Elsevier

The Lancet

Volume 352, Issue 9141, 21 November 1998, Pages 1664-1668
The Lancet

Articles
Differences in sexual risk behaviour between young men and women travelling abroad from the UK

https://doi.org/10.1016/S0140-6736(98)09414-8Get rights and content

Summary

Background

Identification of people who most frequently engage in sexual risk behaviour while travelling abroad would be useful for the design and targeting of health education and promotion campaigns.

Methods

Eligible participants were people living in the UK aged 18–34 years who had travelled abroad without a partner in the previous 2 years. Respondents were first screened for eligibility as part of representative face-to-face and telephone surveys by a market research company. Eligible individuals who agreed to take part then underwent a computer-assisted telephone interview. Reinterviewing continued until 400 eligible people had been contacted. We also interviewed a control group of 568 young people who had travelled abroad without a partner in the previous 2 years but who did not report a new sexual relationship during their travels.

Flndings

One in ten of the eligible participants reported sexual intercourse with a new partner. Travellers who reported a new sexual relationship abroad were also likely to report large numbers of sexual partners at home. Of the 400 people who had a new sexual partner abroad, 300 (75%) used condoms on all occasions with the new partner. Logistic regression modelling showed differences between men and women in those factors linked to the practice of unsafe or safer sex while travelling. For men, patterns of condom use abroad with casual partners (p<0·001) reflected patterns of use at home (p<0·001), whereas for women, patterns of condom use varied according to their partners' backgrounds (p<0·001).

Interpretation

Condoms are widely used among young travellers, but patterns of use vary by sex. Campaigns about sexual health targeted at international travellers should continue, not least because young people who meet new sexual partners abroad may be a convenient proxy group for that minority of the population who report most sexual partners at home. Such campaigns should be designed differently for men and women.

Introduction

Sexual risk behaviour among international travellers has become an important issue because of the HIV-1 epidemic.1 A common assumption is that people are more likely to engage in high-risk sexual behaviour when travelling than when they are at home. Of the several national European studies on sexual behaviour,2 the Swiss national survey is the only one that collected data separately on respondents' sexual partners while travelling abroad.3 There have also been studies on travellers' sexual risk behaviour based on local samples,4 clinic samples,5, 6, 7 and subgroups of travellers such as sex tourists8, 9 and returning expatriates.10

Many European countries have targeted intervention campaigns at international travellers to reduce high-risk sexual behaviour, but such efforts are hampered by the limited information available on those subgroups of travellers who are most likely to engage in such behaviour. Our feasibility study, supported by the European Commission, was designed to lay the groundwork for coordinated individual national studies and interventions in Member States, as projected in the Europe Against AIDS Programme. We collected reports of different risk behaviours to allow a detailed analysis of those subgroups of travellers who might be most appropriately targeted for health promotion. We restricted sampling to young people travelling abroad unaccompanied by a sexual partner, since earlier research4 indicated that such travellers were those most likely to report a new sexual partner.

Section snippets

Respondents

The easiest way to collect many representative reports of sexual risk behaviour is to use a two-stage sampling strategy. The first stage involves screening a large number of people for eligibility in one heterogeneous survey that is designed to serve various research needs. Such so-called omnibus surveys are carried out on representative samples on a regular basis by market research organisations. Our initial screening work was done by National Opinion Polls plc (NOP) as part of its regular

Results

Refusal rates in the 11 first-stage omnibus surveys (which yielded 59% of the achieved sample) varied between 32% and 38%. A similar proportion of men and women refused to take part. A mean of 73% of interviewees agreed to be recontacted. Those who refused to be recontacted were more likely to be older than 65 years and in socioeconomic grades D and E. Refusal rates in the 17 first-stage Telebus surveys (which yielded 33% of the achieved sample) were between 71% and 82%. A mean of 85% of people

Discussion

Concern about the possible public-health implications of international travel has been stimulated by clinical reports of HIV-1 infection and other sexually transmitted diseases among travellers returning from abroad.16, 17, 18, 19 The proportion of travellers who reported using condoms in this study is therefore encouraging. When the UK National Survey of Sexual Attitudes and Lifestyles (NATSAL)12 collected data on condom use with a new sexual partner within the previous 4 weeks, the

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