A new study, published today in The European Journal of Contraception and Reproductive Health Care highlights key factors associated with an increased likelihood of having unprotected sex.1. Lack of any formal sex education was a key factor: 59% of respondents over the age of 35 reported having never received any formal sex education, and they were 45% more likely to have unprotected sex than those who had received formal sex education. Age at loss of virginity was also identified as resulting in an increased likelihood of unprotected sex. Of those who lose their virginity at 14 years or younger, 72% go on to have unprotected sex. Those who wait until they are at least 20 years of age were 79% lesslikely to have unprotected sex (p-value <0.01).

The results are based on analysis of responses from 9381 sexually active individuals to a global, web-based survey conducted in the UK.2. The study showed that the incidence of unprotected sex is significantly associated with a lower age of first sexual intercourse, greater age of the respondent, the absence of formal sex education and a higher number of sexual partners'.2.

Commenting on the study, Dr Richard Ma, a GP from North London and a member of the Royal College of GPs, Sex, Drugs and HIV Task Group said: "This study is well timed, following on from the recent publication of the NICE guidelines, 'One to one interventions to reduce STIs and teenage conceptions' which came out in February this year. This study highlights the clear need for better education and our role as GPs must go beyond simply providing free condoms. We are in an ideal position to offer advice and support to all sexually active individuals, particularly teenagers and young adults, with the aim of helping to improve the sexual health of the overall population. The NICE guidelines will help by ensuring care is consistent across the UK."

The UK currently has the highest teenage birth rate in Western Europe.3. According to Department of Health statistics one in every ten babies born in England is to a teenage mother. These children are at high risk of growing up in poverty and suffering from poor health and social outcomes. Infant mortality rates for babies born to teen mothers (under the age of 18) are twice the average.4. In addition there is an increasing incidence of both bacterial and viral sexually transmitted infections (STIs) in the UK.5. The situation is complicated by the fact that many STIs have no obvious symptoms, but if left untreated they can result in long-term effects on health causing pelvic inflammatory diseases, fertility problems and even cervical cancer.6.

"These results further support the need for improvements to be made in provision of sex education. As healthcare professionals we see many teenagers and young people contracting STIs which are easily preventable by simply practicing safer sex. Clearly lack of education and access to services remain key issues and need to be addressed in order to ensure we work towards decreasing levels of STIs and unwanted pregnancies in the UK, in young and older people alike," said Dr Immy Ahmed, Consultant in Genitourinary Medicine, Nottingham City Hospital and Vice President British Association for Sexual Health and HIV.

The results

The final study results were based on responses from 9381 sexually active individuals across the UK.

-- Over half (51%) of the individuals surveyed admitted to having unprotected sex without being aware of their partners' full sexual history and there was a fairly equal split between men and women with 53% of men and 50% of women admitting to having unprotected sex.

-- Of those who admitted having unprotected sex without knowing their partners sexual history : 32% were under 16 years; 38% were 16 - 20 years; 52% were 21 -24 years; 62% were 25 - 34 years; 64% were 35 - 44 years and 65% were over 45 years of age.

-- In addition respondents who had a higher number of sexual partners were more likely to have had unprotected sex.

No differences were found in Adjusted Odds Ratios (AOR) calculated for gender, sexual orientation, relationship status or frequency of sex indicating that these factors do not play a direct role in increasing the likelihood of having unprotected sex.

Commenting on the findings, co-author of the study, Peter Roach, Head of Social Marketing SSL International said, "The study results highlight the need for further investigation into the relationship between the role of sex education, age of first sex, the number of sexual partners and the likelihood of this resulting in an increased incidence of unprotected sex. They demonstrate that many people do not always practice safer sex even if they are unaware of their partner's sexual history. Improving the quality and availability of sex education is fundamental to help combat the rising incidence of STIs and unplanned pregnancies in the UK."

Age at first sex

There were significant differences observed in reported rates of unprotected sex based on respondents age when they first had sex e.g. of those who lost their virginity before the age of 14, almost three quarters (72%) reported having unprotected sex. This figure consistently declined for respondents that stated an older age when they first had sex e.g. those who lost their virginity at 20 years of age were 79% less likely to have experienced unprotected sex compared to those who lost their virginity at 14 years of age (AOR 0.56; confidence interval (CI) 0.40 - 0.79; p-value 0.01).

Lack of formal sex education

59% of respondents over the age of 35 reported having never received any formal sex education. These respondents that stated having never received formal sex education were significantly more likely to report having had unprotected sex (AOR 1.45; CI 1.12 - 1.87; p-value <0.01). Compared to the reference group, those who had never had sex education were 45% more likely to have unprotected sex.

Age at time of response to survey

60% of respondents over the age of 25 reported having unprotected sex. In the crude analysis the likelihood of having unprotected sex continuously increased with increasing age, however in the adjusted analysis this increase stabilises after the age of 24 years.

Number of sexual partners

For those reporting having had up to five sexual partners 32% reported having unprotected sex compared to 77% of those who had had more than six sexual partners.

"We all need to work together to help ensure people are provided with the best education so they make informed decisions about their sexual health. Better education should lead to a decrease in the incidence of STIs and unplanned pregnancies which will lead to better overall sexual health for people across the UK," added Peter.

About the Durex Network

The Durex Network is the social marketing arm of Durex, the world's largest condom manufacturer. The Network was established to consolidate the ongoing collaboration between Durex and a variety of international organisations, healthcare professionals, educators, charities and politicians to promote the benefits of good sexual health and the importance of consistent condom use to prevent HIV and other sexually transmitted infections.

www.durex.com

1. Fontes M, Roach P. Predictors and Confounders of unprotected sex: a UK web-based study. The European Journal of Contraception and Reproductive Health Care. Vol 12, no.1. 36 - 45 March 2007.
2. The Durex Global Sex Survey, 2004. (Accessed 30.03.07) Link here.
3. Innocenti Report Card, No.3: A league table of teenage births in rich nations. Issue no.3, July 2001.
4. Department of Health (Accessed 30.03.07) Link here.
5. Health Protection Agency. Focus on Prevention HIV and other Sexually Transmitted Infections in the United Kingdom in 2003, Annual Report, November 2004. (Accessed 30.03.07) Link here.
6. Department of Health. The national strategy for sexual health and HIV. Better prevention, better services, better sexual health. 2001. London, Department of Health.