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National Survey of Sexual Attitudes and Lifestyles (Natsal)

National Survey of Sexual Attitudes and Lifestyles (Natsal)

Revealing the changing sexual attitudes and behaviour of the British population, Natsal is one of the largest scientific studies of sexual health and lifestyles in the world.

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About

The Natsal surveys have been carried out every 10 years since 1990. More than 45,000 people have been interviewed and the findings have helped to shape sexual and reproductive health policy in Britain.

Who we are

Natsal is led by a research team from the London School of Hygiene & Tropical Medicine, and (NatCen).

Resources and publications

See results from the Natsal studies and download infographics to illustrate some of the key findings.

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About
About Natsal

is one of the largest and most comprehensive studies of sexual behaviour and lifestyles in the world, and is a major source of data informing sexual and reproductive health policy in Britain.

The project is led by a research team from the London School of Hygiene & Tropical Medicine, and (NatCen).

The survey has been carried out every 10 years since 1990, involving interviews with a total of 45,000 people. More than 15,000 adults aged 16-74 participated in the latest survey (Natsal-3) in 2010. Data collection for Natsal-4 will take place September 2022 to December 2023.

Studying such a large representative sample of people living in Britain allows us to produce key estimates on patterns of sexual behaviour, attitudes, health, and wellbeing across the population.  showed that different aspects of sexual health affect people at different times throughout their lives, and that sexual health is an important component of our overall health and wellbeing. They also revealed how sexual attitudes and lifestyles have changed in the last sixty years.

Lancet video of findings from the third National Survey of Sexual Attitudes and Lifestyles

Background

The first Natsal survey was conducted in 1990 in response to an urgent need for information about sexual practices in the context of the HIV/AIDS epidemic. A total of 18,876 men and women aged 16-59 years were interviewed. The survey provided much needed data to predict and prevent HIV transmission in Britain.

The data were used more widely than had been anticipated, by academics and practitioners in the fields of sexual health epidemiology, policy and practice.

Towards the end of the 1990s, new data were needed to investigate changes in sexual behaviour and to respond to demand for up-to-date information.

In response, Natsal-2 was carried out in 2000 and included 12,110 adults aged 16-44. The objectives of Natsal-2 were broader and it also aimed to provide a detailed understanding of patterns of sexual behaviour in Britain; provide data for HIV/AIDS projections in Britain; assess whether there had been changes in sexual behaviour since Natsal-1; and measure the prevalence of Chlamydia trachomatis infection, via the collection and analysis of urine samples.

Impact

Natsal findings play an important role in informing health policy in Britain. The studies provide valuable data for predicting and preventing HIV/STI transmission, and for improving our understanding of sexual and reproductive health. The data have been extensively used to design and promote sexual health education and services, and the methodology has been replicated elsewhere.

The studies have contributed to:

  • The National Sexual Health & HIV Strategy in England; the Scottish Sexual Health Strategy (2005-) and the Welsh Sexual Health Strategy
  • The Teenage Pregnancy Strategy (2000-2010)
  • The National Chlamydia Screening Programme (NCSP)
  • The national human papillomavirus (HPV) immunisation programme in 2008/9
  • The statutory provision of Personal, Social, Health & Economic (PHSE) education in schools in 2009
  • Sexual health campaigns, such as "Sex: worth talking about" in 2010
  • National Institute for Health and Clinical Excellence (NICE) guidelines on, for example, long acting contraception (2006)

