Our data from a national probability survey show that a substantial minority proportion of the sexually active, resident British population have new sexual partners while overseas, with twice as many men as women reporting doing so, and with men reporting a greater number of partners than women. In addition to gender, partner acquisition overseas is associated with a range of sociodemographic and behavioural characteristics. Of particular note is the large proportion of never married young people who acquire new partners while overseas, as others have noted.2,3,5,13
Reporting of higher numbers of sexual partners by men has been observed in many studies.14
In the context of partners overseas, this may relate to gender differences in the opportunity for travel overseas, and men being more likely than women to pay for sex, but may also be in part due to gender‐linked reporting bias or sampling bias,15
as well as to possible under‐representation of sex workers in probability surveys.16
In common with these other studies, we also found a marked association between an individual's likelihood of reporting acquiring new partners abroad and their patterns of sexual risk behaviours at home, especially their reported numbers of sex partners.2,3,5,13
Acquiring new sex partners abroad may therefore be part of a wider spectrum of high‐risk sexual activity in which those who are highly sexually active at home (whether with opposite‐sex or same‐sex partners) are more likely to continue this behaviour while overseas. This is also evident from the strong and independent association between reporting new partners overseas and the increased likelihood of reporting STI diagnosis/es and HIV testing.
- Data from this national probability survey suggest that a substantial minority of young, unmarried people form new sexual partnerships abroad, but these are typically with residents from the UK or other European countries.
- Those who have new partners while abroad are likely to have higher‐risk sexual lifestyles generally and be at higher risk of STIs.
- Greater attention should be paid to sexual health promotion for travellers abroad, especially young travellers, emphasising the risks of new sexual relationships with compatriots as well as those from other countries in terms of STI/HIV acquisition and onwards transmission.
Our data suggest that partner acquisition overseas, at least among those resident in Britain, appears to be largely assortative, with a large proportion of individuals reporting sex with others who originate from the UK and/or other European Union countries, in common with some studies.5,13,17
This, in part, reflects travel trends as, for example, over three‐quarters of overseas travel by UK residents in 2005 was to European destinations.1
However, this may also reflect how people perceive HIV risk in different countries, which as our study showed, varies considerably.
At the individual level, the sexual health risks associated with acquiring new sex partners abroad depend on numerous factors, including the prevalence, patterns and distribution of high‐risk sexual behaviour (in turn influenced by many sociodemographic factors including age, marital status and sexual orientation), and the background prevalence of disease of the new partner's country of residence. The assortative nature of sexual mixing when abroad suggests that, although HIV transmission risk may be relatively low in Europe, the risk of acquiring more common bacterial STIs (eg, genital chlamydial infection or gonorrhoea) may be greater given recent rising trends in STI diagnoses in Britain and other European countries.18,19
Consequently, sexual health interventions targeting British travellers, especially the young and those who have multiple partners at home, should include information on the risk of having sex with compatriots as well as the STI/HIV prevalence in the local population or sex industry of foreign destinations.
Our study has several limitations. As a general population study, robust estimates are not readily available for individuals who are likely to be at high HIV and STI transmission risk (eg, injecting drug users and sex workers), and among whom these risk behaviours may have a disproportionate contribution to disease transmission. Further detailed studies of these groups are required. Using cross‐sectional survey data, we could identify associations between factors but we could not determine causality, including the ordering of events—for example, we could not link STI acquisition with new partner acquisition or paying for sex while overseas. Finally, as our study was limited to people aged 16–44, our results are not generalisable to older people, among whom overseas travel is also increasing.
In conclusion, HIV prevention interventions, such as safer sex promotion and HIV testing, have traditionally been targeted at migrants arriving from countries with high HIV prevalence,20
and STI/HIV interventions targeting Britons travelling overseas remain relatively underdeveloped. The results from this national probability survey support recent calls by the travel industry and medical specialists for proactive safer sex promotion and risk reduction counselling,5,21
especially for young people on package holidays as well as those travelling overseas for longer periods, such as gap year students and young people working in holiday resorts. Health professionals should make the most of opportunities to reinforce safer sex messages among those who visit general practitioners or travel clinics for travel advice, as well as among people who are seen for STI or HIV care and are planning to travel abroad. This travel advice needs to include information on safer sex and the risks of sex abroad with compatriots as well as those of other nationalities in terms of STI/HIV acquisition and onward transmission.