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 selfisolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing selfreporting 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,

Evaluation of the Sexual Functioning of Individuals Living in Turkey During the COVID-19 Pandemic: An Internet-Based Nationwide Survey Study

“…In a study with 868 participants which was conducted in Britain during the COVID-19 pandemic, being sexually active, which was defined as having at least one sexual intercourse per week, was related to being a young male, being married or in a domestic partnership, consuming alcohol and practicing self-isolation/social distancing for a high number of days. 10 Similarly, alcohol consumption, marital status, having a regular sexual partner, and being a woman was associated with worsening sexual functions according to our study results during the COVID-19 pandemic. Interestingly, in our study population, the mean number of sexual intercourse tended to decrease while the mean number of masturbation had increased values when compared to pre-pandemic period.…”

“…8,9 Despite this knowledge, very few articles have investigated the effects of the COVID-19 pandemic on sexual life. [10][11][12] Reducing in the sexual activity and related factors were determined in a recent study which was conducted in the British public during the COVID-19 pandemic. 10 Moreover, newly detailed reports were presented about the challenges in the practice of sexual medicine from several countries as sexual health is being an important healthcare issue.…”

“…[10][11][12] Reducing in the sexual activity and related factors were determined in a recent study which was conducted in the British public during the COVID-19 pandemic. 10 Moreover, newly detailed reports were presented about the challenges in the practice of sexual medicine from several countries as sexual health is being an important healthcare issue. 13 We hypothesized that sexual functioning may worsen due to strict social distancing rules and the contagious nature of the disease among individuals who have no medical history of COVID-19 during the pandemic period.…”

Changes in Sexuality and Quality of Couple Relationship During the COVID-19 Lockdown

“…Other studies on sexuality during the lockdown considered the frequency of sexual activity or sexual intercourses. In the United Kingdom and Spain, respectively, only 41 and 39% of the participants had maintained the same frequency ( Ibarra et al, 2020 ); decrease in sexual intercourse frequency was found in 60% of United Kingdom participants ( Jacob et al, 2020 ), and a decrease in sexual activity was found in 37% of the Chinese participants ( Li G. et al, 2020 ). In three south-east Asian countries, nearly 70% of the participants engaged in sexual activity with their partner one to five times a week or more, with a considerable increase from before the lockdown ( Arafat et al, 2020 ); similar results were found in Turkish women ( Yuksel and Ozgor, 2020 ).…”

“…On the one hand, partners have lost their privacy due to the constant presence of children or other family members, whereas on the other hand, forced lockdown can exacerbate existing relationship problems. Fear of being infected also drastically reduced physical contact in couples: a decrease in vaginal sex was found in United States couples ( Hensel et al, 2020 ), while in the United Kingdom, 60.1% of the participants did not engage in sexual activity during the self-isolation period, while the remaining 39.9% had sex at least once a week, where being male, young, and married was associated with an increase in sexual activity, and a prolonged period of quarantine was associated with an increase in sexual activity, probably due to reduced stress and anxiety or as a diversion to deal with boring days ( Jacob et al, 2020 ). In another study, 43.5% of the participants from several countries reported a decline in sexual quality along with a severe reduction in the frequency of intercourse during lockdown compared to the previous year, even if many people living with the partner have experimented new sexual positions, BDSM, and acted out some sexual fantasies, while those who did not live with the partner tried new activities such as sexting ( Lehmiller et al, 2020 ).…”