Article Text

Prevalence and correlates of ‘sexual competence’ at first heterosexual intercourse among young people in Britain
  1. Melissa J Palmer1,
  2. Lynda Clarke1,
  3. George B Ploubidis2,
  4. Kaye Wellings3
  1. 1 Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2 Department of Social Science, UCL Institute of Education, University College London, London, UK
  3. 3 Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr Melissa J Palmer, Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; Melissa.Palmer{at}


Background A greater understanding of the circumstances of first sexual intercourse, as opposed to an exclusive focus on age at occurrence, is required in order that sexual health and well-being can be promoted from the onset of sexual activity.

Methods We used data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) conducted in Britain. Participants were categorised as ‘sexually competent’ at first heterosexual intercourse if the following self-reported criteria applied to the event: contraceptive use, autonomy of decision, both partners ‘equally willing’, and occurrence at the perceived ‘right time’. We examined the prevalence of ‘sexual competence’, and its component parts, by age at first intercourse among 17–24-year-olds. Using multivariable logistic regression, we explored associations between sexual competence and potential explanatory factors.

Results Variation in ‘sexual competence’ and its component parts was associated with, but not fully explained by, age at first sex: 22.4% and 36.2% of men and women who had first sex at age 13–14 years were categorised as ‘sexually competent’, rising to 63.7% and 60.4% among those aged ≥18 years at first intercourse. Lack of sexual competence was independently associated with: first intercourse before the age of 16 years, area-level deprivation (men only), lower educational level, black ethnicity (women only), reporting ‘friends’ as main source of learning about sex (women only), non-’steady’ relationship at first sex, and uncertainty of first partner’s virginity status.

Conclusions A substantial proportion of young people in Britain transition into sexual activity under circumstances incompatible with positive sexual health. Social inequalities in sexual health are reflected in the context of first intercourse.

  • surveys
  • first sexual intercourse
  • young people
  • sexual behaviour

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials


  • Funding Natsal-3 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 Department of Health. MJP was funded by an ESRC PhD Studentship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.