Kaye Wellings discusses the findings from Natsal-3

About Natsal podcast
Resources & Publications
Resources & Publications Natsal
Resources
Publications
Publications List
Kirstin R. Mitchell, Catherine H. Mercer, Philip Prah, Soazig Clifton, Clare Tanton, Kaye Wellings & Andrew Copas
The Journal of Sex Research. DOI: 10.1080/00224499.2018.1481193
Ruth Lewis, Clare Tanton, Catherine H. Mercer, Kirstin R. Mitchell, Melissa Palmer, Wendy Macdowall, Kaye Wellings
Journal of Adolescent Health. DOI: 10.1016/j.jadohealth.2017.07.004
Graham CA, Mercer CH, Tanton C, Jones KG, Johnson AM, Wellings K, Mitchell KR
2017
BMJ Open 2017. DOI:10.1136/bmjopen-2017-016942
Mitchell KR, Geary R, Graham CA, Datta J, Wellings K, Sonnenberg P, Field N, Nunns D, Bancroft J, Jones KG, Johnson AM, Mercer CH.
BJOG. 2017. doi: 10.1111/1471-0528.14518
Palmer, MJ; Clarke, L; Ploubidis, GB; Mercer, CH; Gibson, LJ; Johnson, AM; Copas, AJ; Wellings, K; (2017)
Journal of sex research, 54 (1). pp. 91-104. ISSN 0022-4499 DOI: 10.1080/00224499.2015.1134424
Khadr SN, Jones KG, Mann S, Hale D, Johnson AM, Viner RM, Mercer CH*, Wellings K* (* joint senior authors).
BMJ Open, 2016 Jun 30; 6(6):e011961. doi: 10.1136/bmjopen-2016-011961
Prah P, Hickson F, Bonell C, McDaid LM, Johnson AM, Wayal S, Clifton S, Sonnenberg P, Nardone A, Erens B, Copas AJ, Riddell J, Weatherburn P, Mercer CH.
2016. Sex Transm Infect. 92(6): 455-63
Mitchell KR, Geary R, Graham C, Clifton S, Mercer CH, Lewis R, Macdowall W, Datta J, Johnson AM, Wellings K.
2016. J Adolesc Health. 59(4): 422-8
Black KI, Geary R, French R, Leefe N, Mercer CH, Glasier A, Macdowall W, Gibson L, Datta J, Palmer M, Wellings K.
2016. BJOG. 123(10): 1600-7
Geary RS, Tomes C, Jones KG, Glasier A, Macdowall W, Datta J, Sonnenberg P, Wellings K, French RS, Mercer CH, Johnson AM.
2016. BMJ Open. 6(9):e011966
Clifton S, Macdowall W, Copas AJ, Tanton C, Keevil BG, Lee DM, Mitchell KR, Field N, Sonnenberg P, Bancroft J, Mercer CH, Wallace AM, Johnson AM, Wellings K, Wu F
J Clin Endocrinol Metab.2016. Aug 23:jc20161669
Mercer CH, Jones KG, Johnson AM, Lewis R, Mitchell KR, Gravningen K, Clifton S, Tanton C, Sonnenberg P, Wellings K, Cassell JA, Estcourt CS
Sex Transmit Infect. 2016. doi:10.1136/sextrans-2016-052646
Mercer CH, Prah P, Field N, Tanton C, Macdowall W, Clifton S, Hughes G, Nardone A, Wellings K, Johnson AM, Sonnenberg P
BMC Public Health. 2016; 16(1); DOI: 10.1186/s12889-016-3149-z
Datta J, Palmer MJ, Tanton C, Gibson LJ, Jones KG, Macdowall W, Glasier A, Sonnenberg P, Field N, Mercer CH, Johnson AM, Wellings K
Hum Reprod. 2016; 31(9); 2108-2118
Tanton C, Johnson AM, Macdowall W, Datta J, Clifton S, Field N, Mitchell KR, Wellings K, Sonnenberg P, Mercer CH
Sex Transmit Infect. 2016; doi:10.1136/sextrans-2015-052459
Wellings K, Palmer MJ, Geary RS, Gibson LJ, Copas A, Datta J, Glasier A, Scott RH, Mercer CH, Erens B, Macdowall W, French RS, Jones K, Johnson AM, Tanton C, Wilkinson P
Lancet 2016; doi: 10.1016/S0140-6736(16)30449-4
Field N, Prah P, Mercer CH, Rait G, King M, Cassell, J, Tanton C, Heath L, Mitchell KR, Clifton S, Datta J, Wellings K, Johnson AM, Sonnenberg P
BMJ Open 2016; 6(3) e010521-?. doi:10.1136/bmjopen-2015-010521
Clifton S, Nardone A, Field N, Mercer CH, Tanton C, Macdowall W, Johnson AM, Sonnenberg P
AIDS 2016; 20(6); 943-951
Mitchell, KR; Prah, P; Mercer, CH; Datta, J; Tanton, C; Macdowall, W; Copas, AJ; Clifton, S; Sonnenberg, P; Field, N; Johnson, AM; Wellings, K; (2016)
Sexually transmitted infections, 92 (1). pp. 32-8. ISSN 1368-4973 DOI: 10.1136/sextrans-2015-052094
Using the web to collect data on sensitive behaviours: a study looking at mode effects on the British National Survey of Sexual Attitudes and Lifestyles
PLoS ONE 11(2): e0147983.doi:10.1371/journal.pone.0147983
Mapp F, Hickson F, Mercer CH, Wellings K
The Journal of Sexual Medicine, 2015; 12. p. 320. ISSN 1743-6095
Mitchell KR, Jones KG, Wellings K, Johnson AM, Graham C, Datta J, Copas AJ, Bancroft J, Sonnenberg P, Macdowall W, Field N, Mercer CH
(2015) Journal of Sex Research; DOI: 10.1080/00224499.2015.1089214
Homfray V, Tanton C, Mitchell K, Miller R, Field N, Macdowall W, Wellings K, Sonnenberg P, Johnson A, Mercer CH (2015)
AIDS 29:1411–1416
Sonnenberg P, Ison CA, Clifton S, Field N, Tanton C, Soldan K, Beddows S, Alexander S, Khanom R, Saunders P, Copas AJ, Wellings K, Mercer CH, Johnson AM
