice from a healthcare professional. Those who had were most likely to have talked to their GP. 0% 16-24 25-34 35-44 45-54 55-64 65-74 0%- 16-24 25-34 35-44 45-54 55-64 65-74 Age at interview Age at interview Sexual function We asked men and women who had had sex in the past year whether they had experienced any sexual difficulties lasting three or more months in the past year, including lack of interest in having sex, feeling anxious during sex, pain during sex, vaginal dryness, and problems getting or keeping an erection. Had sex in No sex in past past year year Had sex in No sex in past past year year Dissatisfied with sex life Dissatisfied with sex life 15% 32% 12% 22% Sexual difficulties were common, even in young people. However, it was much less common for people to say that they were distressed or worried about their sex lives. Distressed or worried about sex life Distressed or worried about sex life 10% 15% 11% 10% Avoided sex because of sexual difficulties Avoided sex because of sexual difficulties 11% 21% 13% 17% People who hadn't had sex in the past year were more likely to say that they were dissatisfied with their sex life, and that they had avoided sex because of sexual difficulties (either theirs, or a partner's), compared with people who did have sex in the past year. However, only a minority of people who had not had sex in the past year said they were dissatisfied, distressed, or avoiding sex. Experienced one or more sexual difficulties 42% 51% Distressed or worried about sex life 10% 11% 1 in 4 men and women who are in a relationship said that their partner had experienced sexual difficulties in the past year. 1 in 5 men and women who are in a relationship do not share the same level of interest in sex as their partner. We created a sexual function score that took account of people's experience of sexual difficulties, their sexual relationship and how they rate their sex life. People with a lower sexual function score were more likely to report: finding it having been diagnosed with an STI having experienced sex against their will paying for sex (men only) having more partners (women only) relationship break-up being unhappy in their relationship difficult to talk about sex with a partner Sexually transmitted infections (STIS) Overall, around one in a hundred people aged 16-44 had chlamydia, although this varied by age, peaking at almost one in twenty women aged 18-19 and one in thirty men aged 20-24. Although people who reported more partners in the past year were more likely to have chlamydia, a lot of the chlamydia was found in people who reported only one partner in the past year, because most people only had one partner. We collected urine from a sample of men and women aged 16-44 which we tested anonymously for sexually transmitted infections (STIS), including chlamydia, gonorrhoea, human papillomavirus (HPV), and HIV. These findings are for men and women who have ever had sex. Percentage of people in the population with chlamydia 1 1 partner partner 2 3+ 2 3+ partners partners partners partners HPV was the most common STI, followed by chlamydia. HIV and gonorrhoea were found in around one in a thousand people. 0.7% 0.7% 4% 1.1% 3.2% 3.7% For more information about these STIS and where you can test for them you can visit the NHS website: www.nhs.uk/Livewell/STIS/Pages/STIS-hub.aspx Size of population People with chlamydia (percentage of that population) Key Over the past decade, national sexual health strategies in Britain have aimed to increase access to sexual health services and STI / HIV testing. Compared with the previous survey (1999-2001), more people reported having an HIV test or going to a sexual health clinic in the past 5 years. It is encouraging to see that these increases were even larger in those at highest risk, such as people who reported more partners. Sexual health clinic attendance, past 5 years (people aged 16-44) HIV testing, past 5 years (people aged 16-44) Number Number Number Number of partners, past 5 years of partners, past 5 years of partners, past 5 years of partners, past 5 years 60% 10+-O- 60%- 10+-O- 60%- 60%- 10+-O- 5-9 A 2-4-- 0-1 - 10+-O- 5-9 A- 2-4-- 0-1 - 5-9 A 5-9 A 50%- 2-4-- 50%- 2-4-- 50%- 50%- 0-1 - 0-1 - 40%- 40%- 40%- 40%- 30%- 30%- 30%- 30%- 20%- 20%- 20%- 20%- 10%- 10%- 10%- 10%- 0% Natsal-1 1990-1991 0%- Natsal-1 0% Natsal-1 0%- Natsal-1 Natsal-2 Natsal-3 Natsal-2 Natsal-3 Natsal-2 Natsal-3 Natsal-2 Natsal-3 1999-2001 2010-2012 1990-1991 1999-2001 2010-2012 1990–1991 1999-2001 2010-2012 1990-1991 1999-2001 2010-2012 Experiencing sex against your will could happen at any age, but it was more common at younger ages. Person responsible at most recent occurrence Non-volitional sex We asked men and women "since the age of 13, has anyone made you have sex with them, against your will?" which we refer to as 'non-volitional sex'. One in 10 women and one in 71 men said that they had experienced non- volitional sex since age 13. 23% 41% Current or Median age at most former partner recent occurrence of 30% Proportion of men and women who have experienced non-volitional sex Family member or friend non-volitional sex 20% Known, but not as a family member or friend Stranger 30% Other 21% 15% 15% 1 in 71 2% 3% (1.4%) 1 in 10 (9.8%) 16 18 In most cases the person responsible was someone known to the individual. We found that people who said they had experienced sex against their will were more likely to report potentially harmful health behaviours and poorer physical, mental and sexual health, including treatment for depression or another mental health condition in the past year, a long-term illness or disability, and a lower sexual function score. We do not know whether these things happened before or after experiencing sex against their will. Over the past 60 years, the gap between the age people start having sex, the age they first live with a partner, and the age they have their first child has widened - so there is now a longer period in women's lives where efforts are needed to prevent unplanned pregnancy. Unplanned pregnancy 10% of women aged 16-44 had been pregnant in the past year (given birth, miscarried, or had an abortion in the past year). An estimated one in six of these pregnancies were unplanned, two in six were ambivalent and three in six were planned. Median age at first intercourse, first live-in relationship and birth of first child Age Percentage of women who have been pregnant in the past year 35 14% Planned 12% Ambivalent Unplanned 30 8% 4% 25 0% 16-19 20-24 25-29 30-34 35-39 40-44 Although pregnancies among 16-19 year old women were more likely to be unplanned than those among older women, most unplanned pregnancies were in women aged 20-34, simply because that is when most women become pregnant. 20 Age profile of unplanned pregnancies 16-19 21% 30-34 23% 20-24 25-29 35-39 40-44 15 23% 16% 12% 5% 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 -64 -69 -39 -44 -49 -54 -59 -74 -79 -84 -89 -96 Year of birth Key We found that unplanned pregnancy was less common than has been found in studies done in some other high income countries such as the USA. This may in part reflect the fact that contraception is provided free of charge in Britain under the NHS. Birth of first child *Some data not shown because less than 50% of age group had experienced event First live-in relationship First intercourse Natsal-3 is a collaboration between: LONDON SCHOOLOF HYGIENE &TROPICAL MEDICINE UCL NatCen MANCHESTER 1824 Public Health Social Research that works for society England The University of Manchester The study was funded through grants from: With additional funding from: E S R C Medical Research MRC Foundation wellcometrust Department of Health ECONOMIC & SOCIAL RESEARCH COUNCIL