The Digital Sexual Health Initiative team conducted a survey to understand how the COVID-19 pandemic has affected people’s sex lives, their access to sexual health services, and whether alternate ways of delivering sexual health services would be acceptable. The results will help inform possible changes & decisions on sexual health services in British Columbia (BC).
The online survey was offered to sexual health service clients of the BC Centre for Disease Control (BCCDC) from July 21 to August 4, 2020. Clients were recruited from the BCCDC STI clinic in Vancouver, and through GetCheckedOnline, an internet-based testing service available in the Metro Vancouver, Island and Interior regions of BC.
1. Changes in sexual behaviours & sexual health related to COVID-19
Among those with partners, 80% had regular sex partner(s), and 31% of partner(s) lived in the same household. In the number of sex partners, 40% reported no change during the pandemic and 31% reported a decrease in number. Of the 25% reporting an increased number of partners, most (20%) reported the increase in partner number later in the pandemic. Overall, 26% of participants agreed that they were, or would soon be, having sex with more people than earlier in the pandemic.
In the first phase (March – mid-May 2020) of the BC pandemic, 65% of participants reported worry about getting COVID-19 during sexual encounters. By the time of taking the survey, 26% reported feeling less worried. Most (91%) participants had used strategies to reduce risk of COVID-19 during sexual encounters, with the most common being masturbation, asking partners about symptoms or their precautions, limiting sex to a small number of regular partners, and not having sex. Perceived stigma about sex during the pandemic was common.
2. Ability to access needed sexual health services
Fifty-nine percent (59%) of participants reported needing a sexual health service since the beginning of the COVID-19 epidemic, with the most common being sexual health testing or screening, speaking to a healthcare provider about a sexual or mental health concern, birth control or PrEP. Of those who needed services, 57% accessed the service and 43% did not. In some cases, access differed by type of service needed. Overall, 66% reported avoiding or delaying seeking sexual health services during the pandemic.
Despite service closures, a substantial number of participants accessed sexual health clinics to meet their service needs (20% for a testing need, 27% for another sexual health service need). Seeing a family doctor or a nurse practitioner was the next most common service access point.
3. Informing future planning for sexual health services during the pandemic
Overall, 41% of participants preferred to test through GetCheckedOnline as a result of the pandemic. New options for sexual health services that reduce person-to-person contacts were highly acceptable to the majority of participants.
Participants also reported other impacts of the pandemic that may affect sexual behavior, including worsening of mental health, difficulty meeting financial needs, and increases in alcohol and recreational drug use.
Implications for practice
These survey findings fill a gap in knowledge around how people’s sexual behavior, sexual health and need for sexual health services has evolved over the course of the COVID-19 pandemic in BC. The findings are current as of early August 2020, and reflect people engaged in sexual health care who were likely more sexually active prior to the pandemic.
The study findings do not suggest changes in sexual behavior that would contribute greatly to increased spread of COVID-19 in BC, with almost all participants reporting using strategies to reduce their risk of COVID-19 infection during sexual encounters. However, many individuals who needed sexual health services did not have this need met. Findings support the importance of using sex-positive, harm reduction service educational messages related to sex and COVID-19, and developing alternative methods of sexual healthcare to facilitate access during the pandemic.