Household structure and its association with sexual risk behaviours and sexual health outcomes: evidence from a British probability sample survey

Abstract

ObjectivesEconomic and social changes over the last 20 years have led to changes in the living situations of young people in Britain. A person’s home-life context might influence their sexual behaviour, with implications for their sexual healthcare needs; we investigated this hypothesis.MethodsBritain’s third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey undertaken in 2010–2012, interviewed 15 162 men and women aged 16–74 years in Britain (with 3869 aged 16–24 years). We examined household structure by gender and age group. We then focused on sexually experienced young people (aged 16–24 years), and used multivariable models to explore associations between household structure, sexual risk behaviours and sexual health outcomes, independent of confounders including age, relationship status, employment and area of residence.ResultsYoung people were most likely to be living with parents (women 57.1% (95% CI 54.5% to 59.6%) and men 68.7% (95% CI 65.4% to 71.8%)) or non-relatives (women 10.5% (95% CI 8.5% to 12.9%) and men 12.6% (95% CI 10.1% to 15.6%)). Among the 81.3% of young people who were sexually experienced, compared with young women living with parents (reference category), young women living alone or with non-relatives had a higher likelihood of reporting ≥2 sexual partners (adjusted OR 1.54 (95% CI 1.03 to 2.31); 1.76 (95% CI 1.03 to 3.00), respectively). Women living alone were also more likely to have had unsafe sex (2.04 (95% CI 1.38 to 3.02)). Despite these differences in sexually transmitted infection (STI) risk, there was no difference in sexual healthcare-seeking behaviour. Young men and women living with partners reported lower levels of sexual risk behaviours.ConclusionsOur study suggests household structure may influence the sexual behaviour of young people in Britain. Given changes in their living arrangements, the role of household structure in sexual health research should be further investigated, and also considered as a possible marker for STI risk in clinical consultations.

Impacts of COVID-19 on sexual behaviour in Britain: findings from a large, quasi-representative survey (Natsal-COVID)

“…Sexual activity at a population level appears largely unaffected by the COVID-19 restrictions, reflecting how most of the British population are in cohabiting relationships. 2 3 However, a substantial minority perceived sizeable changes following the initial lockdown. Declines in frequency were perceived most commonly by those not living with a partner but who reported partnered sex since lockdown.…”

“…These two factors in turn being primarily driven by lifestage. 2 3 In contrast, opportunities for non-partnered sex (masturbation and virtual sex) may have increased as technology and market forces responded to an anticipated demand 4–7 as people spent more time at home and online. However, the specific impacts of the COVID-19 pandemic on sexual behaviour are unclear, reflecting how, for example, adherence to physical restrictions was not universal and may have changed over time, 8 and for those cohabiting, while the opportunity to have sex was theoretically unaffected, inclination to do so may have been altered by lifestyle changes and stress engendered by the pandemic.…”

Prevalence and types of sexual inactivity in Britain: analyses of national cross-sectional probability survey data

“…First, as our analyses relied on self-reported data, the findings might have been affected by under-reporting or over-reporting of sexual inactivity due to social desirability bias 50. Second, although the response rate in Natsal-3 was in line with other major social surveys in Britain51 52 and the sample was weighted to be broadly representative of the underlying British population with respect to the distribution of gender, age and regions as used in the census, non-response could be a source of bias for our data especially as the sexually inactive may have been less likely to participate although the invitation to do so emphasised the importance of everyone’s participation regardless of sexual experience. Third, as the question on satisfaction with sex life was not asked to those with no previous sexual experience, we could not assess the potential dissatisfaction with the absence of sex among the sexually inexperienced.…”

“…Sixth, as our analyses were limited to information available in Natsal-3, some factors of potential importance, such as health conditions impairing sexual desire and availability of private space in multiperson households, were not investigated. Previous studies have assessed factors associated with the broader issue of sexual activity, including as outcomes: lacking interest in sex,15 low sexual function43 as well as the role of household structure on sexual behaviour,52 and the association between general health and well-being and sexual activity 46. Finally, in some of our analyses on subgroups of the sexually inactive population, sample size was limited and detailed analyses of participant characteristics was therefore not possible to perform.…”

Explaining the Decline in Young Adult Sexual Activity in the United States

“…The tendency for young adults to reside in the parental home has increased sharply over recent decades (Payne, 2019) as a consequence of both a later age at home‐leaving and high rates of returning home, or “boomeranging,” after having attained residential independence (South & Lei, 2015; Stone et al, 2014). And, coresiding with parents appears to reduce sexual frequency among young adults (Curtis et al, 2018), as well as to impede the transition to marriage (Yu & Kuo, 2016). Compared to young adults who live independently, young adults living with parents are likely to have less opportunity to engage in sexual intercourse and they are more likely to have their sexual behavior closely monitored—and hence likely impeded—by their parents (Allison, 2016; Sassler et al, 2008).…”