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Sexual and Reproductive Health in Britain During the First Year of the COVID-19 Pandemic: National Population Survey (Natsal-COVID Study)

25 Pages Posted: 25 Mar 2022

See all articles by Kirstin Rebecca Mitchell

Kirstin Rebecca Mitchell

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit

Malachi Willis

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit

Emily Dema

University College London - Institute for Global Health

Andrew Baxter

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit

Anne Conolly

University College London - Institute for Global Health

Julie Riddell

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit

Raquel Bosó Pérez

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit

Soazig Clifton

University College London - Institute for Global Health

Jo Gibbs

University College London - Institute for Global Health

Clare Tanton

London School of Hygiene & Tropical Medicine

Rebecca Geary

University of Liverpool

Natasha Ratna

World Health Organization (WHO) - Global HIV, Hepatitis and Sexually Transmitted Infections Programmes

Hamish Mohammed

World Health Organization (WHO) - Global HIV, Hepatitis and Sexually Transmitted Infections Programmes

Magnus Unemo

Örebro University

Chris Bonell

London School of Hygiene & Tropical Medicine

Andrew Copas

University College London - Institute for Global Health

Pam Sonnenberg

University College London - Institute for Global Health

Catherine Heather Mercer

University College London - Institute for Global Health

Nigel Field

University College London - Institute for Global Health

More...

Abstract

Background: Restrictions to prevent SARS-CoV-2 transmission profoundly affected sexual and reproductive health (SRH) and services, but the consequences remain unclear. We examined SRH outcomes in Britain during the first year of the pandemic. 

Methods: 6,658 participants (18-59 years) completed a web-panel survey in March-April 2021. We used quota-based sampling and weighting to achieve a quasi-representative population sample. We estimated SRH outcomes in the year from the first UK lockdown in March 2020, by age and gender, and by same-sex behaviour. We triangulated our data descriptively with the most recent probability sample population data (from Natsal-3; collected 2010-12) and surveillance data (2010-2020) to provide context. 

Findings: Among 5,733 participants reporting sexual experience ever, over two-thirds reported one or more sexual partner(s) in the year following lockdown (women 71·8%; men 69·9%); median of 2 occasions of sex per four weeks. Compared with Natsal-3, we found less sexual risk behaviour (lower reporting of multiple partners, new partners, and new condomless partners). Reduced risk included among participants reporting same-sex behaviour. We found similar reporting of HIV testing and STI-related service use, but less reporting of chlamydia testing; fewer reported pregnancies, of which a smaller proportion were scored as unplanned; less reported abortion; and increased sexual dissatisfaction and distress. Compared with trends in surveillance data over the previous decade, we found lower than expected use of STI related services, lower levels of chlamydia testing and fewer conceptions and abortions. 

Interpretation: We observed major shifts in sexual behaviour, SRH, and service uptake in the year following the first COVID-19 lockdown in Britain. These data from multiple sources suggest that shifts were at least partly due to the pandemic and indicate the scale of impact. Restrictions on social mixing and disruption to SRH services are plausible explanations. 

Funding Information: Natsal (Wellcome/ESRC/NIHR), MRC/CSO, and UCL Coronavirus Response Fund.

Declaration of Interests: The other authors declare that they have no conflicts of interest.

Ethics Approval Statement: We obtained ethics approval from University of Glasgow MVLS College Ethics Committee (reference 20019174) and London School of Hygiene and Tropical Medicine Research Ethics committee (reference 22565).

Keywords: COVID-19, sexual behaviour, sexual health, reproductive health, sexually transmitted infections, cervical screening, pregnancy, abortion, sexual difficulties, sexual satisfaction, community survey, prevalence, Men who have sex with men (MSM), Women who have sex with women (WSW).

Suggested Citation

Mitchell, Kirstin Rebecca and Willis, Malachi and Dema, Emily and Baxter, Andrew and Conolly, Anne and Riddell, Julie and Bosó Pérez, Raquel and Clifton, Soazig and Gibbs, Jo and Tanton, Clare and Geary, Rebecca and Ratna, Natasha and Mohammed, Hamish and Unemo, Magnus and Bonell, Chris and Copas, Andrew and Sonnenberg, Pam and Mercer, Catherine Heather and Field, Nigel, Sexual and Reproductive Health in Britain During the First Year of the COVID-19 Pandemic: National Population Survey (Natsal-COVID Study). Available at SSRN: https://ssrn.com/abstract=4066418 or http://dx.doi.org/10.2139/ssrn.4066418

Kirstin Rebecca Mitchell (Contact Author)

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit ( email )

Glasgow
United Kingdom

Malachi Willis

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit ( email )

Emily Dema

University College London - Institute for Global Health ( email )

United Kingdom

Andrew Baxter

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit

Anne Conolly

University College London - Institute for Global Health ( email )

Julie Riddell

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit ( email )

Glasgow
United Kingdom

Raquel Bosó Pérez

University of Glasgow - MRC/CSO Social and Public Health Sciences Unit ( email )

Glasgow
United Kingdom

Soazig Clifton

University College London - Institute for Global Health ( email )

United Kingdom

Jo Gibbs

University College London - Institute for Global Health ( email )

United Kingdom

Clare Tanton

London School of Hygiene & Tropical Medicine ( email )

United Kingdom

Rebecca Geary

University of Liverpool ( email )

Chatham Street
Brownlow Hill
Liverpool, L69 7ZA
United Kingdom

Natasha Ratna

World Health Organization (WHO) - Global HIV, Hepatitis and Sexually Transmitted Infections Programmes ( email )

Hamish Mohammed

World Health Organization (WHO) - Global HIV, Hepatitis and Sexually Transmitted Infections Programmes ( email )

Magnus Unemo

Örebro University ( email )

Fakultetsgatan 1
SE-701 82
Örebro, 70210
Sweden

Chris Bonell

London School of Hygiene & Tropical Medicine

Keppel Street
London, WC1E 7HT
United Kingdom

Andrew Copas

University College London - Institute for Global Health

United Kingdom

Pam Sonnenberg

University College London - Institute for Global Health ( email )

United Kingdom

Catherine Heather Mercer

University College London - Institute for Global Health ( email )

United Kingdom

Nigel Field

University College London - Institute for Global Health ( email )

United Kingdom

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