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National Survey of Sexual Attitudes and Lifestyles

Natsal

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Aim

Natsal is one of the largest scientific studies of sexual behaviour in the world. Together Natsal-1 (1990-91), Natsal-2 (1999-2001) and Natsal-3 (2010-12) have interviewed more than 45,000 men and women, spanning those born through much of the 20th Century. Fieldwork for Natsal-4 is planned for 2021-22. Results from the survey are usually published as journal articles; you can find results from the latest survey below.

More information can be found at www.natsal.ac.uk.

Background information

Natsal was initiated in response to the emerging HIV epidemic and has evolved to become internationally-renowned in the population-based measurement of the social, behavioural and biological aspects of sexual health. Natsal has captured dramatic changes in sexual attitudes and lifestyles in Britain, such as earlier sexual debut, increasing partner numbers and same-sex experience. Natsal provides the evidence-base for major sexual health interventions and monitoring their impact, including the National Chlamydia Screening Programme; enhanced HIV testing; HPV vaccination; the Teenage Pregnancy Strategy; and sex and relationship education.

Natsal’s unique contribution is to generate high-quality detailed data on sexual behaviour, attitudes, outcomes, and service use, representative of the British general population. Natsal’s consistent methodology and repeated-nature enables rigorous assessment of trends, which capture generational changes and broad societal shifts through the measurement of both period and birth cohort effects.

Funding has now been secured from the Wellcome Trust as part of its Longitudinal Population Studies Strategy with contributions from the Economic and Social Research Council and the National Institute for Health Research to undertake a fourth Natsal study (Natsal-4), and to build upon the existing studies by creating and enhancing a Natsal Resource.

Publications

This report presents the findings from a scoping review, carried out to identify the optimum method currently available for the collection of updated data on sexual behaviour, attitudes and lifestyles among the general population in Britain (Natsal-4), whether via a dedicated survey or using existing research infrastructure.

  • BMJ Sexually Transmitted Infections (in press)

This editorial describes the collection and use of Natsal data to understand Britain’s sexual health needs.

  • Lancet, November 2013  

The initial findings from Natsal-3 were published as a series of 6 papers in the Lancet and focused on changes in sexual behaviour, sex and general health and wellbeing, sexual function, STIs, non-volitional sex and unplanned pregnancy. Details of and links to subsequent papers to be published from Natsal-3 can be found here

These tables present the findings for key variables from Natsal-3.

This report presents findings from Scottish participants in the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

This paper describes the methods used in Natsal-3.

Methodology

For Natsal-3, we interviewed just over 15,000 men and women aged between 16 and 74. The questionnaire can be found here.

The interview included the following topics:

  • General health
  • Pregnancies and fertility
  • Attitudes towards sex and relationships
  • Contraception
  • Family, marriage and relationships
  • Learning about sex
  • First sexual experiences
  • Sexual partners and practices
  • Sexually transmitted infections
  • Sexual health service use (including testing for chlamydia and HIV)
  • Non-volitional sex
  • Sexual function
  • Demographics

Sone of these question topics were new, others had been asked in previous waves. The questionnaires from Natsal-1 and Natsal-2 can be found here.

For Natsal-2 and Natsal-3 we collected urine samples from participants aged 16-44 years and tested these for a range of sexually transmitted infections (STIs).

For Natsal-3 we also collected saliva samples to test for testosterone.

For Natsal-4, household-based face-to-face interviews (using CAPI/CASI) will be carried out with nearly 10,000 people aged between 15 and 59. Qualitative and quantitative development work will be carried out during 2019-2020, with main survey fieldwork in 2021-2022 and results published in 2023. We will again collect biological samples to test for a range of STIs.