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Kılıç D, Armstrong HL, Graham CA. (Dis)Similarities in Attitudes Between Partners About Women's Solo Masturbation: A Dyadic Approach to Solo Masturbation and Its Associations with Sexual Satisfaction. JOURNAL OF SEX RESEARCH 2024:1-13. [PMID: 38935022 DOI: 10.1080/00224499.2024.2370943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Attitudes among couples about women's solo masturbation are not well understood. The primary aim of this study was to assess (dis)similarities in attitudes between partners about women's solo masturbation and associations of each partner's attitudes with women's and their partners' sexual satisfaction. One hundred and four mixed-sex couples (M = 27.43 years), recruited through social networking websites and Prolific (an online research participant platform), completed an online survey about demographics, their experiences of solo masturbation, and validated measures of attitudes about women's masturbation and sexual satisfaction. Dyadic data were analyzed using correlational methods and the Actor-Partner Interdependence Model. Women and their partners reported similar and positive attitudes about women's solo masturbation. For women, reports of positive attitudes toward women's solo masturbation were associated with both their own and their partner's sexual satisfaction; there were no associations for men. The role of solo masturbation within romantic relationships is complex but our results support the idea that women's masturbation is now less stigmatized than commonly thought. Normalizing and including masturbation in the sexual script for individuals in relationships may help maximize their, and their partners,' sexual satisfaction.
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Affiliation(s)
- Dilan Kılıç
- Department of Psychology, University of Southampton
| | | | - Cynthia A Graham
- Department of Psychology, University of Southampton
- Department of Gender Studies, The Kinsey Institute, Indiana University
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Begum T, Cullen E, Moffat M, Rankin J. Contraception prescribing in England during the COVID-19 pandemic. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:76-82. [PMID: 37852734 DOI: 10.1136/bmjsrh-2023-201856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND National lockdowns in England due to COVID-19 resulted in rapid shifts in healthcare provision, including in primary care where most contraceptive prescriptions are issued. This study aimed to investigate contraception prescribing trends in primary care during the pandemic and the impact of socioeconomic deprivation. METHODS Prescribing data were accessed from the English Prescribing Dataset for the first year of the COVID-19 pandemic (1 March 2020-28 February 2021) and the year prior (1 March 2019-29 February 2020). Data were analysed by geographical region (London, Midlands and East of England, North of England, South of England) and contraceptive type (progestogen-only pill (POP), combined oral contraception (COC), emergency hormonal contraception (EHC) and contraceptive injections). Differences in prescribing rates were calculated using Poisson regression. Pearson correlation coefficients were calculated for the Index of Multiple Deprivation (IMD) scores for each Clinical Commissioning Group (CCG) in the North East and North Cumbria (NENC). RESULTS Contraception prescribing rates decreased overall during the COVID-19 pandemic in England (Poisson regression coefficient (β)=-0.035), with a statistically significant (p<0.01) decrease in all four regions. Prescriptions decreased for COC (β=-0.978), contraceptive injections (β=-0.161) and EHC (β=-0.2005), while POP (β=0.050) prescribing rates increased. There was a weak positive correlation between IMD and prescribing rates in NENC (p>0.05). CONCLUSIONS Contraception provision was impacted by COVID-19 with an overall decrease in prescribing rates. The deprivation results suggest that this may not be a significant contributing factor to this decrease. Further research is recommended to better understand these changes, and to ensure that services respond appropriately to population needs.
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Affiliation(s)
- Tanha Begum
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - Emer Cullen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Malcolm Moffat
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Muschialli L, Samartsidis P, Presanis AM, Mercer CH. Examining changes in sexual lifestyles in Britain between 1990-2010: a latent class analysis approach. BMC Public Health 2024; 24:366. [PMID: 38310277 PMCID: PMC10837868 DOI: 10.1186/s12889-024-17850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Understanding sexual lifestyles and how they change over time is important for determining the likelihood of sexual health outcomes. Standard descriptive and regression methods are limited in their ability to capture multidimensional concepts such as sexual lifestyles. Latent Class Analysis (LCA) is a mixture modelling method that generates a categorical latent variable to derive homogenous groups from a heterogeneous population. Our study investigates (1) the potential of LCA to assess change over time in sexual lifestyles and (2) how quantifying this change using LCA compares to previous findings using standard approaches. METHODS Probability-sampled data from three rounds of the National Survey of Sexual Attitudes and Lifestyle (Natsal) were used, restricted to sexually active participants (i.e., those reporting sexual partners in the past year) aged 16-44 years (N1990 = 11,738; N2000 = 9,690; N2010 = 8,397). An LCA model was built from four variables: number of sexual partners (past year), number of partners without a condom (past year), age at first sex and self-perceived HIV risk. Covariates included age, ethnicity, educational attainment, same-sex attraction, and marital status. Multinomial regression analyses and Chi-Squared tests were used to investigate change over time in the size of each class. RESULTS We successfully used a LCA approach to examine change in sexual lifestyle over time. We observed a statistically significant increase between 1990 and 2010 in the proportion of men (χ2 = 739.49, p < 0.01) and women (χ2 = 1270.43, p < 0.01) in a latent class associated with reporting 2 or more partners in the last year, relatively high probabilities of reporting condomless sex partners, greater self-perceived HIV risk, and a high probability of first sex before age 16 years, increasing from 19.5% to 31.1% (men) and 9.9% to 22.1% (women). CONCLUSION Our results indicate the viability of LCA models to assess change over time for complex behavioural phenomena. They align with previous findings, namely changing sexual lifestyles in Britain in recent decades, partnership number driving class assignment, and significant sex differences in sexual lifestyles. This approach can be used to extend previous LCA models (e.g., to investigate the impact of COVID-19 on sexual lifestyles) and to support empirical evidence of change over time, facilitating more nuanced public health policy.
