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.
Percentage of the population who have ever had
same-sex experience (people aged 16–44)
Changes in sexual
behaviour
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.
Natsal–1
1990–1991
Natsal–2
1999–2001
Natsal–3
2010–2012
6%
8%
7%
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.
Percentage who had sexual intercourse with
someone of the opposite sex before age 16
Age at
interview
31%
26%
4%
2%
10%
16%
5%
8%
Average (mean) number of opposite–sex
partners, lifetime (people aged 16–44)
Key
Natsal–1
1990-1991
8.6
3.7
Natsal–2
1999-2001
12.6
6.5
Natsal–3
2010-2012
11.7
Median (middle)
number of
occasions of sex
in the past
4 weeks (people
aged 16–44)
7.7
Natsal–1
Natsal–2
Natsal–3
2
3
1
27%
35–44
27%
45–54
55–64
15%
5
2
4
25%
25–34
17%
100% of population
Any same-sex experience
Same-sex experience with genital contact
29%
16–24
18%
15%
10%
4%
65–74
On average over
the past two
decades there has
been a decrease in
how often people
say they have sex.
9
9
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
74%
Vaginal sex
Given/received oral sex
Anal sex
Other genital contact
Age at
interview
16–24
Age at
interview
16–24
19%
Age at
interview
16–24
Age at
interview
16–24
80%
17%
25–34
16%
76%
25–34
77%
75%
15%
35–44
13%
74%
35–44
73%
14%
45–54
8%
55–64
4%
65–74
4%
75%
71%
89%
25–34
91%
80%
25–34
91%
35–44
89%
80%
35–44
85%
81%
45–54
75%
57%
65–74
71%
59%
55–64
63%
45–54
52%
37%
71%
55–64
35%
8%
19%
30% 65–74
3%
17%
71%
66%
45–54
56%
37%
55–64
65–74
73%
62%
41%
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.
Percentage reporting a health condition that
affected their sex life in the past year
Sex and health
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.
1 in 6
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.
Percentage reporting recent sexual activity (in past four weeks)
100%
Health status
Very good or good
Fair, bad or very bad
100%
80%
80%
60%
60%
40%
40%
20%
20%
0%
16–24
25–34
35–44 45–54
Age at interview
55–64
65–74
0%
Health status
Very good or good
Fair, bad or very bad
24%
16–24
25–34
35–44 45–54
Age at interview
Page 1 of 4
55–64
65–74
Of those, percentage
who had sought
help or advice
from a healthcare
professional
18%
Almost one in six people said they had a health
condition that affected their sex life in the past year,
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.
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
15%
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.
Dissatisfied with sex life
12%
32%
Distressed or worried about sex life
10%
15%
11%
Avoided sex because of sexual difficulties
11%
Experienced one
or more sexual
difficulties
42%
10%
Distressed or
worried about
sex life
51%
11%
22%
Distressed or worried about sex life
10%
Avoided sex because of sexual difficulties
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.
men and women who
are in a relationship do
1
in
4
not share the same level of interest
1 in 5 are in a relationship said
that their partner had experienced
men and women who
sexual difficulties in the past year.
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:
relationship
break-up
being unhappy in
their relationship
finding it
difficult to talk
about sex with
a partner
Sexually transmitted
infections (STIs)
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.
having
experienced sex
against their
will
having
been diagnosed
with an STI
having
more partners
(women only)
paying for sex
(men only)
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.
Percentage of people in the population with chlamydia
1
partner
1
partner
HPV was the most common STI, followed by
chlamydia. HIV and gonorrhoea were found in
around one in a thousand people.
