Published 19th March 2019

The National Survey of Sexual Attitudes and Lifestyles begins its fourth study on sexual health and well-being in Britain, led by researchers from UCL in collaboration with the London School of Hygiene & Tropical Medicine, the University of Glasgow and NatCen Social Research.

The National Surveys of Sexual Attitudes and Lifestyles (Natsal) are regarded as the world’s largest, most detailed studies of sexual behaviour.

Three Natsal surveys have taken place at the turn of each decade since 1990, with a new wave of data collection (Natsal-4) due to begin in 2021. People are randomly selected, based on their postcodes, and invited to participate, so the surveys represent the general population in Britain. Further information on Natsal’s robust approach is available here: http://dx.doi.org/10.1136/sextrans-2018-053571

For the 2021 survey, interviewers will collect information from nearly 10,000 people aged 15-59 using computerised questionnaires to ensure privacy. Survey answers will be combined with information from biological samples (e.g. to test for sexually transmitted infections) and routinely-collected data (e.g. health records). Development work for the next wave will start in May 2019 to ensure that the questions asked and the data collected are ‘fit for purpose’ in 2021.

Dr Cath Mercer, Co-Principal Investigator of the latest Natsal, said: “Improving sexual health remains a key public health challenge in Britain. Last year there were over 420,000 new STI diagnoses in England alone, and teenage pregnancy rates, although reducing, remain among the highest in Europe. There is increasing awareness about sexual violence, but also the importance of a satisfying sex life for our general health and well-being.”

Combining all four surveys will create a resource that provides a comprehensive picture of the sexual health of the nation and show how this has changed over time and across generations.

Professor Pam Sonnenberg, Co-Principal Investigator, said: “The three surveys to date have already had a major impact on policy, practice, and the public dialogue about sex. Natsal data have been – and will continue to be - used to plan services and monitor the progress of interventions and national strategies.”

The next wave of Natsal is being funded by a grant from Wellcome Trust’s new Longitudinal Population Studies Strategy, reflecting Wellcome’s long-standing support for Natsal since its inception. The National Institute for Health Research (NIHR) and the Economic and Social Research Council (ESRC) as part of UK Research and Innovation are also contributing to funding this latest wave, reflecting the importance of the study for informing policy and practice, as well as its multidisciplinary focus.

Natsal was initiated in response to the emerging HIV epidemic and has provided the evidence-base for major sexual health interventions and monitoring their impact (including for models on cost-effectiveness). These include the National Chlamydia Screening Programme; enhanced HIV testing; HPV vaccination; and the Teenage Pregnancy Strategy. Previous waves have been funded by the Medical Research Council and the Department for Health. The initial feasibility study for Natsal was funded by ESRC and the Health Education Authority.

Prof Kirstin Mitchell, who is the University of Glasgow lead for Natsal, said: "We are delighted that the University of Glasgow is joining the endeavour to continue the Natsal legacy. This is a great opportunity both for the University of Glasgow and for Scotland. In this fourth survey, the Glasgow team will be leading on the development of a measure of sexual wellbeing which we hope will contribute to a fuller understanding of the positive dimensions of people's sexual lives".

First published: 13 March 2019

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