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Affiliation(s)
- Luke Muschialli
- UCL Medical School, Faculty of Medical Sciences, University College London, London, UK.
| | - Pantelis Samartsidis
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Anne M Presanis
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Catherine H Mercer
- Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
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Fountain H, Migchelsen SJ, Charles H, Ram T, Fifer H, Mohammed H, Sinka K. Rebound of Gonorrhea after Lifting of COVID-19 Preventive Measures, England. Emerg Infect Dis 2024; 30:329-332. [PMID: 38167386 PMCID: PMC10826777 DOI: 10.3201/eid3002.231148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
After lifting of all COVID-19 preventive measures in England in July 2021, marked, widespread increases in gonorrhea diagnoses, but not testing numbers, were observed, particularly in persons 15-24 years of age. Continued close surveillance and public health messaging to young persons are needed to control and prevent gonorrhea transmission.
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Affiliation(s)
| | | | | | - Tika Ram
- UK Health Security Agency, London, UK
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Setty E, Dobson E. Young Love "Locked Down": Adolescent and Young Adult Perspectives on Sexting During the Covid-19 Pandemic in England. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:481-495. [PMID: 37968536 PMCID: PMC10844455 DOI: 10.1007/s10508-023-02734-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/17/2023]
Abstract
There were limited opportunities for in-person social, intimate, and sexual interactions in England during 2020-2021, due to restrictions imposed by the UK government in response to the Covid-19 pandemic. While previous studies examined the effects of lockdown on intimate relationships, there is less qualitative research regarding young people's perspectives on and experiences of digitally mediated intimacy (sexting) during the period. This paper discusses findings from focus groups with 80 adolescents and interviews with 38 young adults that explored the topic. Analysis identified a normalization of non-consensual distribution of intimate images within adolescent peer culture and a reluctance to report or intervene in response to incidents of non-consensual distribution that are witnessed or experienced. The adolescent girls and young adult women also described other forms of unwanted and invasive image-sharing and requests for images. Young adults held various perspectives on sexting during lockdown, with some describing sexting as unfulfilling and/or "risky" and others sharing experiences of using sexting to generate intimacy and, among some, engaging in unwanted sexting with partners. By considering both adolescent and young adult perspectives obtained through focus groups and interviews, the study highlighted how group-level norms and meanings surrounding the risks and rewards of sexting may be reproduced or reworked as individuals transition from adolescence to young adulthood. The study underscores the need to support adolescents and young adults in cultivating healthy digital sexual cultures and interpersonal relationships.
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Affiliation(s)
- Emily Setty
- Department of Sociology, 11 AD 03, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
| | - Emma Dobson
- School of Education, University of Durham, Durham, UK
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Nimbi FM, Cavagnis S, Eleuteri S. Changes in Sexual Behavior and Satisfaction and Violent Behavior during COVID-19 Lockdown: Explorative Results from the Italian Cross-Sectional Study of the I-SHARE Multi-Country Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:96. [PMID: 38248559 PMCID: PMC10815040 DOI: 10.3390/ijerph21010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND The COVID-19 pandemic has had effects on sexual and reproductive health and intimate partner violence (IPV). This study aims to describe changes in sexual health and IPV in the Italian population both during and after the lockdowns. METHODS This cross-sectional online study was conducted, as part of the I-SHARE multicountry project, between June 2020 and January 2021. Recruitment was carried out through convenience sampling; a total of 329 participants were included in the analysis. A generalized linear model was used to analyze the difference in sexual health and IPV variables before, during, and after the lockdown. RESULTS Fifty-three percent of the participants reported having sexual problems during the first wave of the pandemic. Sexual satisfaction decreased during the first wave, and then, returned to the pre-lockdown level. While during the lockdown, some activities were reduced (such as kissing, cuddling, and sexual activities with a steady partner), for other activities, no difference was reported (such as masturbation, sexual activities with casual partners, or sexting). Few participants reported having issues accessing HIV testing and contraception. There was no difference in terms of physical and sexual violence, while there was a significant decrease in feeling vulnerable to sexual or physical assault during the first wave. CONCLUSIONS The first wave of the pandemic has had significant effects on sexual health. This should be taken into consideration when preparing for future epidemics and health emergencies.
