The National Survey of Sexual Attitudes and Lifestyles 2010 ( Natsal 2010 )

The two British National Surveys of Sexual Attitudes and Lifestyles (Natsal) carried out in 1990 and 2000, are the largest studies of sexual behaviour undertaken anywhere in the world. They have provided data that have been extensively used to improve understanding of patterns of sexual behaviour in Britain and helped to guide policy to improve sexual health education and health services. A third Natsal study is planned for 2010 to provide up to date measures of sexual attitudes and lifestyles and also extend its scope. Once again, participants will be randomly selected from across Britain and invited to take part. This will ensure that the survey represents views and lifestyles from all regions and from all walks of life. We aim to interview 15,000 men and women aged 16-74. Laptop computers will be used to allow participants to record personal information in privacy. New elements will be introduced to the survey: the upper age limit will be higher than in previous Natsal surveys at 74 years; the sample of younger adults will be increased so that we have a better understanding of those most likely to engage in risk-behaviours. A random sample of participants aged 16-44 will be asked to provide a urine sample to be tested anonymously for sexually transmitted infections to understand the prevalence of infection in the population. Some participants of all ages will be asked to provide a saliva sample to measure hormone levels. A small number of participants will be asked to undertake more detailed qualitative interviews to understand some aspects of high?risk behaviour in greater detail. We will analyse the data to provide comparisons over time in sexual attitudes and lifestyles, and to understand better the relationship between sexual lifestyle and sexual health, and between other aspects of health and quality of sexual relationships. We will use the findings to help to guide policy on services and interventions to improve sexual health in Britain.

Improving sexual & reproductive health is a public health priority in Britain. Concern is driven by high levels of teenage pregnancy and rising rates of sexually transmitted infections (STIs). In addition, policy makers have increasingly recognised the importance of other facets of sexual health, including sexual function, relationship quality, reproductive choice and the interplay between physical and sexual health. The Natsal surveys of 1990 and 2000 (the largest anywhere in the world) quantified the wide diversity of sexual lifestyles and their relationship to health outcomes. At the population level, time trends (1990-2000) demonstrated the relationship between increasing risk behaviour, rising STI incidence and sustained HIV transmission. The surveys have been widely used to inform health and social policy and the information has been essential in the design, implementation and assessment of initiatives aimed at improving sexual and reproductive health.



We propose to carry out a third National Survey of Sexual Attitudes and Lifestyles in 2010 in a probability sample of 15,000 men and women aged 16-74 years, resident in Britain, using computer-assisted interviewing techniques. Survey design and execution will be based on methods established in Natsal 1990 and Natsal 2000, allowing comparability. Innovations for Natsal 2010 include an extended age range; additional questions exploring new areas; the inclusion of new biological measures: i.e. a wider range of STIs (anonymous testing in a random sample of those aged 16-44 for Chlamydia trachomatis, HPV, Mycoplasma genitalium, HIV antibody and Neisseria gonorrhoeae) and measurement of testosterone levels in saliva; a qualitative component; use of audio-CASI and methodological advances providing capacity development.



Natsal 2010 will explore the variation in, and factors associated with, sexual lifestyles in a large population-based probability survey, including a closer understanding of the relationship between physical and sexual health, especially in those aged 45-74 years. We will examine the relationship between behaviours, attitudes, general health and well-being, and sexual and reproductive health outcomes. Natsal 2010 will continue to provide comparative time trends, building on the findings from Natsal 1990 and 2000 and provide essential analyses to inform sexual and reproductive health policy. Combining data from all three surveys enables both period and cohort analyses to be carried out, as the surveys include people born in the 1930s-1990s, a period spanning much of the last century.