STI Risk Perception in the British Population and How It Relates to Sexual Behaviour and STI Healthcare Use: Findings From a Cross-sectional Survey (Natsal-3)

Soazig Clifton, Catherine H. Mercer*, Pam Sonnenberg, Clare Tanton, Nigel Field, Kirsten Gravningen, Gwenda Hughes, Fiona Mapp, Anne M. Johnson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Background: We investigated how STI risk perception relates to behavioural STI risk and STI healthcare (sexual health clinic attendance/chlamydia testing) in the British population. Methods: Natsal-3, a national probability-sample survey undertaken 2010–12, included 8397 sexually-active 16–44 year-olds. Participants rated their risk of STIs (excluding HIV) given their current sexual lifestyle. Urine from a randomly-selected sub-sample of participants (n = 4550) was tested for prevalent STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis). Findings: Most men (64% (95% CI: 62–66)) and women (73% (72–74)) rated themselves as not at all at risk of STIs, 30% (29–32) men and 23% (22–25) women self-rated as not very much, and 5% (5–6) men and 3% (3–4) women as greatly/quite a lot at risk. Although those reporting STI risk behaviours were more likely to perceive themselves as at risk, > 70% men and > 85% women classified as having had unsafe sex in the past year, and similar proportions of those with a prevalent STI, perceived themselves as not at all or not very much at risk. Increased risk perception was associated with greater STI healthcare-use (past year), although not after adjusting for sexual behaviour, indicating in a mediation analysis that risk perception was neither necessary or sufficient for seeking care Furthermore, 58% (48–67) men and 31% (22–41) women who had unsafe sex (past year) and rated themselves as greatly/quite a lot at risk had neither attended nor tested. Interpretation: Many people at risk of STIs in Britain underestimated their risk, and many who correctly perceived themselves to be at risk had not recently accessed STI healthcare. Health promotion needs to address this mismatch and ensure that people access healthcare appropriate to their needs.

Original languageEnglish
Pages (from-to)29-36
Number of pages8
JournalEClinicalMedicine
Volume2-3
DOIs
Publication statusPublished - 1 Aug 2018

Bibliographical note

Funding Information:
We thank the study participants and the team of interviewers, operations and computing staff from NatCen Social Research. Natsal-3 is a collaboration between University College London (London, UK), the London School of Hygiene and Tropical Medicine (London, UK), NatCen Social Research, Public Health England, and the University of Manchester (Manchester, UK). The study was supported by grants from the Medical Research Council (G0701757) and the Wellcome Trust (084840) with contributions from the Economic and Social Research Council and UK Department of Health. SC 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). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Funding Information:
We thank the study participants and the team of interviewers, operations and computing staff from NatCen Social Research. Natsal-3 is a collaboration between University College London (London, UK), the London School of Hygiene and Tropical Medicine (London, UK), NatCen Social Research, Public Health England, and the University of Manchester (Manchester, UK). The study was supported by grants from the Medical Research Council ( G0701757 ) and the Wellcome Trust ( 084840 ) with contributions from the Economic and Social Research Council and UK Department of Health . SC 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). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Publisher Copyright:
© 2018

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