Sexual Health & Wellbeing Survey: Main Findings

3 Sub-Group Summaries

3.1 This section summarises key findings for three sub-groups who are of interest in terms of sexual health and wellbeing policy: young adults; respondents who reported having a disability; and lesbian, gay and bisexual people.

Young people aged 18-24

3.2 Young adults and school-age people have long been a focus for sexual health policy in Scotland as a result of a number of factors, including greater likelihood to be in less stable relationships; their relative inexperience of relationships and possible vulnerability; greater proclivity towards general risk-taking and experimentation; perceived higher levels of sexual activity; higher levels of unintended pregnancy in Scotland compared to many other Western countries; and a tendency to have a greater number of partners.

Sixty-three percent of 18-24 year olds report having sex at least once a week compared to 45% of the population as a whole.

As one would expect, young people are the group least likely to have health conditions that affect their sexual activity: just 11% have one which impacts on sexual relationships.

They tend to find discussing sex more difficult than older people which may partly be a consequence of simply having had fewer relationships and sexual experiences. Twenty-one percent of men and 16% of women aged
18-24 find it difficult to say they do not want to have sex. Eleven percent of 18-24 year old women would find it difficult to refuse to have sex if a partner will not use a condom.

Younger people are more likely to be happy with their sex life, however. Three-quarters (75%) of 18-24s are happy with their sexual relationships, higher among women (79%) than men (68%).

Although there are fewer physical health issues that affect their sex life, they are more likely to feel anxious: 22% of 18-24s admit to being anxious about sex or during sex. This is higher among men (28%) than women (19%) but compares starkly to just 11% of people of all ages. Again, this will be partly a consequence of their lack of experience and may also link to differences in expectations and perceptions across age groups of what is acceptable.

Young people are less likely to avoid sex because of a range of common issues which can have a negative impact on sexual experiences and relationships. Of those that do, nearly half (47%) attribute avoidance to anxiety.

Young people are the most likely group to have sought advice and help about sex: 46% had done in the last year, compared to 22% of the wider sample. Twenty-six percent discuss sexual issues with friends or family (compared to 7% of all people) and 17% have used the internet ('other websites') to find help and advice (compared to just 7% of all people again). Once friends and family are excluded as an advice source, 39% of 18-24 year olds have turned to at least one source of advice during the year.

Young people are the most likely to have had sex that they regretted in the last year: 24% for both men and women. This was significantly higher than those aged 25-34, for example, at 11%. Ten percent of 18-24s had done so once and 8% three times or more.

Seventeen percent reported that alcohol had gotten in the way of enjoyable sex at least once in the last year and this was even for men and women. For four percent it has happened just once but for 8% it had been three times or more.

Three percent stated that drugs had affected their sexual activity in the last year: 1% of men and 4% of women.

Young people were the most like to have experienced abusive relationship behaviour with 9% experiencing humiliation or emotional abuse (6% of men, 11% of women. Six percent of men and women had been told by a partner whom they could see and where they could go.

People with disabilities

3.3 People who have a long-term disability or health condition have not been an explicit focus for Scottish Government sexual health and wellbeing policy. However, the results of this survey indicate that there are areas which need to be carefully considered in terms of the quality of relationships and experiences for people with a disability and in terms of inequalities. Additionally, given the ageing profile of our population and findings from NATSAL 3 that more people are continuing to have sexual relationships into older age, the proportion of people with a condition which has the potential to impact negatively on the quality of their relationships is likely to grow. Further work in the future may be beneficial to understand the impacts of different disabilities and conditions and individuals' expectations, confidence and control over their relationships.

Although most feel that their disability or illness affects their sex life, two in five (39%) report that it does not.

However those with a disability do have sex less frequently: 36% have sex once a week or more often, compared to 47% without a disability.

Twenty percent find it difficult to tell a partner if they do not want to have sex, compared to 13% of those without a disability or limiting condition.

Although it may be partly influenced by the age profile of the group, those with a disability are less happy with their sexual relationships and sex life: 48% are happy with their sex life, compared to 67% without a disability.

Connected to this, 86% state that they enjoyed the physical feelings the last time they had sex. Although high, this is significantly lower than other people (91%).

Seventy-one percent have had at least one sexual health issue in the last 12 months compared to 54% of those without a disability.

Thirty-eight percent of people with a disability have avoided sex in the last year, compared to 15% of those without. Key reasons for avoiding sex include erectile dysfunction and other physical problems when having sex.

A third (32%) had sought help or advice in the last year - significantly higher than those without a disability (19%). The GP was by far the most significant source (21%), compared to 6% for those without a disability.

Among those with a very limiting condition there was evidence of abusive experiences with 5% feeling forced to have sex in the last year, compared to 1% of population without a disability or limiting condition. Seven percent of those with a very limiting condition report being told by a partner whom they can see and where they can go in contrast to 3% of those without a disability.

Lesbian, gay and bisexual (LGB)

3.4 A number of sexual health policies have targeted lesbian, gay or bisexual groups within the general population. The majority of such policies and initiatives relate to men who have sex with men and HIV prevention. The findings from this survey suggest areas which may need closer attention in policies and services aimed at improving sexual wellbeing and health for LGB people. As the sample was representative of the population as whole, the actual number of LGB respondents was small (n=91) although at 6% this is consistent with other online surveys. Caution is required in drawing firm conclusions for the wider LGB population.

Three percent of those surveyed describe themselves as gay or lesbian and 3% as bisexual. This is highest among the 18-24 age group with 6% gay or lesbian and 9% bisexual.

Sixteen percent of LGB respondents are currently in a sexual relationship with more than one person, this compares to 2% of heterosexuals.

A quarter (25%) feel that conversations about Sexually Transmitted Infections are 'difficult' to have with their sexual partner(s).

LGB respondents tend to be less happy with their sexual relationships and sex life than heterosexuals. For example, 63% of heterosexuals are happy with their sex life compared to 56% of this group.

Seventy-one percent have had at least one sexual health or wellbeing issue in the last year, but they were no more likely to have avoided sex as a result of those issues than anyone else.

As with younger people, a significantly higher proportion (39%) of LGB respondents have sought help and advice in the last year: 10% had used a sexual health clinic in the past 12 months, compared to just 2% of heterosexuals.

Nineteen percent had sex that they regretted in the last year. There was no difference between LGB and heterosexual people in terms of alcohol affecting sex.

Abusive experiences at the hand of a partner or ex-partner were reported by a higher proportion of LGB respondents although again this may be driven by their younger age profile and higher level of sexual activity, and caution needs to be exercised due to the small number of responses.