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The lower prevalence of people having condomless sex with multiple or new partners during the early stages of the Covid-19 pandemic, was still evident one year after Britain’s first lockdown, finds a new study led by researchers at UCL and the University of Glasgow.

The research, published in Sexually Transmitted Infections, provides the most comprehensive picture to date of the impact of Covid-19 on sexual and reproductive health in Britain. It found that while there were fewer reported unplanned pregnancies and abortions than a decade before, respondents had significantly higher levels of sexual dissatisfaction and worries about their sex life.

During the pandemic’s initial months, earlier studies found that changes in sexual behaviour were primarily due to reduced opportunities for people not cohabiting with a partner to have sex.

The researchers also note that most studies found that the frequency of partnered sex declined overall.

However, the timeframe of these early studies was too short to reliably detect changes in sexual behaviour and outcomes, such as sexually transmitted infection (STI) testing, pregnancy and abortion.

The Natsal Covid-19 web panel, which was designed by researchers at the University of Glasgow and UCL, was conducted in two waves. The first wave was four months after the first UK lockdown (July-August 2020) and second was in March-April 2021.

The second wave – which informs this current study – was designed to track behaviour over a longer period and provide 1-year estimates for important sexual and reproductive health outcomes.

These were: patterns of sexual behaviour; sexual health and service use; pregnancies, abortions, and fertility management; sexual function and quality of sex life in the year after the first lockdown (which started 23 March 2020) in Britain.

The online Natsal-COVID-Wave 2 survey was completed by 6658 British residents aged 18-59, with 92% having had some sexual experience in their lifetime.

The responses were compared with those of Natsal-3 (2010-2012) which surveyed 15,162 people aged 16-74. Researchers also compared the results against national data on the number of recorded STI tests in England, and conceptions and abortions in England and Wales, between 2010 and 2020.
The results showed that in the year following the first lockdown, more than two-thirds of survey respondents reported one or more sexual partners (women 72%; men 70%), while fewer than a fifth of all respondents reported a new partner (women 10.4%; men 16.8%). This was compared with a quarter reporting a new partner in the past year (women 18.1%; men 23.3%) in Natasl-3.

They also reported less condomless sex with new partners than 10 years previously.

Professor Nigel Field, from UCL (University College London), said, “Although each data source in our study has limitations, they are consistent in suggesting that COVID-19 and lockdowns had a significant influence on sexual and reproductive health during the first year of the pandemic. Young people, who are less likely to live with their partners, were particularly affected.”

Professor Kirstin Mitchell, from the University of Glasgow, said: “As we recover from the pandemic, public health messages about safer sexual behaviour and STI testing are important. In the UK, we are fortunate to have free and confidential sexual health services, which include asymptomatic STI testing and PrEP for HIV prevention. This is particularly important because some young people may have missed out on sex education due to school closure and disruptions.”

The median number of times respondents said they had sex was twice a month, compared with three times in 2010 (Natsal-3), although the researchers note that this average has been falling since 1990, so may be unrelated to the pandemic.

However, dissatisfaction was common with regards to sex life – with 19% of women and 23% of men reporting distress or concerns about their sexual activity, and a quarter of respondents feeling their sex life during the pandemic was worse than the previous year.

Meanwhile, both the number of unplanned pregnancies and abortions fell.

Compared with surveillance trends from 2010 to 2019, use of sexual health services and testing for HIV and chlamydia were also lower. This is in line with the survey observations, where only 16% of participants who said they had at least one new partner in Nastal-COVID-2 reported a chlamydia test in the past year, compared with 39% of respondents in Natsal-3.

Nevertheless, comparison with Natsal-3 should be interpreted cautiously, say the researchers, as that was a household interviewer-led survey rather than a web panel online survey. Additionally, Natsal-3 data were collected 10 years ago, in which time sexual behaviours, sexual mores, and service provision have all changed.

Now, the researchers are advising that pandemic recovery should focus on restoring STI prevention behaviours, provision of free or low-cost condoms, catching up on service-provision backlogs, counselling for sexual difficulties and ex education for young people who missed out during the pandemic.

The study was led by researchers at UCL and the University of Glasgow, and included researchers at the London School of Hygiene and Tropical Medicine and NatCen Social Research, and epidemiologists from UK Health Security Agency. The survey was undertaken by Ipsos.

The study was funded by the Wellcome Trust, supported by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR), the Medical Research Council, the Scottish Government Chief Scientist Office and the UCL Coronavirus Response Fund.

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Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk / 0141 330 6557 or 0141 330 4831

First published: 27 March 2023