Those who go online regarding their sexual health are potential users of new Internet-based sexual health interventions. Understanding the size and characteristics of this population is important in informing intervention design and delivery. Prevalence of recent past year use of Internet sources for key sexual health reasons was estimated.
Prevalence declined with age men years: No statistically significant association was observed with of sex partners reported after age adjustment, but use was more common among men reporting same-sex partners last 5 years: A minority in Britain used the Internet for the sexual health reasons examined.
However, the impact on health inequalities needs addressing during design and evaluation of online sexual health interventions so that they maximize public health benefit.
Sexual health is increasingly recognized as encompassing physical, mental, and emotional well-being in relation to sexuality and sexual relationships, and freedom from coercion [ 1 ].
In Britain, and globally, there has been an expansion in online sexual health services [ 2 - 5 ]. As well as providing information, these services take advantage of the interactive potential of the Internet, such as for sexual health promotion [ 6 ], to aid "Order sexual health leaflets definition" choices [ 7 ], or for individual counseling via Web chat [ 89 ]. Condoms and contraceptives are purchasable online from Internet vendors and pharmacies. Privately provided Internet-ordered STI human immunodeficiency virus HIV testing and STI treatment services are increasingly available, although they have been poorly regulated and of variable quality [ 35 ].
Recently, the British government legalized HIV home tests, which have been available for purchase online since [ 10 ].
Although new Internet-based sexual health services continue to be developed [ 12 - 15 ], the number and characteristics of people who use currently available online sexual health services in Britain are unknown.
To inform the design and delivery of new online sexual health interventions and services, we need to understand the demographic and behavioral characteristics of existing users. This will help inform whether Internet-based services could reach that underutilize conventional sexual health services relative to their need for sexual health care.
This may include people at elevated risk of STI, such as young people aged yearspeople of black ethnic origins, men who have sex with men MSM [ 16 ], Order sexual health leaflets definition who report multiple sexual partners, those living in deprived areas [ 17 ], and sexually active people who report no recent sexual health care use.
This evidence is necessary for estimating the likely impact of online services which are currently being developed, and for informing the targeting of these services to maximize public health benefit. We conjectured that those reporting use of the Internet for these reasons might represent a population likely to take up online sexual health services that are currently being developed.
Detailed methods have been reported elsewhere; briefly, Natsal-3 used a multistage, clustered, and stratified probability sample design with a boost sample of those aged 16 to 34 years [ 1819 ].
An interviewer visited each selected household and randomly selected one person in the eligible age range to participate, with oral informed consent. Order sexual health leaflets definition completed the survey using mixture of computer-assisted personal interview CAPI conducted face-to-face and computer-assisted self-interview CASI for Order sexual health leaflets definition more sensitive questions [ 1819 ].
Natsal-3 achieved an overall response rate of The full survey is available online [ 20 ]. Variables used in this study were based on self-reported responses to closed-ended survey questions, except Index of Multiple Deprivation IMD quintile [ 21 ] and Output Area Classification OAC supergroup OAC categorizes census output areas into 8 supergroups based on population characteristics [ 2223 ].
Several survey questions relevant to these analyses were not asked to participants aged 45 years and older. We further limited the denominator to sexually experienced people, defined as those who reported ever having had any opposite- or same-sex sexual partners, because they are most likely to require sexual health services. One response could be selected at each question.
For timeframe, the question on sources of contraceptive supplies referred to the past year. For comparability, only participants who indicated that this last occurrence was in the previous year determined from responses to other survey questions were included as reporting these behaviors.
We had the following categories of explanatory variables: Variables for sexual behavior and service use were selected to match the timeframe of the primary outcome variable the year before the survey interview.
Some variables corresponding to the 5 years before the interview were included having had same-sex partners, number of sexual partners, sexual health clinic attendance, and STI diagnosis to reflect greater variability in certain behaviors in the population over this longer period [ 25 ]. Data were analyzed using the complex survey functions of Stata 12 to take account of clustering, stratification, and weighting of the Natsal-3 sample.
Weights were applied to adjust for unequal probabilities of selection for participation in the survey. All analyses were conducted separately by sex.
Participants with missing data for a given variable were excluded from analyses using this variable because item nonresponse in Natsal-3 was low typically less than 0.
The observed low prevalences of other outcome variables meant that it was not possible to explore their associated factors. Among sexually experienced persons aged 16 to 44 years, Internet use for chlamydia testing, HIV testing, or STI treatment combined in the previous year was reported by 0.
Mostly this was chlamydia testing. No one in the sample reported Internet treatment for STIs other than chlamydia. Participants were not asked which method they obtained online, but it is likely that this was mostly condoms: Overall, use of the Internet for any of these sexual health reasons in the past year was reported Order sexual health leaflets definition 6.
Those not reporting this were on average older men: Denominators vary due to item nonresponse. A strong association was observed with education level; 1. Associations with socioeconomic status [ 24 ] followed similar trends. Notably, numbers in minority ethnic groups were relatively small. Having home Internet access was reported by No association was observed with having used STI services in the previous year.
Among sexually experienced persons aged 16 to 44 years reporting use of any "Order sexual health leaflets definition" method in the previous year, 5. Although Internet access is nearly universal in Britain, data from a recent national probability sample survey show that use of the Internet for key sexual health reasons is rare in the British population.