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Household structure and its association with sexual risk behaviours and sexual health outcomes: evidence from a British probability sample survey
  1. Tyrone J Curtis1,
  2. Nigel Field2,
  3. Soazig Clifton1,
  4. Catherine H Mercer1
  1. 1 Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
  2. 2 Centre for Molecular Epidemiology and Translational Research, Institute for Global Health, University College London, London, UK
  1. Correspondence to Tyrone J Curtis; tyrone.curtis{at}


Objectives Economic 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.

Methods Britain’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.

Results Young 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.

Conclusions Our 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.

  • genitourinary medicine
  • epidemiology
  • sexual medicine

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  • Contributors This paper was conceived by TJC, NF, SC and CHM. TJC wrote the first draft of the article, with further contributions from NF, SC and CHM. TJC carried out the statistical analysis, with support from SC, NF and CHM. All authors interpreted data, reviewed successive drafts and approved the final version of the article.

  • Funding The study was supported by grants from the Medical Research Council (G0701757 and MR/N013867/1); and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health. Soazig Clifton was funded to undertake independent research supported by the National Institute for Health Research (NIHR Research Methods Programme, Fellowships and Internships, NIHR-RMFI-2014-05-28).

  • Disclaimer The sponsors of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all of the data in the study and had final responsibility for the decision to submit for publication.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The Natsal-3 study was approved by the Oxfordshire Research Ethics Committee A (reference: 09/H0604/27).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The Natsal-3 data set is publicly available from the UK Data Service:; SN: 7799; persistent identifier: 10.5255/UKDA-SN-77991-1.

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