Institute for Global Health


The National Surveys of Sexual Attitudes and Lifestyles (Natsal)

The National Surveys of Sexual Attitudes and Lifestyles (Natsal) are the world’s largest, most detailed studies of sexual behaviour.

Project Summary

The National Surveys of Sexual Attitudes and Lifestyles (Natsal) are the world’s largest, most detailed studies of sexual behaviour. People are randomly selected, based on their postcodes, and invited to participate, so the surveys represent the general population in Britain. 

Natsal has taken place roughly every 10 years (1990/’91, 1999-2001, 2010-‘12) with a fourth survey planned for 2022/'23. Interviewers will collect information from nearly 10,000 people aged 16-59 using computerised questionnaires to ensure privacy. Survey answers will be combined with information from biological samples (e.g. urine to test for sexually transmitted infections) and routinely-collected data (e.g. health records). 

By combining Natsals, we will create a resource that provides a comprehensive picture of the sexual health of the nation and show how this has changed over time and across generations. The findings will guide policy on services and interventions to improve sexual health in Britain. Examples of Natsal’s impact to date include:

  • Natsal data have been used to plan services, including evaluating progress towards targets outlined in national strategies, (e.g. the Teenage Pregnancy Strategy) and modelling the effects of HPV vaccination. 
  • Natsal has demonstrated population-based increases in uptake of chlamydia screening, HIV testing, and sexual health service use, and continues to be used to estimate HIV prevalence and undiagnosed HIV in the population.
  • Natsal has informed policy debates, including being extensively cited in the House of Commons Education Select Committee Inquiry into Personal, Social, Health, and Economic Education and more recently as a submission to the 2018 Health and Social Care Committee's Inquiry into Sexual Health. 
  • Data from Natsal have provided the scientific justification for the revised severity criteria for diagnosis of sexual dysfunction in DSM-5. 

Natsal has also played an important role in the public dialogue about sex, has advanced science, and built research capacity. Natsal was a well-received Impact Statement in the 2014 Research Excellence Framework and was selected as one of 14 case studies at the Wellcome Trust 75th anniversary celebrations.

Links to other research

Other research from IGH on Sexual HealthPopulation HealthSexually Transmitted Infections (STI)HIV and Epidemiology

Other research from IGH in the UK