International Journal of Epidemiology 2015; 1-13. doi: 10.1093/ije/dyv194
Prah P, Johnson AM, Nardone A, Clifton S, Mindell JS, Copas AJ, Robinson C, Craig R, Woodhall S, Macdowall W, Fuller E, Erens B, Sonnenberg P, Wellings K, Mercer CH
PLOS ONE, 2015;10(8):e0135203 doi: 10.1371/journal.pone.0135203
Fuller E, Clifton S, Field N, Mercer CM, Prah P, Macdowall W, Mitchell K, Sonnenberg P, Johnson AM, Wellings K
Scottish Government, 2015
High-risk human papillomavirus (HPV) infection and cervical cancer prevention in Britain: Evidence of differential uptake of interventions from a national probability survey
Cancer Epidemiology, Biomarkers, and Prevention. 2015; 24(5) 842-53
Tanton C, Jones KG, Macdowall W, Clifton S, Mitchell KR, Datta J, Lewis R, Field N, Sonnenberg P, Stevens A, Wellings K, Johnson AM, Mercer CH
BMJ Open. 2015; 5: e007834. doi:10.1136/bmjopen-2015-007834
Macdowall W, Jones KG, Tanton C, Clifton S, Copas AJ, Mercer CH, Palmer MJ, Lewis R, Datta J, Mitchell KR, Field N, Sonnenberg P, Johnson AM, Wellings K
BMJ Open. 2015; 5:e007837. doi:10.1136/bmjopen-2015-007837
Field N, Clifton S, Alexander S, Ison CA, Hughes G, Beddows S, Tanton C, Soldan K, Coelho da Silva F, Mercer CH, Wellings K, Johnson AM, Sonnenberg P
Sexually Transmitted Infections. Published online first doi:10.1136/sextrans-2014-051850
Jones KG, Mitchell KR, Ploubidis GB, Wellings K, Datta J, Johnson AM, Mercer CH
Journal of Sex Research. 2015; DOI: 10.1080/00224499.2014.985813
Erens B, Burkill S, Couper MP, Conrad F, Clifton S, Tanton C, Phelps A, Datta J, Mercer CH, Sonnenberg S, Prah P, Mitchell KR, Wellings K, Johnson AM, Copas AJ
Journal of Medical Internet Reseach. 2014;16(12):e276
Jones KG, Johnson AM, Wellings K, Sonnenberg S, Field N, Tanton C, Erens B, Clifton S, Datta J, Mitchell KR, Prah P, Mercer CH
Sex Transm Infect. 2014; Published Online First: 17 November 2014. doi:10.1136/sextrans-2014-051683
Keevil BG, MacDonald P, Macdowall W, Lee DM, Wu FCW and the NATSAL Team
Ann Clin Biochem.2014; 51:368-378
Mercer CH, Wellings K, Johnson AM
Sex Transm Infect. 2014; 90: 80-81
Erens B, Phelps A, Clifton S, Mercer CH, Tanton C, Hussey D, Sonnenberg P, Macdowall W, Field N, Datta J, Mitchell K, Copas AJ, Wellings K, Johnson AM
Sex Transm Infect. 2014; 90: 84-89
Prah P, Copas AJ, Mercer CH, Clifton S, Erens B, Phelps A, Tanton C, Sonnenberg P, Macdowall W, Wellings K, Johnson AM
Sex Transm Infect. 2014; 90: 90-93
Wellings K, Johnson AM
Lancet. 2013; 382: 1759-1761
Mercer CH, Tanton C, Prah P, Erens B, Sonnenberg P, Clifton S, Macdowall W, Lewis R, Field N, Datta J, Copas AJ, Phelps A, Wellings K, Johnson AM
Lancet. 2013; 382: 1781-1794
Sonnenberg P, Clifton S, Beddows S, Field N, Soldan K, Tanton C, Mercer CH, Coelho da Silva F, Alexander S, Copas AJ, Phelps A, Erens B, Prah P, Macdowall W, Wellings K, Ison CA Johnson AM
Lancet. 2013; 382: 1795-1806
Wellings K, Jones KG, Mercer CH, Tanton C, Clifton S, Datta J, Copas AJ, Erens B, Gibson LJ, Macdowall W, Sonnenberg P, Phelps P, Johnson AM
Lancet. 2013; 382: 1807-1816
Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, Datta J, Field N, Copas AJ, Tanton C, Erens B, Sonnenberg P, Clifton S, Macdowall W, Phelps A, Johnson AM, Wellings K
Lancet. 2013; 382: 1817-1829
Field N, Mercer CH, Sonnenberg P, Tanton C, Clifton S, Mitchell KR, Erens B, Macdowall W, Wu FC, Datta J, Jones KG, Stevens A, Prah P, Copas AJ, Phelps A, Wellings K, Johnson AM
Lancet. 2013; 382: 1830-1844
Macdowall W, Gibson LJ, Tanton C, Mercer CH, Lewis R, Clifton S, Field N, Datta J, Mitchell KR, Sonnenberg P, Erens B, Copas AJ, Phelps A, Prah P, Johnson AM, Wellings K
Lancet. 2013; 382: 1845-1855
Mitchell KR, Ploubidis GB, Datta J, Wellings K
Eur J Epidemiol. 2012; 27(6): 409-18
Macdonald PR, Owen LJ, Wu FC, MacDowall W, Keevil BG For the NATSAL team
Clin Chem. 2011; 57:774-775
Keevil, BG, Clifton S, Tanton C, Macdowall W, Copas AJ, Lee D, Field N, Mitchell KR, Sonnenberg P, Bancroft J, Mercer CH, Johnson AM, Wellings K, Wu, FCW
Journal of the Endocrine Society. 2017. 1(1); 14-25
Aicken CRH, Estcourt CS, Johnson AM, Sonnenberg P, Wellings K, Mercer CH
Journal of Medical Internet Research, 2016; 18(1):e14. doi: 10.2196/jmir.4373
Updates
Updates List Block
Updates List
Sexual partners study could help improve estimates of STI transmission rates

