Latest NATSAL survey reports low engagement with sexual health clinics

Summary results from the latest national NASTAL-4 (National Survey of Sexual Attitudes and Lifestyles) survey reported that most people who were sexually active and at risk of STI’s hadn’t visited a sexual health clinic over the previous year.

This was against a background of increases diagnoses of STIs including syphilis since 2015 during which time council spending on sexual health was cut by one-third.

The survey included just under 6000 participants aged 16-59 years old and was carried out between 2022 to 2024, just after the largest COVID outbreaks. Highest engagement with sexual health services was reported by gay and bisexual men, but this still only reached about 50% of those sampled. Chlamydia testing ‘decreased massively’, especially in women aged 16-24 years old.

These results showed no significant improvements over the last ten years and were generally similar to the previous NASTAL-3 survey a decade earlier. The response rate had also dropped in the latest survey – from 58% to only 25% and led to an overall reduced sample size.

The results perhaps show the importance of expanding some sexual health services to other settings, including online, in GP services and community spaces.

The results were presented by Nigel Field from UCL London on behalf of the NASTAL team.

Ref: Knuppel A et al. Sexual health service use, HIV testing, and chlamydia testing in Britain from 2010-2024: insights from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). 6th Joint BHIVA/BASHH Spring Conference, 27–29 April 2026, Liverpool. Oral abstract 01.
https://onlinelibrary.wiley.com/toc/14681293/2026/27/S1