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Affiliation(s)
- Filippo Maria Nimbi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy;
| | - Sara Cavagnis
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Stefano Eleuteri
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
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Dema E, Conolly A, Willis M, Copas AJ, Clifton S, Blake M, Riddell J, Bosó Pérez R, Tanton C, Bonell C, Sonnenberg P, Mercer CH, Mitchell KR, Field N. Methodology of Natsal-COVID Wave 2: A large, quasi-representative, longitudinal survey measuring the impact of COVID-19 on sexual and reproductive health in Britain. Wellcome Open Res 2024; 7:166. [PMID: 37794900 PMCID: PMC10545983 DOI: 10.12688/wellcomeopenres.17850.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 10/06/2023] Open
Abstract
Background The National Surveys of Sexual Attitudes and Lifestyles COVID study (Natsal-COVID) was designed to understand the impact of COVID-19 on Britain's sexual and reproductive health (SRH). Natsal-COVID Wave 1 survey and qualitative follow-up interviews were conducted in 2020. The Wave 2 survey was designed to capture one-year prevalence estimates for key SRH outcomes and measure changes over the first year of the pandemic. We describe the Wave 2 survey methodology and assess the sample representativeness. Methods Natsal-COVID Wave 2 was conducted March-April 2021; approximately one year after the start of Britain's first national lockdown. Data were collected using an online web-panel survey administered by Ipsos. The sample comprised a longitudinal sample of Wave 1 participants who had agreed to re-contact plus a sample of participants residing in Britain, aged 18-59, including a boost sample comprising people aged 18-29. Questions covered reproductive health, relationships, sexual behaviour and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British population. Comparisons were made with recent national probability surveys, Natsal-3 (2010-12) and Natsal-COVID Wave 1 to understand bias. Results A total of 6,658 individuals completed the survey. In terms of gender, age, ethnicity, and rurality, the weighted Natsal-COVID Wave 2 sample was like the general population. Participants were less likely to be married or to report being in good health than the general population. The longitudinal sample (n=2,098) were broadly like participants who only took part in Wave 1 but were older. Among the sexually active, longitudinal participants were less likely to report multiple sexual partners or a new sexual partner in the past year compared to those who only took part in Wave 1. Conclusions Natsal-COVID collected longitudinal, quasi-representative population data to enable evaluation of the population-level impact of COVID-19 on SRH and to inform policy.
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Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
| | - Anne Conolly
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
- NatCen Social Research, 35 Northampton Square, London, EC1V 0AX, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Andrew J. Copas
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
- NatCen Social Research, 35 Northampton Square, London, EC1V 0AX, UK
| | | | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
| | - Catherine H. Mercer
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
| | - Kirstin R. Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Nigel Field
- Institute for Global Health, University College London, Mortimer Market Centre, London, WC1E 6JB, UK
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Cooper E, Read B, Sanyaolu L, Ahmed H, Lecky D. Impact of sociodemographic status and UTI symptoms on women's health-care seeking and management in England: findings from an e-survey conducted during the first year of the COVID-19 pandemic. BJGP Open 2023; 7:BJGPO.2023.0039. [PMID: 37429633 PMCID: PMC11176701 DOI: 10.3399/bjgpo.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Multiple factors may influence women's experiences of urinary tract infection (UTI) and its clinical management. AIM To explore how women's background, symptoms, and severity of symptoms influence UTI reporting and management. DESIGN & SETTING Internet questionnaire targeting women in England, focusing on UTI symptoms, care seeking, and management. METHOD A total of 1096 women aged ≥16 years with UTI symptoms in the previous year completed the questionnaire in March and April 2021. Multivariable logistic regression was ued to estimate the odds of relevant outcomes while adjusting for background characteristics. RESULTS Women with children in their household, who were aged under 45 years, or who were married or cohabitating were more likely to experience UTI symptoms. The odds of antibiotic prescribing were lower if women reported dysuria (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] = 0.49 to 0.85), frequency (AOR = 0.63, 95% CI = 0.48 to 0.83), or vaginal discharge (AOR = 0.69, 95% CI = 0.50 to 0.96), but higher if reporting haematuria (AOR = 2.81, 95% CI = 1.79 to 4.41), confusion (AOR = 2.14, 95% CI = 1.16 to 3.94), abdominal pain (AOR = 1.35, 95% CI = 1.04 to 1.74), or systemic symptoms (AOR = 2.04, 95% CI = 1.56 to 2.69). Those with abdominal pain or two or more of nocturia, dysuria, or cloudy urine had lower odds of receiving a delayed antibiotic, while those with incontinence, confusion, unsteadiness, or low temperature had higher odds of a delayed prescription. Increasing symptom severity was associated with greater odds of receiving antibiotics. CONCLUSION Except for reduced prescribing if a woman had dysuria and frequency, antibiotic prescribing followed an expected pattern, aligning generally with national guidance. Symptom severity and the likelihood of systemic infection probably influenced care seeking and prescribing. Sexual intercourse and childbirth may be key times to target women with messages about UTI prevention.
