GEOGRAPHIC-VARIATION IN SEXUAL-BEHAVIOR IN BRITAIN - IMPLICATIONS FORSEXUALLY-TRANSMITTED DISEASE EPIDEMIOLOGY AND SEXUAL HEALTH PROMOTION

Objectives: To explore geographical variation in sexual behaviour in G reat Britain with reference to the prevalence of HIV infection. Design : The National Survey of Sexual Attitudes and Lifestyles comprises a r andomly selected, representative sample of almost 19 000 men and women aged 16-59 years living in Great Britain. Methods: The survey was car ried out using a combination of face-to-face interview and self-comple tion questionnaires and a wide range of data was collected. In this st udy, data on numbers and sex of sexual partners, condom use, injecting drug use, perception of risk of AIDS and lifestyle change were analys ed, and comparisons were made between the different geographical areas in Great Britain. Results: In the last 5 years, men living in Inner L ondon were more likely to have a male partner [odds ratio (OR), 5.6; 9 5% confidence interval (CI), 3.1-10.0] or to have had 10 or more femal e partners (OR, 2.4; 95% CI, 1.6-3.6) than men living in other parts o f the country. Similar results were observed for women living in Inner London: OR for a female partner in the last 5 years was 4.1 (95% CI, 1.6-10.2) and for five or more male partners in the last 5 years was 2 .1 (95% CI, 1.5-2.8). More complex, but less striking patterns of beha viour were seen in different parts of the country. Both men and women living in Inner London were more likely to recognize that they were at some risk of acquiring HIV and were also more likely to report a chan ge in sexual lifestyle. Conclusions: These analyses highlight the diff iculties inherent in extrapolating from sexual behaviour data gathered using purposive samples to the population as a whole. The results are consistent with the known epidemiology of HIV and sexually transmitte d diseases in Britain. The data suggest that cases of HIV will continu e to be concentrated in Inner London, but Londoners are particularly a ware of their risk. Reported behaviour change in response to perceptio n of risk of AIDS underlines the importance of effective health promot ion.