Changes in Solo and Partnered Sexual Behaviors during the COVID-19 Pandemic: Findings from a U.S. Probability Survey

Abstract

Background: Research demonstrates that pandemics adversely impact sexual and reproductive health (SRH), but few have examined their impact on participation in sex. We examined self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the public health response to COVID-19. Methods: We conducted an online, nationally representative, cross-sectional survey of U.S. adults (N=1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted multinomial logistic regression to examine past month self-reported changes (decreased, stable or increased) in ten solo and partnered sexual behaviors. Predictor variables included: having children at home, past month depressive symptoms, (ACHA 3-item scale), past month loneliness (UCLA 3-Item Loneliness scale), COVID-19 protection behaviors (adapted 12-item scale), perceived COVID-19 consequences (adapted 10-item scale) and COVID-19 knowledge (adapted 10-item scale). Findings: Nearly half of all adults reported some kind of change, most commonly, a decrease, in their sexual behavior in the past month. Having elementary aged children at home, past month depressive symptoms and loneliness and enacting more COVID-19 protective behaviors were associated with both reduced partnered bonding behaviors, such as hugging, cuddling, holding hands and kissing, as well as reduced partnered sexual behaviors, such as oral sex, partnered genital touching and vaginal sex. Greater COVID19 risk perception and greater COVID19 knowledge were associated with mixed effects in behavior outcomes. Interpretations: Our data illustrate the very personal ways in which different pandemic-associated factors may create or inhibit opportunities for solo and partnered sex. The centrality of sexuality to health and well-being, even during pandemics, means that a critical piece of public health prevention and management responses should is ensuring that services and resource that support positive sexual decision making remain open and available.

Individual Motives for Security Influence Sexual Activity During the COVID-19 Pandemic

“…Other studies highlighted the importance of knowledge and risk perception to sexual functioning during the pandemic. For example, partnered people who were more knowledgeable about COVID-19 (e.g., knew more about the ways of transmission), and those who engaged in more protective behaviors against infection (e.g., adhered to social distancing), reported a decrease in intercourse and oral sex frequency during the pandemic (Hensel et al, 2020). Moreover, people who perceived more risks related to COVID-19 were more likely to report negative changes in sexual activity during the pandemic (Ko et al, 2020).…”

“…As such, people with a focus on prevention (vs. promotion) at baseline (T1) should also perceive more threat from the COVID-19 pandemic (Hypothesis 3) two weeks later (T2). To the extent that threat perceptions have also been associated with risk-taking, sexual functioning and sexual behaviors (Bancroft et al, 2009;Duncan et al, 2009;Hensel et al, 2020;Ko et al, 2020;Murray et al, 2013;Velten, 2017), we expect these perceptions to explain the impact of prevention focus on sexual activity (Hypothesis 4) (see Figure 1).…”

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

“…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 ).…”

Projected HIV and Bacterial Sexually Transmitted Infection Incidence Following COVID-19–Related Sexual Distancing and Clinical Service Interruption

“…In the United States, men who have sex with men (MSM) are a key population for HIV/STI prevention [ 6 ]. COVID-19 has already resulted in sexual distancing for MSM [ 4 , 7–9 ]. Behavioral changes that began during COVID-19–related restrictions (March 2020) have included reductions in the number of sexual partners (range of estimates across studies, 40%–60% of MSM) and lower frequency of sexual activity within partnerships (20%).…”