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Affiliation(s)
- Emily Cooper
- Primary Care and Interventions Unit, UK Health Security Agency, Twyver House, Gloucester, UK
| | - Brieze Read
- Primary Care and Interventions Unit, UK Health Security Agency, Twyver House, Gloucester, UK
| | - Leigh Sanyaolu
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Haroon Ahmed
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Donna Lecky
- Primary Care and Interventions Unit, UK Health Security Agency, Twyver House, Gloucester, UK
- School of Medicine, Cardiff University, Cardiff, UK
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Berdychevsky L. (Un)forgotten Sex Lives During the COVID-19 Pandemic: Coping Strategies That Work and the Role of Experience. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3343-3363. [PMID: 37407891 DOI: 10.1007/s10508-023-02630-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 07/07/2023]
Abstract
Available literature points to a worsening trend in sexual functioning, desire, and satisfaction during the pandemic. Nevertheless, virtually no empirical research was conducted on the mechanisms of coping with the pandemic's impacts on sex life. Thus, the purpose of this exploratory study was to examine a variety of coping mechanisms and their perceived usefulness by people who have and have not tried these coping strategies to maintain and enhance their sex lives during the first year of the pandemic. The cross-sectional data were collected using an online survey methodology (N = 420; 66.9% women) and analyzed utilizing exploratory factor analysis, analysis of variance, and multiple regression. The results revealed nine factors/coping mechanisms (based on 59 items/strategies), including goal-setting strategies, risk and experimentation strategies, relational strategies, caution and logistical strategies, creativity and innovation strategies, substances and context-related strategies, online and technology strategies, diversion strategies, and educational strategies. Consistently, across all the specific coping strategies and overall coping mechanisms, people who tried them found them significantly more useful than those who had not tried these coping strategies. Moreover, a higher diversity of tried strategies per coping mechanism consistently and significantly predicted the perceived usefulness of that coping mechanism. These results emphasize the crucial role of experience with coping mechanisms and show that amidst COVID-related adversity and challenges, many people found ways to adapt their sex lives and enjoy silver-lining opportunities. This exploratory study offers promising evidence for potential sexual coping strategies during times of stress that could be informative for clinical practice and education.
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Affiliation(s)
- Liza Berdychevsky
- Department of Recreation, Sport and Tourism, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 219 Huff Hall, 1206 South Fourth St., Champaign, IL, 61820, USA.
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Baxter AJ, Geary RS, Dema E, Bosó Pérez R, Riddell J, Willis M, Conolly A, Oakley LL, Copas AJ, Gibbs J, Bonell C, Sonnenberg P, Mercer CH, Clifton S, Field N, Mitchell K. Contraceptive use and pregnancy planning in Britain during the first year of the COVID-19 pandemic: findings from a large, quasi-representative survey (Natsal-COVID). BMJ SEXUAL & REPRODUCTIVE HEALTH 2023; 49:260-273. [PMID: 36958823 PMCID: PMC10579517 DOI: 10.1136/bmjsrh-2022-201763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Contraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic. METHODS Natsal-COVID Wave 2 surveyed 6658 adults aged 18-59 years between March and April 2021, using quotas and weighting to achieve quasi-representativeness. Our analysis included sexually active participants aged 18-44 years, described as female at birth. We analysed contraception use, contraceptive switching due to the pandemic, contraceptive service access, and pregnancy plannedness. RESULTS Of 1488 participants, 1619 were at risk of unplanned pregnancy, of whom 54.1% (51.0%-57.1%) reported routinely using effective contraception in the past year. Among all participants, 14.3% (12.5%-16.3%) reported switching or stopping contraception due to the pandemic. 3.2% (2.0%-5.1%) of those using effective methods pre-pandemic switched to less effective methods, while 3.8% (2.5%-5.9%) stopped. 29.3% (26.9%-31.8%) of at-risk participants reported seeking contraceptive services, of whom 16.4% (13.0%-20.4%) reported difficulty accessing services. Clinic closures and cancelled appointments were commonly reported pandemic-related reasons for difficulty accessing services. This unmet need was associated with younger age, diverse sexual identities and anxiety symptoms. Of 199 pregnancies, 6.6% (3.9%-11.1%) scored as 'unplanned'; less planning was associated with younger age, lower social grade and unemployment. CONCLUSIONS Just under a third of participants sought contraceptive services during the pandemic and most were successful, indicating resilience and adaptability of service delivery. However, one in six reported an unmet need due to the pandemic. COVID-induced inequalities in service access potentially exacerbated existing reproductive health inequalities. These should be addressed in the post-pandemic period and beyond.
