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).


Mercer, CH; Tanton, C; Prah, P; Erens, B; Sonnenberg, P; Clifton, S; MacDowall, W; Lewis, R; Field, N; Datta, J; Copas, AJ; Phelps, A; Wellings, K; Johnson, AM; (2013) 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). Lancet. ISSN 0140-6736 DOI: https://doi.org/10.1016/S0140-6736(13)62035-8

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Abstract

Background: Understanding sexual attitudes and behaviour is essential for the design and evaluation of interventions aimed at improving sexual health. We present results and trends from Britain's three National Surveys of Sexual Attitudes and Lifestyles (Natsal). Methods: Natsal-3 is a probability sample survey of 15,162 people aged 16-74 (6,294 men) resident in Britain, undertaken 2010-2012 using computer-assisted interviews. We make comparisons with Natsal-1 (1990-1991) and Natsal-2 (1999-2001), and explore changes through the lifecourse and trends over time. Findings: In Natsal-3, 82.1% (95%CI: 81.0%-83.1%) of men and 77.7% (76.7%-78.7%) of women reported opposite-sex partner(s) in the past year. These proportions declined with age, as did the frequency of heterosexual sex and range of heterosexual practices, especially for women. The increased levels of sexual activity and diversity observed between Natsal-1 and Natsal-2 among those aged 16-44 have generally been sustained in Natsal-3, but in men have not increased further. In women however, we observed increases in the reported number of opposite-sex partners (lifetime): age-adjusted odds ratio (aAOR) 1.19 (95%CI: 1.09-1.29), and same-sex experience (ever and past 5 years): aAORs 1.69 (1.43-2.00) and 2.00 (1.59- 2.51), respectively, relative to Natsal-2. While sexual frequency has declined since Natsal-2 from a median of 4 to 3 occasions (past four weeks), we observed an expansion of heterosexual repertoires, particularly oral and anal sex, over successive birth cohorts and over time. Attitudes towards same-sex partnerships have become more accepting; conversely, those towards sexual non-exclusivity in marriage less so. Interpretation: The Natsal surveys have captured substantial changes in sexual lifestyles over the past 60 years, with changes in behaviour appearing more marked among women than men. The continuation of sexual activity into older age, albeit diminished in range and frequency, emphasises the need for attention to sexual health and well-being throughout the lifecourse. Funding: Grants from Medical Research Council, Wellcome Trust.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
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PubMed ID: 24286784
Web of Science ID: 327540700023
URI: http://researchonline.lshtm.ac.uk/id/eprint/1367702

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