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Collecting and exploiting data to understand a nation’s sexual health needs: Implications for the British National Surveys of Sexual Attitudes and Lifestyles (Natsal)
  1. Catherine H Mercer1,
  2. Soazig Clifton1,2,
  3. Gillian Prior2,
  4. Robert W Aldridge3,
  5. Chris Bonell4,
  6. Andrew J Copas1,
  7. Nigel Field1,
  8. Jo Gibbs1,
  9. Wendy Macdowall4,
  10. Kirstin R Mitchell5,
  11. Clare Tanton6,
  12. Nick Thomson7,
  13. Magnus Unemo8,9,
  14. Pam Sonnenberg1
  1. 1 Institute for Global Health, University College London, London, UK
  2. 2 NatCen Social Research, London, UK
  3. 3 Institute of Health Informatics, University College London, London, UK
  4. 4 Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
  5. 5 MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  6. 6 Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
  7. 7 Wellcome Trust Sanger Institute, Cambridge, UK
  8. 8 WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro, Sweden
  9. 9 National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
  1. Correspondence to Dr Catherine H Mercer, Institute for Global Health, University College London, London WC1E 6BT, UK; c.mercer{at}

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Accurate information about a nation’s sexual health is essential to plan and evaluate services, inform prevention efforts, and contribute to societal discourse on sexuality. In Britain, sexual health data come from a range of sources. There are world-class surveillance data on STIs and reproductive health, although these only represent people attending services and collect limited data.1 2 A number of British surveys draw on convenience samples of populations of particular interest, such as sexual health clinic attendees, men who have sex with men and particular ethnic groups,3–7 and are therefore not generalisable to the wider population. Furthermore, such surveys often focus on specific aspects of sexual health (eg, STIs), and while some nationally representative surveys have included questions on sex and relationships, space limitations mean that questions are restricted to a small number of key behaviours and outcomes.8

Since 1990, the British National Surveys of Sexual Attitudes and Lifestyles (Natsal) have provided a decennial ‘census’ of the sexual health of the nation, capturing detailed data from probability samples of the population (Natsal-1: 1990–1991; Natsal-2: 1999–2001; Natsal-3: 2010–2012). This has involved randomly selecting addresses to which a trained fieldworker calls to randomly select and invite one household member to participate in a detailed structured interview using a combination of computer-assisted face-to-face and self-completion questions, with a subsample of participants invited to provide biological samples. This design seeks to represent the population as …

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