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Affiliation(s)
- Andrew J Baxter
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rebecca S Geary
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Anne Conolly
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Laura L Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | | | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | | | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
| | - Kirsten Mitchell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Mitchell KR, Willis M, Dema E, Baxter AJ, Connolly A, Riddell J, Bosó Pérez R, Clifton S, Gibbs J, Tanton C, Geary R, Ratna N, Mohammed H, Unemo M, Bonell C, Copas A, Sonnenberg P, Mercer CH, Field N. Sexual and reproductive health in Britain during the first year of the COVID-19 pandemic: cross-sectional population survey (Natsal-COVID-Wave 2) and national surveillance data. Sex Transm Infect 2023; 99:386-397. [PMID: 36973042 PMCID: PMC10447381 DOI: 10.1136/sextrans-2022-055680] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/03/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVES To assess sexual behaviour, and sexual and reproductive health (SRH) outcomes, after 1 year of the COVID-19 pandemic in Britain. METHODS 6658 participants aged 18-59 and resident in Britain completed a cross-sectional web-panel survey (Natsal-COVID-Wave 2, March-April 2021), 1 year after the first lockdown. Natsal-COVID-2 follows the Natsal-COVID-Wave 1 survey (July-August 2020) which captured impacts in the initial months. Quota-based sampling and weighting resulted in a quasi-representative population sample. Data were contextualised with reference to the most recent probability sample population data (Natsal-3; collected 2010-12; 15 162 participants aged 16-74) and national surveillance data on recorded sexually transmitted infection (STI) testing, conceptions, and abortions in England/Wales (2010-2020). The main outcomes were: sexual behaviour; SRH service use; pregnancy, abortion and fertility management; sexual dissatisfaction, distress and difficulties. RESULTS In the year from the first lockdown, over two-thirds of participants reported one or more sexual partners (women 71.8%; men 69.9%), while fewer than 20.0% reported a new partner (women 10.4%; men 16.8%). Median occasions of sex per month was two. Compared with 2010-12 (Natsal-3), we found less sexual risk behaviour (lower reporting of multiple partners, new partners, and new condomless partners), including among younger participants and those reporting same-sex behaviour. One in 10 women reported a pregnancy; pregnancies were fewer than in 2010-12 and less likely to be scored as unplanned. 19.3% of women and 22.8% of men were distressed or worried about their sex life, significantly more than in 2010-12. Compared with surveillance trends from 2010 to 2019, we found lower than expected use of STI-related services and HIV testing, lower levels of chlamydia testing, and fewer conceptions and abortions. CONCLUSIONS Our findings are consistent with significant changes in sexual behaviour, SRH, and service uptake in the year following the first lockdown in Britain. These data are foundational to SRH recovery and policy planning.
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Affiliation(s)
- Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Andrew J Baxter
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anne Connolly
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Rebecca Geary
- Institute of Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - Natasha Ratna
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden
| | - Christopher Bonell
- Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | | | - Nigel Field
- Institute for Global Health, University College London, London, UK
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12
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Kılıç D, Armstrong HL, Graham CA. The Role of Mutual Masturbation within Relationships: Associations with Sexual Satisfaction and Sexual Self-Esteem. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:495-514. [PMID: 38596452 PMCID: PMC10903564 DOI: 10.1080/19317611.2023.2237950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/13/2023] [Indexed: 04/11/2024]
Abstract
Objectives We explored mutual masturbation among women and men and investigated associations with sexual satisfaction and sexual self-esteem. Methods 117 women and 151 men (Mage = 29.7 years), mostly heterosexual, all in current relationships, completed an online survey covering experiences of solo and partnered sexual activities, feelings about mutual masturbation, sexual self-esteem, and sexual satisfaction. Results Mutual masturbation was common among both genders. Men reported significantly higher positive feelings about mutual masturbation than women. Recent mutual masturbation was positively associated with sexual satisfaction but not with sexual self-esteem. Conclusions These findings have implications for sex and couple therapy and research.
