Perspectives

Kaye Wellings is Professor of Sexual and Reproductive Health Research at the London School of Hygiene and Tropical Medicine (LSHTM), and co-leader of the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) published in The Lancet. She prefers to think in terms of sexual evolution rather than revolution when looking back to the time when she left school in York to study social science at London University during the late 1960s. “Moving to London at that time was like moving forward a decade”, she recalls. “While it was an exciting time to be a student, it was still early days for sexual health. The contraceptive pill only became widely available in 1972, and discussion of sex was still taboo for most families.” After graduation, Wellings found herself writing travel guides to London and the inland waterways of Britain. Later, after family commitments, she worked in journalism writing for the journal New Society, before moving into health policy research at the Family Planning Association (FPA). It was during her time as a Research Officer at the FPA in the early 1980s that Wellings first became fascinated with sexual health—and realised how research could be easily distorted by politics and the media. Later that decade, as Senior Research Officer at the Health Education Authority (HEA), she monitored the public’s response to the growing HIV/ AIDS epidemic and locked horns with government health ministers. “Research had guided us to communicate key HIV/AIDS prevention messages using a ‘drip drip’ approach, across a variety of media”, she explains. “The politicians had other ideas, wanting us instead to provide findings to support a high-visibility television campaign. My experience there made me seek a safe haven in academia, where I could tell the story as it was, without having to suppress data or manipulate angles.” Wellings had become increasingly aware of the need for data on sexual behaviour in the general population, and, in 1987, while at the HEA, began development work for a national study with Julia Field at what is now the National Centre for Social Research. “Back in the late 80s, we knew nothing about patterns of sexual behaviour, and so we had no information with which to guide prevention programmes”, Wellings says. She later joined forces with Anne Johnson and Jane Wadsworth, who had plans for a similar study linked to HIV transmission, and they collectively submitted a grant proposal for a feasibility study for a national survey of sexual attitudes and lifestyles, what was to become Natsal. After a lengthy delay, the government rejected support for the project. Wellings later discovered that former Prime Minister Margaret Thatcher, ignoring the recommendations of her chief scientist, did not support Natsal, believing it to be intrusive and concerned www.thelancet.com Vol 382 November 30, 2013

with a subject that the nation already knew enough about. The first Natsal survey was rescued by the Wellcome Trust and published by Blackwell and Penguin in 1994. After working as a Wellcome Senior Research Fellow at St Mary’s Hospital Medical School, London, Wellings moved to LSHTM in 1993, which has been her professional home ever since. Wellings and her team undertook the first global study of sexual behaviour, based on analysis of data from 59 countries, and a programme of research to evaluate England’s teenage pregnancy strategy—both studies were published in this journal in 2006. In the past decade she has been awarded honorary fellowships of the Royal College of Obstetricians and Gynaecologists, the Faculty of Public Health, and the Faculty of Sexual and Reproductive Healthcare, tributes that are usually the preserve of the medical establishment and of which she is justifiably proud. Wellings is only too aware of the media’s role in influencing attitudes to sexual behaviour, and is often frustrated by imbalanced and sensational reporting. “Recently, I took part in a BBC discussion programme about sexual behaviour”, she says. “There were some unusual contributors, and the lifestyles they described were by no means run of the mill. One listener to the programme later told me that she felt that her sex life was boring. This is why Natsal is important, because it describes the full range of sexual behaviour in the population as a whole”, she adds. Richard Smith, Dean of the Faculty of Public Health and Policy at LSHTM, has worked with Wellings for many years and knows her well. “Kaye’s clear grounding with interests outside the ivory tower, and her great compassion for others have led her to spearhead the Natsal work over the past 20 years which has provided a firm foundation not just to a flourishing programme of work within LSHTM on sexual health, but the impetus for wider research in other sensitive areas, and opened doors internationally for others to undertake similar work. Ever collegiate and good humoured, Kaye possesses an inner steel forged through pioneering work within a sensitive area. She is not only tremendously good company, but very supportive and with a ready willingness to advise when she feels one may be mistaken.” As to the future, Wellings sees herself sitting in the British Library writing a book about the evolution of sexual behaviour through the ages, and also devoting time to her passion for cookery. “I would love to write a book about traditional English food, for the French”, she says. “We have a wonderful culinary tradition, but our French neighbours are not aware of it.” But for now, her focus remains what she is best known for, shaping the agenda of sexual health.

Lesley Bruce

Profile Kaye Wellings: pioneering figure in sexual health

Published Online November 26, 2013 http://dx.doi.org/10.1016/ S0140-6736(13)62346-6 See Comment page 1759 See Articles page 1781 For podcast see http:// download.thelancet.com/ flatcontentassets/audio/ lancet/2013/26november.mp3

Richard Lane 1773

Kaye Wellings: pioneering figure in sexual health.

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