3F 4 Asking about Sex in General Health Surveys: Comparing Data Collected By the 2010 Health Survey for England with the Third Natsal Survey of Sexual Attitudes and Lifestyles

Wednesday, June 11, 2014: 11:15 AM
Philip Prah, MSc, University College London, London, United Kingdom

Background: The HSE is administered annually to a probability sample of people in England. In 2010, the HSE included, for the first time, questions about sexual health, which previously were considered too sensitive for a general health survey. This paper compares the reporting of sexual behaviours by people aged 16-69 in HSE2010 with Natsal-3, Britain’s national probability survey of sexual behaviour. 

Methods: HSE2010 interviewed 6,966 people aged 16-69. Natsal-3 interviewed 12,524 people aged 16-69 in 2010-12. HSE2010 used pen-and-paper self-completion questionnaires for the sexual health questions, while Natsal-3 used computer-assisted self-interviews for the more sensitive questions. 

Results: Collecting sexual behaviour data was acceptable to HSE2010 participants with low item non-response (5-10%), albeit slightly higher than in Natsal-3 (<5%). Reported age at 1st intercourse was comparable in the two surveys: medians of 17 (men) and 16 (women) aged 16-24. However, for some very sensitive questions there were lower levels of reporting in HSE2010 than in Natsal-3: while the proportion reporting same-sex in the last 5 years was similar (2-3%), reporting of ever having same-sex was lower in HSE2010 for men (2% vs 5% in Natsal-3). Similarly, the mean number of opposite-sex partners reported in HSE2010 was a little lower than in Natsal-3, particularly for men: 9.5 vs 12.7, respectively; (5.4 vs 6.5 for women, respectively). Men were also slightly less likely to report STI diagnoses in HSE2010 vs Natsal-3: 8.0% vs 13.2%, respectively.

Conclusions: Sexual behaviour data can be successfully collected by the HSE, albeit in less detail than in Natsal. HSE2010 has demonstrated the feasibility and utility of including such questions in general health surveys, providing a useful vehicle for monitoring sexual risk behaviour more frequently than is possible with decennial Natsal surveys.