Sexual partners study could help improve estimates of STI transmission rates.

Read the full article on the sexual partners study

Changes in young people’s sexual practices over the last 20 years revealed

New study shows increasing diversity in young people’s heterosexual practices, helping to develop understanding of current sexual trends which could help guide education policy and safeguard young people’s health and well-being.

Read the full article on changes on young people's sexual practices

Open communication and emotional closeness linked to fewer low sexual interest problems

British women living with a partner are more than twice as likely to lack interest in sex compared to men living with a partner, according to a new study published in the BMJ Open.

Read the full article on lack of interest in sex

Nearly one in 10 British women experience painful sex linked to poorer sexual, physical and mental health

Nearly one in 10 British women are experiencing painful sex (dyspareunia), according to a new study published in BJOG: An International Journal of Obstetrics and Gynaecology.

Distressing sexual problems reported by at least one in ten young people in Britain

Around one in ten young men and one in eight young women in Britain who are sexually active have experienced a distressing sexual problem lasting at least three months in the past year, according to new research published in the Journal of Adolescent Health.

Nearly half of women and men do not seek medical help for infertility

One in eight women and one in ten men have experienced infertility, yet nearly half of them have not sought medical help, according to a study of more than 15,000 women and men in Britain published in the journal Human Reproduction.

Substantial numbers of British adults find new sexual partners while travelling abroad

The authors of the study published in Sexually Transmitted Infections call for safer sex information to be routinely provided in pre-departure travellers’ health advice regardless of age, destination or reason for travel.

1.8 million adults in Britain experience severe sexual problems

An estimated 1.8 million adults in Britain are experiencing sexual problems that need medical help but only around one third of these men and women seek professional support, according to new research published in the Journal of Sex Research.

New research highlights differences in how young men and women learn about sex and relationships

More young people than ever are getting most of their information about sexual matters from school, but the majority feel they are not getting all the information they need, and men in particular are missing out, according to new research published in BMJ Open.

1 in 10 British men say they have paid for sex

11% of men in Britain report having ever paid for sex and 3.6% report doing so in the past five years, according to findings published in Sexually Transmitted Infections.

Read the full article on men paying for sex

Results from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Results published The Lancet give the most detailed picture yet of the British population’s sex lives over the last 10 years.

Who we are
Who we are Natsal

Natsal is led by a research team from the , and (NatCen). School researchers working on the project:

Team Block
Profiles List

Chris
Bonell

Professor of Public Health & Sociology

Clare
Tanton

Assistant Professor in Epidemiology

Wendy Macdowall

Melissa Palmer

Research Fellow