Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom

Abstract

Background: On 23rd March 2020, the UK government released self-isolation/social distancing guidance to reduce the risk of transmission of SARS-CoV-2. The influence such guidance has on sexual activity is not known.

Aim: To investigate levels and correlates of sexual activity during COVID-19 self-isolation/social distancing in a sample of the UK public.

Methods: This paper presents preplanned interim analyses of data from a cross-sectional epidemiological study, administered through an online survey.

Outcomes: Sexual activity was measured using the following question: "On average after self-isolating how many times have you engaged in sexual activity weekly?" Demographic and clinical data were collected, including sex, age, marital status, employment, annual household income, region, current smoking status, current alcohol consumption, number of chronic physical conditions, number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and number of days of self-isolation/social distancing. The association between several factors (independent variables) and sexual activity (dependent variable) was studied using a multivariable logistic regression model.

Results: 868 individuals were included in this study. There were 63.1% of women, and 21.8% of adults who were aged between 25 and 34 years. During self-isolation/social distancing, 39.9% of the population reported engaging in sexual activity at least once per week. Variables significantly associated with sexual activity (dependent variable) were being male, a younger age, being married or in a domestic partnership, consuming alcohol, and a higher number of days of self-isolation/social distancing.

Clinical implications: In this sample of 868 UK adults self-isolating owing to the COVID-19 pandemic, the prevalence of sexual activity was lower than 40%. Those reporting particularly low levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption.

Strength and limitations: This is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic.

Conclusion: Interventions to promote health and well-being during the COVID-19 pandemic should consider positive sexual health messages in mitigating the detrimental health consequences in relation to self-isolation/social distancing and should target those with the lowest levels of sexual activity. Jacob L, Smith L, Butler L, et al. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom. J Sex Med 2020;17:1229-1236.

Keywords: COVID-19; SARS-CoV-2; Self-isolation; Sexual activity; UK.

Figure 1

Sexual activity by number of days of self-isolation during the SARS-CoV-2 pandemic in the United Kingdom. Sexual activity was dichotomized into sexual activity (at least one sexual intercourse per week on average) versus no sexual activity (zero sexual intercourse per week on average). The prevalence of sexual activity was significantly different between the 3 groups (P-value = .010). SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.

Figure 2

Factors significantly associated with sexual activity in self-isolated adults during the SARS-CoV-2 pandemic in the United Kingdom. Sexual activity was dichotomized into sexual activity (at least one sexual intercourse per week on average) versus no sexual activity (zero sexual intercourse per week on average). The association between several independent variables and sexual activity (dependent variable) was assessed using a multivariable logistic regression model. Independent variables included sex, age, marital status, employment, annual household income, region, current smoking, current alcohol consumption, the number of chronic physical conditions, the number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and the number of days of self-isolation. All potential predictors were included in the regression analysis as categorical variables except the number of chronic physical conditions, the number of chronic psychiatric conditions, and the number of days of self-isolation that were included as continuous variables. Because the effect size was small for the number of days of self-isolation, odds ratio and 95% confidence interval are displayed for a 7-day increase. Significant findings and findings that were not significant are displayed in black and gray, respectively. SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.