2
partners
3+
partners
0.7%
4%
0.7%
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
1.1%
2
partners
3+
partners
3.2%
3.7%
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)
60%
50%
Number
of partners,
past 5 years
10+
5–9
2–4
0–1
60%
50%
HIV testing, past 5 years (people aged 16–44)
Number
of partners,
past 5 years
10+
5–9
2–4
0–1
60%
50%
Number
of partners,
past 5 years
10+
5–9
2–4
0–1
60%
50%
40%
40%
40%
40%
30%
30%
30%
30%
20%
20%
20%
20%
10%
10%
10%
10%
0%
Natsal–1
1990–1991
Natsal–2
1999–2001
Natsal–3
2010–2012
0%
Natsal–1
1990–1991
Natsal–2
1999–2001
Natsal–3
2010–2012
Page 2 of 4
0%
Natsal–1
1990–1991
Natsal–2
1999–2001
Natsal–3
2010–2012
0%
Number
of partners,
past 5 years
10+
5–9
2–4
0–1
Natsal–1
1990–1991
Natsal–2
1999–2001
Natsal–3
2010–2012
Person responsible at most recent occurrence
Experiencing sex
against your will could
happen at any age, but
it was more common
at younger ages.
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 nonvolitional sex since age 13.
23%
Median age at most
recent occurrence of
non-volitional sex
Proportion of men and women who have experienced non-volitional sex
30%
41%
Current or
former partner
Family member
or friend
20%
Known, but not as a
family member or friend
Stranger
30%
15%
1 in 71
1 in 10
15%
2%
(1.4%)
16
(9.8%)
18
21%
Other
3%
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
35
Percentage of women who have been pregnant in the past year
14%
Planned
Ambivalent
Unplanned
12%
30
8%
4%
0%
*
25
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%
20–24
23%
25–29
16%
*
30–34
23%
35–39
12%
40–44
5%
15
1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990
–39 –44 –49 –54 –59 –64 –69 –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
First live-in relationship
First intercourse
Natsal-3 is a collaboration between:
The study was funded through grants from:
With additional funding from:
Page 3 of 4
ome data not shown because
*Sless
than 50% of age group
had experienced event
Further information
If you would like information or advice about the topics covered in the Natsal study,
you can contact one of the organisations below.
NHS website
London Gay/Lesbian Switchboard
This website provides information about
sexual health and allows you to search for
your nearest sexual health service.
Provides support and information to lesbian,
gay, bisexual & transgendered communities
throughout the UK
www.nhs.uk/livewell/sexualhealth
Your registered GP
They can provide consultations and refer you
to specialist agencies. You can find a GP on
the NHS website:
www.nhs.uk/Service-Search/GP/
LocationSearch/4
Family Planning Association
Provides guidance on where you can seek
help for a wide range of issues relating to
health, sexual and personal relationships
www.fpa.org.uk
Helpline 0845 122 8690
British Association for Counselling
Can suggest a local counsellor
www.bacp.co.uk
01455 883300
Samaritans
The Samaritans provide counselling and
support on any issue of concern
www.samaritans.org
@ [email protected]
Helpline: 08457 909090
Marie Stopes International
Advice and information on a range of
topics including family planning, abortion,
contraception, sexually transmitted diseases
and menopause
www.mariestopes.org.uk
@ [email protected]
Helpline: 0845 300 8090
Men’s advice line
Provides advice and support for men in
abusive relationships
www.mensadviceline.org.uk
@ [email protected]
Helpline: 0808 801 0327
www.llgs.org.uk
For
info on local lines:
www.switchboard.org.uk
@ [email protected]
Helpline: 020 7837 7324
Relate
Provides counselling and advice on
relationship and sexual problems
www.relate.org.uk
@ [email protected]
Helpline: 0300 100 1234
Safeline
Support for adults who have been sexually
abused as children
www.safeline.org.uk
@ [email protected]
Helpline: 01926 402498
Rape Crisis
Provides counselling and help for people
who have been raped or sexually assaulted
www.rapecrisis.org.uk
@ [email protected]
Helpline: 0808 802 9999
The Havens
Provides counselling and help for people in
London who have been raped or sexually
assaulted
www.thehavens.co.uk
Camberwell branch: 020 3299 1599
Paddington branch: 020 3312 1101
Whitechapel branch: 020 7247 4787
Sexual Advice Association
(formerly the Sexual Dysfunction Association)
Advice and information on male and female
sexual problems
www.sda.uk.net
Helpline: 020 7486 7262
Page 4 of 4