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Affiliation(s)
- Dilan Kılıç
- Department of Psychology, University of Southampton, Southampton, UK
| | | | - Cynthia A. Graham
- Department of Gender Studies and The Kinsey Institute, Indiana University, Bloomington, IN, USA
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13
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Masukume G, Ryan M, Masukume R, Zammit D, Grech V, Mapanga W, Inoue Y. COVID-19 induced birth sex ratio changes in England and Wales. PeerJ 2023; 11:e14618. [PMID: 36814957 PMCID: PMC9940645 DOI: 10.7717/peerj.14618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/01/2022] [Indexed: 02/19/2023] Open
Abstract
Background The sex ratio at birth (male live births divided by total live births) may be a sentinel health indicator. Stressful events reduce this ratio 3-5 months later by increasing male fetal loss. This ratio can also change 9 months after major population events that are linked to an increase or decrease in the frequency of sexual intercourse at the population level, with the ratio either rising or falling respectively after the event. We postulated that the COVID-19 pandemic may have affected the ratio in England and Wales. Methods Publicly available, monthly live birth data for England and Wales was obtained from the Office for National Statistics up to December 2020. Using time series analysis, the sex ratio at birth for 2020 (global COVID-19 onset) was predicted using data from 2012-2019. Observed and predicted values were compared. Results From 2012-2020 there were 3,133,915 male and 2,974,115 female live births (ratio 0.5131). Three months after COVID-19 was declared pandemic (March 2020), there was a significant fall in the sex ratio at birth to 0.5100 in June 2020 which was below the 95% prediction interval of 0.5102-0.5179. Nine months after the pandemic declaration, (December 2020), there was a significant rise to 0.5171 (95% prediction interval 0.5085-0.5162). However, December 2020 had the lowest number of live births of any month from 2012-2020. Conclusions Given that June 2020 falls within the crucial window when population stressors are known to affect the sex ratio at birth, these findings imply that the start of the COVID-19 pandemic caused population stress with notable effects on those who were already pregnant by causing a disproportionate loss of male fetuses. The finding of a higher sex ratio at birth in December 2020, i.e., 9 months after COVID-19 was declared a pandemic, could have resulted from the lockdown restrictions that initially spurred more sexual activity in a subset of the population in March 2020.
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Affiliation(s)
| | | | - Rumbidzai Masukume
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Victor Grech
- Academic Department of Paediatrics, Medical School, Mater Dei Hospital, Msida, Malta
| | - Witness Mapanga
- Division of Medical Oncology, Department of Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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14
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Mitchell KR, Shimonovich M, Bosó Pérez R, Dema E, Clifton S, Riddell J, Copas AJ, Tanton C, Macdowall W, Bonell C, Sonnenberg P, Mercer CH, Field N. Initial Impacts of COVID-19 on Sex Life and Relationship Quality in Steady Relationships in Britain: Findings from a Large, Quasi-representative Survey (Natsal-COVID). JOURNAL OF SEX RESEARCH 2023; 60:1-12. [PMID: 35286182 DOI: 10.1080/00224499.2022.2035663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Intimate relationships are ubiquitous and exert a strong influence on health. Widespread disruption to them may impact wellbeing at a population level. We investigated the extent to which the first COVID-19 lockdown (March 2020) affected steady relationships in Britain. In total, 6,654 participants aged 18-59 years completed a web-panel survey (July-August 2020). Quasi-representativeness was achieved via quota sampling and weighting. We explored changes in sex life and relationship quality among participants in steady relationships (n = 4,271) by age, gender, and cohabitation status, and examined factors associated with deterioration to a lower-quality relationship. A total of 64.2% of participants were in a steady relationship (of whom 88.9% were cohabiting). A total of 22.1% perceived no change in their sex-life quality, and 59.5% no change in their relationship quality. Among those perceiving change, sex-life quality was more commonly reported to decrease and relationship quality to improve. There was significant variation by age; less often by gender or cohabitation. Overall, 10.6% reported sexual difficulties that started/worsened during lockdown. In total, 6.9% reported deterioration to a "lower quality" relationship, more commonly those: aged 18-24 and aged 35-44; not living with partner (women only); and reporting depression/anxiety and decrease in sex-life quality. In conclusion, intimate relationship quality is yet another way in which COVID-19 has led to divergence in experience.
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Affiliation(s)
| | | | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - Emily Dema
- Institute for Global Health, University College London
| | - Soazig Clifton
- Institute for Global Health, University College London
- NatCen Social Research
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | | | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine
| | - Wendy Macdowall
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine
| | | | | | - Nigel Field
- Institute for Global Health, University College London
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15
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Endo A, Murayama H, Abbott S, Ratnayake R, Pearson CAB, Edmunds WJ, Fearon E, Funk S. Heavy-tailed sexual contact networks and monkeypox epidemiology in the global outbreak, 2022. Science 2022; 378:90-94. [PMID: 36137054 DOI: 10.1126/science.add4507] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The outbreak of monkeypox across non-endemic regions confirmed in May 2022 shows epidemiological features distinct from previously imported outbreaks, most notably its observed growth and predominance amongst men who have sex with men (MSM). We use a transmission model fitted to empirical sexual partnership data to show that the heavy-tailed sexual partnership distribution, in which a handful of individuals have disproportionately many partners, can explain the sustained growth of monkeypox among MSM despite the absence of such patterns previously. We suggest that the basic reproduction number (R0) for monkeypox over the MSM sexual network may be substantially above 1, which poses challenges to outbreak containment. Ensuring support and tailored messaging to facilitate prevention and early detection among MSM with high numbers of partners is warranted.
