Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal) - PubMed (original) (raw)

. 2013 Nov 30;382(9907):1781-94.

doi: 10.1016/S0140-6736(13)62035-8. Epub 2013 Nov 26.

Clare Tanton, Philip Prah, Bob Erens, Pam Sonnenberg, Soazig Clifton, Wendy Macdowall, Ruth Lewis, Nigel Field, Jessica Datta, Andrew J Copas, Andrew Phelps, Kaye Wellings, Anne M Johnson

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Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal)

Catherine H Mercer et al. Lancet. 2013.

Abstract

Background: Sexual behaviour and relationships are key components of wellbeing and are affected by social norms, attitudes, and health. We present data on sexual behaviours and attitudes in Britain (England, Scotland, and Wales) from the three National Surveys of Sexual Attitudes and Lifestyles (Natsal).

Methods: We used a multistage, clustered, and stratified probability sample design. Within each of the 1727 sampled postcode sectors for Natsal-3, 30 or 36 addresses were randomly selected and then assigned to interviewers. To oversample individuals aged 16-34 years, we randomly allocated addresses to either the core sample (in which individuals aged 16-74 years were eligible) or the boost sample (in which only individuals aged 16-34 years were eligible). Interviewers visited all sampled addresses between Sept 6, 2010, and Aug 31, 2012, and randomly selected one eligible individual from each household to be invited to participate. Participants completed the survey in their own homes through computer-assisted face-to-face interviews and self-interview. We analysed data from this survey, weighted to account for unequal selection probabilities and non-response to correct for differences in sex, age group, and region according to 2011 Census figures. We then compared data from participants aged 16-44 years from Natsal-1 (1990-91), Natsal-2 (1999-2001), and Natsal-3.

Findings: Interviews were completed with 15,162 participants (6293 men, 8869 women) from 26,274 eligible addresses (57·7%). 82·1% (95% CI 81·0-83·1%) of men and 77·7% (76·7-78·7%) of women reported at least one sexual partner of the opposite sex in the past year. The proportion generally decreased with age, as did the range of sexual practices with partners of the opposite sex, especially in women. The increased sexual activity and diversity reported in Natsal-2 in individuals aged 16-44 years when compared with Natsal-1 has generally been sustained in Natsal-3, but in men has generally not risen further. However, in women, the number of male sexual partners over the lifetime (age-adjusted odds ratio 1·18, 95% CI 1·08-1·28), proportion reporting ever having had a sexual experience with genital contact with another woman (1·69, 1·43-2·00), and proportion reporting at least one female sexual partner in the past 5 years (2·00, 1·59-2·51) increased in Natsal-3 compared with Natsal-2. While reported number of occasions of heterosexual intercourse in the past 4 weeks had reduced since Natsal-2, we recorded an expansion of heterosexual repertoires--particularly in oral and anal sex--over time. Acceptance of same-sex partnerships and intolerance of non-exclusivity in marriage increased in men and women in Natsal-3.

Interpretation: Sexual lifestyles in Britain have changed substantially in the past 60 years, with changes in behaviour seeming greater in women than men. The continuation of sexual activity into later life--albeit reduced in range and frequency--emphasises that attention to sexual health and wellbeing is needed throughout the life course.

Funding: Grants from the UK Medical Research Council and the Wellcome Trust, with support from the Economic and Social Research Council and the Department of Health.

Copyright © 2013 Mercer et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd. All rights reserved.

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Figures

Figure 1

Figure 1

Association between key social determinants and (A) sexual behaviours and (B) attitudes in Natsal-3 participants aged 16–74 years, by sex Horizontal bars indicate 95% CIs. NS-SEC excludes people who are long-term unemployed and full-time students. Oral sex is defined as mouth on a partner's genital area. Anal sex is defined as a man's penis in a partner's anus. QIMD=Quintile of Index of Multiple Deprivation. NS-SEC=National Statistics Socio-Economic Classification. *Not defined when asked in interview. †Participants aged ≥17 years.

Figure 2

Figure 2

Participants from Natsal-1, Natsal-2, and Natsal-3 reporting heterosexual sexual practices at any point, by sex and 10-year birth cohort Each line connects values for the same birth cohort at different ages. Data for the 45–54 years age group missing for 1946–55 birth cohort, because only individuals aged 16–44 years were included in Natsal-2. Vaginal sex is defined as a man's penis in a woman's vagina. Oral sex is defined as mouth on a partner's genital area. Anal sex is defined as a man's penis in a woman's anus.

Figure 3

Figure 3

Number of sexual partners of the opposite sex over the lifetime reported by participants in Natsal-1, Natsal-2, and Natsal-3, by sex and 10-year birth cohort Each line connects values for the same birth cohort at different age groups. Data for the 45–54 years age group missing for 1946–55 birth cohort, because only individuals aged 16–44 years were included in Natsal-2.

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References

    1. UK Department of Health A framework for sexual health improvement in England. March, 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil... (accessed June 29, 2013).
    1. Glasier A, Gülmezoglu AM, Schmid GP, Garcia Moreno C, Van Look PFA. Sexual and reproductive health: a matter of life and death. Lancet. 2006;368:1595–1607. - PubMed
    1. Field N, Mercer CH, Sonnenberg P. Associations between health and sexual lifestyles in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) Lancet. 2013 doi: 10.1016/S0140-6736(13)62222-9. published online Nov 26. - DOI - PMC - PubMed
    1. Public Health England Sexually transmitted infections and chlamydia screening in England, 2012. June 7, 2013. http://www.hpa.org.uk/hpr/archives/2013/hpr2313.pdf (accessed June 29, 2013).
    1. Bearinger LH, Sieving RE, Ferguson J, Sharma V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention and potential. Lancet. 2007;369:1220–1231. - PubMed

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