Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours

Background Sexual behaviour is a major determinant of sexual and reproducti ve health. We did a National Survey of Sexual Attitudes and Lifestyles (Nat sal 2000) in 1999-2001 to provide population estimates of behaviour pattern s and to compare them with estimates from 1990-91 (Natsal 1990). Methods We did a probability sample survey of men and women aged 16-44 year s who were resident in Britain, using computer-assisted interviews. Results were compared with data from respondents in Natsal 1990. Findings We interviewed 11 161 respondents (4762 men, 6399 women). Patterns of heterosexual and homosexual partnership varied substantially by age, re sidence in Greater London, and marital status. In the past 5 years, mean nu mbers of heterosexual partners were 3.8 (SD 8.2) for men, and 2.4 (SD 4.6) for women; 2.6% (95% CI 2.2-3.1) of both men and women reported homosexual partnerships; and 4.3% (95% CI 3.7-5.0) of men reported paying for sex. In the past year, mean number of new partners varied from 2.04 (SD 8.4) for si ngle men aged 25-34 years to 0.05 (SD 0.3) for married women aged 35-44 yea rs. Prevalence of many reported behaviours had risen compared with data fro m Natsal 1990. Benefits of greater condom use were offset by increases in r eported partners. Changes between surveys were generally greater for women than men and for respondents outside London. Interpretation Our study provides updated estimates of sexual behaviour pat terns. The increased reporting of risky sexual behaviours is consistent wit h changing cohabitation patterns and rising incidence of sexually transmitt ed infections. Observed differences between Natsal 1990 and Natsal 2000 are likely to result from a combination of true change and greater willingness to report sensitive behaviours in Natsal 2000 due to Improved survey metho dology and more tolerant social attitudes.