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Affiliation(s)
- Akira Endo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Murayama
- School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Sam Abbott
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruwan Ratnayake
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Carl A B Pearson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, Republic of South Africa
| | - W John Edmunds
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Fearon
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Sebastian Funk
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
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16
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Toldam NE, Graugaard C, Meyer R, Thomsen L, Dreier S, Jannini EA, Giraldi A. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022; 10:714-753. [PMID: 37051956 PMCID: PMC9242892 DOI: 10.1016/j.sxmr.2022.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures. OBJECTIVES The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed. METHODS The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach. RESULTS Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health. CONCLUSION The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health. Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714-753.
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Affiliation(s)
- Nana Ernst Toldam
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Denmark,Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Denmark
| | - Rikke Meyer
- Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark
| | | | | | | | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Corresponding Author: Annamaria Giraldi, MD, PhD, FECSM, IF, Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Ole Maaloesvej 14, 2200 Copenhagen, Denmark. Tel: + 45 38 64 71 69
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17
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Dema E, Sonnenberg P, Gibbs J, Conolly A, Willis M, Riddell J, Bosó Pérez R, Copas AJ, Tanton C, Bonell C, Oeser C, Clifton S, Unemo M, Mercer CH, Mitchell KR, Field N. How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID). Sex Transm Infect 2022; 99:261-267. [PMID: 35981863 DOI: 10.1136/sextrans-2022-055516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/16/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic. METHODS British participants (18-59 years) completed a cross-sectional web survey 1 year (March-April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16-74 years) conducted in 2010-2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18-44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors. RESULTS In 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18-24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers. CONCLUSIONS Our study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010-2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.
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Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Anne Conolly
- Institute for Global Health, University College London, London, UK.,Health and Biomedical Surveys, NatCen Social Research, London, UK
| | - Malachi Willis
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Julie Riddell
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Raquel Bosó Pérez
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Clarissa Oeser
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK.,Health and Biomedical Surveys, NatCen Social Research, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University Hospital, Orebro, Sweden
| | | | - Kirstin R Mitchell
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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18
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Lőrincz K, Meznerics FA, Jobbágy A, Kiss N, Madarász M, Belvon L, Tóth B, Tamási B, Wikonkál NM, Marschalkó M, Bánvölgyi A. STIs during the COVID-19 Pandemic in Hungary: Gonorrhea as a Potential Indicator of Sexual Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9627. [PMID: 35954984 PMCID: PMC9368208 DOI: 10.3390/ijerph19159627] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
The social distancing measures introduced due to the COVID-19 pandemic may have affected the sexual behavior of the population. We collected data retrospectively from the National STD Center of Hungary. The overall patient influx data of the STD Center and the number of patients diagnosed with syphilis, chlamydia, and gonorrhea infections were assessed in the three-month period of 2020 when the strict governmental lockdown was introduced in Hungary. Data were compared to the pre- and post-lockdown quarters of 2020 and matched to the respective quarters of 2018 and 2019. The number of patients diagnosed with syphilis and chlamydia infections in 2020 during the lockdown decreased compared to 2018 and 2019, while the number of gonorrhea cases increased. The lower number of STI screenings resulted in a significant decrease in asymptomatic syphilis and chlamydia case numbers. However, the growing number of gonorrhea cases in 2020 during lockdown highlights that sexual behavior remained unchanged regardless of restrictions. Therefore, gonorrhea may be considered as an indicator of STI incidences during the pandemic.
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19
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Ghaznavi C, Kawashima T, Tanoue Y, Yoneoka D, Makiyama K, Sakamoto H, Ueda P, Eguchi A, Nomura S. Changes in marriage, divorce and births during the COVID-19 pandemic in Japan. BMJ Glob Health 2022; 7:bmjgh-2021-007866. [PMID: 35569835 PMCID: PMC9108437 DOI: 10.1136/bmjgh-2021-007866] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/23/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Marriage, divorce and fertility are declining in Japan. There is concern that the COVID-19 pandemic may have accelerated the decrease in marriages and births while increasing the number of divorces. Changes in partnership behaviours and fertility have significant implications for mental health, well-being and population demographics. Methods Japanese vital statistical data were collected for December 2011–May 2021. We used the Farrington algorithm on the daily numbers of marriages, divorces and births (per month) in order to determine whether any given month between January 2017 and May 2021 had a significant excess or deficit. Analyses were conducted at the national and regional levels. Results During the pandemic, significant deficits in the national number of marriages were noted in January 2020, April 2020, May 2020, July 2020, September 2020 and April 2021. Regional marriage patterns reflected national trends. Divorces were noted to be in deficit during April 2020, May 2020 and May 2021 at the country level. Regional analyses mirrored national divorce trends with the exception of Shikoku, which showed no deficits during the pandemic. Significant deficits in the number of total births were noted in December 2020, January 2021 and February 2021. Regionally, birth deficits were concentrated in Chubu, Kansai and Kanto. After the start of the pandemic, no significant excesses in marriages, divorces or births were noted at the national or regional level. Conclusions Marriages and divorces declined during the pandemic in Japan, especially during state of emergency declarations. There were decreased births between December 2020 and February 2021, approximately 8–10 months after the first state of emergency, suggesting that couples altered their pregnancy intention in response to the pandemic. Metropolitan regions were more affected by the pandemic than their less metropolitan counterparts.
