Key findings from Natsal-4

1. People are having less sex, especially young people

The average frequency of sex among adults aged 16-44 has halved in the past three decades, from a reported four times a month in 1990 to two times a month in 2022/24.

Among 16-24 years old, those reporting that they have never had sex has increased from 19% in 2010 to 38% in 2022/24 among women, and from 18% to 28% among men.

2. Growing diversity in sexual attraction, experience and identities

More people are reporting same-sex attraction and experiences, and diverse sexual identities, than in previous Natsal surveys.

For example, in 2024, 26% of women aged 16-44 years reported ever having had a ]same-sex sexual experience (including kissing), compared to 14% in 2010. Among men, reporting of same-sexual experiences have increased from 7% to 16% over the same period.

3. Changes in desire to have children

Fewer women intend to have children in the future.

Among women aged 16-44 with no children, the percentage who said they wanted children fell from 64% in 2010 to 48% in 2022/24.

4. Effective contraceptive use remains low

There has been a persistently high unmet need for contraception since 2010.

Approximately 1 in 5 women who had sex in the past year were not using effective contraception, such as hormonal contraception, the copper coil or condoms.

Women with less education, living in the most deprived areas of Britain, and of black ethnicity are more likely to report not using effective contraception.

5. HPV vaccination is preventing cancer-causing infections

Among young women, the prevalence of the two HPV types responsible for most cervical cancers have fallen by 86%.

HPV vaccination and cervical screening are reaching many women, but gaps remain with uptake and access remaining lower among women born outside the UK or from ethnic or religious minority groups.

6. Chlamydia testing has declined

Testing is declining among all age groups.

For example, among women aged 16-24 years with opposite sex partners, amongst whom the percentage reporting chlamydia testing has fallen from 54% to 13% since 2010. 

7. Gender differences exist in the reporting of sexual wellbeing

Women are more likely to report feeling upset with others about past sexual events, but also having someone to talk openly about sex.

Men are more likely to report shame about sexual thoughts and pleasure.

8. Use of sexual health services has increased among men who have sex with men, but remains low amongst other groups

Among men who had sex with men reporting sexual behaviours that put them at higher risk of sexually transmitted infections, sexual health service use increased from 30% to 53% between 2010 and 2022-24.