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Initial Impacts of COVID-19 on Sexual and Reproductive Health Service Use and Unmet Need in Britain: Findings from a Large, Quasi-Representative Survey (Natsal-COVID)

23 Pages Posted: 1 Jul 2021

See all articles by Emily Dema

Emily Dema

University College London - Institute for Global Health

Jo Gibbs

University College London - Institute for Global Health

Soazig Clifton

University College London - Institute for Global Health

Andrew Copas

University College London - Institute for Global Health

Clare Tanton

London School of Hygiene & Tropical Medicine

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

David Reid

University College London - Institute for Global Health

Chris Bonell

London School of Hygiene & Tropical Medicine

Magnus Unemo

Örebro University

Catherine Heather Mercer

University College London - Institute for Global Health

Kirstin Rebecca Mitchell

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

Pam Sonnenberg

University College London - Institute for Global Health

Nigel Field

University College London - Institute for Global Health

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Abstract

Background: The COVID-19 pandemic has affected sexual and reproductive health (SRH) service use and unmet need, but the impact is unknown.

Methods: 6,654 participants (18-59y) completed a web-panel survey (July-August 2020) 4-months after initial lockdown in Britain (March 2020). Quota-based sampling and weighting enabled a quasi-representative population sample. We estimated reported SRH service use and unsuccessful use, and calculated age-adjusted odds ratios (aOR) among sexually-experienced (≥1sexual partner/lifetime;n=3,065) and sexually-active (≥1sexual partner/past year;n=2,752) participants (18-44y). F

Findings: 9·1% and 2·7% of sexually-active men and women reported new sexual partners in the four months from March 2020, of whom 80·6% also reported condomless sex. 20·8% of sexually-experienced participants reported using SRH services during this timeframe. 9·7% reported being unable to use a service, though most (76·4%) also reported an instance of successful use. STI-related (4·8% of sexually-active participants) and contraceptive services (14·8% of sexually-experienced women) were most commonly used, with use highest among young people. Sexually-active participants reporting condomless sex with new partner(s) since lockdown (n=99) were particularly likely to report using STI-related services (aOR, men: 23.8(95%CI 11.6-48.9), women: 10.5(3.94-28.2)) and, amongst men, inability to access (aOR 13.3(5.39-32.9)). Among those reporting STI testing, 64·4% accessed remotely (telephone/video/online). 2.4% of women (25-59y) reported cervical screening, compared to an estimated 6% under normal circumstances.

Interpretation: Many participants accessed SRH care during the initial lockdown, but young people and those reporting sexual risk behaviours reported difficulties. Services may need to address a backlog of need.

Funding: Natsal (Wellcome/ESRC/NIHR), MRC/CSO, and UCL COVID-19 Rapid Response Fund.

Declaration of Interest: None to declare.

Ethical Approval: 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). An anonymised dataset will be deposited with the UK Data Service.

Keywords: COVID-19, pandemic impact, sexual and reproductive health, service use, risk behaviours, sexually transmitted infections

Suggested Citation

Dema, Emily and Gibbs, Jo and Clifton, Soazig and Copas, Andrew and Tanton, Clare and Riddell, Julie and Bosó Pérez, Raquel and Reid, David and Bonell, Chris and Unemo, Magnus and Mercer, Catherine Heather and Mitchell, Kirstin Rebecca and Sonnenberg, Pam and Field, Nigel, Initial Impacts of COVID-19 on Sexual and Reproductive Health Service Use and Unmet Need in Britain: Findings from a Large, Quasi-Representative Survey (Natsal-COVID). Available at SSRN: https://ssrn.com/abstract=3862707 or http://dx.doi.org/10.2139/ssrn.3862707

Emily Dema (Contact Author)

University College London - Institute for Global Health ( email )

United Kingdom

Jo Gibbs

University College London - Institute for Global Health ( email )

United Kingdom

Soazig Clifton

University College London - Institute for Global Health ( email )

United Kingdom

Andrew Copas

University College London - Institute for Global Health

United Kingdom

Clare Tanton

London School of Hygiene & Tropical Medicine ( email )

United Kingdom

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

David Reid

University College London - Institute for Global Health

United Kingdom

Chris Bonell

London School of Hygiene & Tropical Medicine

Keppel Street
London, WC1E 7HT
United Kingdom

Magnus Unemo

Örebro University ( email )

Fakultetsgatan 1
SE-701 82
Örebro, 70210
Sweden

Catherine Heather Mercer

University College London - Institute for Global Health ( email )

United Kingdom

Kirstin Rebecca Mitchell

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

Glasgow
United Kingdom

Pam Sonnenberg

University College London - Institute for Global Health ( email )

United Kingdom

Nigel Field

University College London - Institute for Global Health ( email )

United Kingdom