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Affiliation(s)
- Cyrus Ghaznavi
- Department of Health Policy and Management, Keio University, Tokyo, Japan .,Medical Education Program, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
| | - Takayuki Kawashima
- Department of Health Policy and Management, Keio University, Tokyo, Japan.,Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Yuta Tanoue
- Department of Health Policy and Management, Keio University, Tokyo, Japan.,Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - Daisuke Yoneoka
- Department of Health Policy and Management, Keio University, Tokyo, Japan.,Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Haruka Sakamoto
- Department of Global Health Policy, The University of Tokyo, Tokyo, Japan.,Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Peter Ueda
- Department of Global Health Policy, The University of Tokyo, Tokyo, Japan.,Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Akifumi Eguchi
- Department of Health Policy and Management, Keio University, Tokyo, Japan.,Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, Keio University, Tokyo, Japan.,Department of Global Health Policy, The University of Tokyo, Tokyo, Japan
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20
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Whitlock GG, Ahmed N, Nori A, Richardson D, Clarke E, Browne R, Doctor J, Williams A, Parkhouse A, Clouser O, Thornhill J. Characteristics of HIV post‐exposure prophylaxis recipients at six English sexual health clinics during COVID‐19. HIV Med 2022; 23:1103-1107. [PMID: 35403371 PMCID: PMC9111810 DOI: 10.1111/hiv.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022]
Abstract
Objectives Disruption to sexual health services during the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; coronavirus disease 2019 [COVID‐19]) pandemic may have adversely affected the provision of HIV post‐exposure prophylaxis (PEP), possibly leading to increased HIV transmission. Globally, services have reported a reduction in the number of PEP prescriptions dispensed during lockdowns, although it is unclear why. Our primary objective was to describe the temporal change in weekly HIV PEP dispensed at six English sexual health clinics in 2020. Methods We performed a cross‐sectional review of PEP prescriptions from six English centres during 2020. Results During 2020, 2884 PEP prescriptions were dispensed across the six centres studied, a fall of 34.5% from the 4403 PEP prescriptions in 2019. Before the COVID‐related lockdown in 2020, the PEP dispensed was stable at 82.5 per week. Following the first lockdown, this fell to a nadir of 13 in week 14 (Figure 1). Prescriptions rose to a peak of 79 in week 37 and then declined to 32 prescriptions in the last week of 2020. There was no difference in the following characteristics of PEP recipients before and during the first lockdown: age, ethnicity, country of birth or the service the recipient attended. Conclusion Whatever the reason for the fall in PEP seen in England over 2020, it is essential that HIV testing and access to HIV prevention is maintained for those in need.
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Affiliation(s)
| | - Nadia Ahmed
- Central and North West London NHS Foundation Trust London UK
| | - Achyuta Nori
- Guy’s and St Thomas’ NHS Foundation Trust London UK
| | - Daniel Richardson
- Brighton and Sussex University Hospitals NHS Trust Brighton UK
- Brighton and Sussex Medical School Brighton UK
| | | | - Rita Browne
- Central and North West London NHS Foundation Trust London UK
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21
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Sonnenberg P, Menezes D, Freeman L, Maxwell KJ, Reid D, Clifton S, Tanton C, Copas A, Riddell J, Dema E, Bosó Pérez R, Gibbs J, Ridge MC, Macdowall W, Unemo M, Bonell C, Johnson AM, Mercer CH, Mitchell K, Field N. Intimate physical contact between people from different households during the COVID-19 pandemic: a mixed-methods study from a large, quasi-representative survey (Natsal-COVID). BMJ Open 2022; 12:e055284. [PMID: 35140158 PMCID: PMC8829844 DOI: 10.1136/bmjopen-2021-055284] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/06/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020. METHODS The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH. RESULTS Of 6654 participants aged 18-59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54; 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34; 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks. CONCLUSIONS Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.
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Affiliation(s)
- Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Dee Menezes
- Institute of Health Informatics, University College London, London, UK
| | - Lily Freeman
- Institute for Global Health, University College London, London, UK
| | - Karen J Maxwell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Mary-Clare Ridge
- Institute for Global Health, University College London, London, UK
| | - Wendy Macdowall
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Magnus Unemo
- Institute for Global Health, University College London, London, UK
- Department of Laboratory Medicine, Örebro University, Orebro, Sweden
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne M Johnson
- Institute for Global Health, University College London, London, UK
| | | | - Kirstin Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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