Can psychosocial and socio-demographic questions help identify sexual risk among heterosexually-active women of reproductive age? Evidence from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Abstract

BackgroundContraceptive advice and supply (CAS) and sexually transmitted infection (STI) testing are increasingly provided in primary care. Most risk assessment tools are based on sexual risk behaviours and socio-demographics, for use online or in specialist services. Combining socio-demographic and psychosocial questions (e.g. religious belief and formative experience) may generate an acceptable tool for targeting women in primary care who would benefit from intervention. We aimed to identify psychosocial and socio-demographic factors associated with reporting key sexual risk behaviours among women in the British general population.MethodsWe undertook complex survey analysis of data from 4911 hetero-sexually active women aged 16–44 years, who participated in Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a national probability sample survey undertaken 2010–2012. We used multivariable regression to examine associations between the available psychosocial and socio-demographic variables in Natsal-3 and reports of three key sexual behaviours: a) 2+ partners in the last year (2PP); b) non-use of condoms with 2+ partners in the last year (2PPNC); c) non-use of condoms at first sex with most recent sexual partner (FSNC). We adjusted for key socio-demographic factors: age, ethnicity and socio-economic status (measured by housing tenure).ResultsWeekly binge drinking (6+ units on one occasion), and first sex before age 16 were each positively associated with all three sexual behaviours after adjustment. Current relationship status, reporting drug use (ever), younger age and living in rented accommodation were also associated with 2+ partners and 2 + partners without condoms after adjustment. Currently being a smoker, older age and respondent ethnicity were associated with FSNC after adjustment for all other variables. Current smoking status, treatment for depression (last year), and living at home with both parents until the age of 14 were each associated with one or more of the behaviours.ConclusionsReported weekly binge drinking, early sexual debut, and age group may help target STI testing and/or CAS among women. Further research is needed to examine the proportion of sexual risk explained by these factors, the acceptability of these questions to women in primary care and the need to customise them for community and other settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3918-8) contains supplementary material, which is available to authorized users.

Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years)

“…Furthermore, the use of subjective physical activity measures that had unknown psychometric properties and neglecting to account for potential confounders (e.g., diet) within analyses were commonly identified risks of bias that may have affected the findings (Table 1 ). Alternatively, it could be that physical activity is not strongly associated with adiposity in the early years, and other factors such as diet and sleep are more important predictors in this age group [ 144 , 145 ]. This conclusion is partly supported by the clearer evidence for the impact of physical activity on more rapidly developing health indicators such as motor development, psychosocial health, and cognitive development in the present review, where similar risk of bias limitations existed.…”

Factors related to healthy sexual and contraceptive behaviors in undergraduate students at university of Seville: a cross- sectional study

“…Consumption of alcohol in young people is more frequent every day, independently of sex. As women and men used alcohol for fun, because of this, it is very usual that both groups have sex under alcohol effects [ 28 ]. But not only alcohol, sometimes under drugs effects as well.…”

Towards a critical epidemiology approach for applied sexual health research

“…In recent years our understanding and measurement of socioeconomic status has advanced, with much recent work focusing on neighbourhood measures (Stoltey et al, 2015) (Haley et al, 2017). However evidence suggests that our understanding remains poorly-developed, with large-scale quantitative surveys demonstrating that associations between SES and sexual morbidity (Woodhall et al, 2015;Edelman et al, 2017) are retained in statistical models even after lifestyle variables are included. The unexplained salience of SES in these instances likely reflects the simplicity of SES proxy measures (e.g.…”

“…In such instances it is likely that convention of practice (such as limited socio-demographic and socio-economic variables) are driving study design and analysis rather than explicit research questions and theory, as should be the case. The author's own work (Edelman et al, 2017) illustrates this point, in which modelling of socio-demographic and psychosocial factors which predict multiple partnerships and condom use is limited by the available dataset and conventions within complex survey methodology.…”

“…The unexplained salience of SES in these instances likely reflects the simplicity of SES proxy measures (e.g. housing tenure (Edelman et al, 2017)), and similarly that epidemiology has failed to explore and capture the experiences and mechanisms by which poverty leads to unequal burden of disease. The explanatory potential of observed socio-demographic associations may be overlooked in interpretations of findings -for example putative mechanisms for how poverty impacts on sexual health are rarely offered in quantitative studies.…”