1
|
Menezes D, Sonnenberg P, Willis M, Mercer CH, Mitchell K, Field N. Compliance with COVID-19 rules on intimate physical contact between households. Sex Transm Infect 2024; 100:54. [PMID: 38071580 DOI: 10.1136/sextrans-2023-055948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/21/2023] [Indexed: 12/22/2023] Open
Affiliation(s)
- Dee Menezes
- Institute of Health Informatics Research, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | | | - Nigel Field
- Institute for Global Health, University College London, London, UK
| |
Collapse
|
2
|
Baxter AJ, Geary RS, Dema E, Bosó Pérez R, Riddell J, Willis M, Conolly A, Oakley LL, Copas AJ, Gibbs J, Bonell C, Sonnenberg P, Mercer CH, Clifton S, Field N, Mitchell K. Contraceptive use and pregnancy planning in Britain during the first year of the COVID-19 pandemic: findings from a large, quasi-representative survey (Natsal-COVID). BMJ Sex Reprod Health 2023; 49:260-273. [PMID: 36958823 PMCID: PMC10579517 DOI: 10.1136/bmjsrh-2022-201763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Contraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic. METHODS Natsal-COVID Wave 2 surveyed 6658 adults aged 18-59 years between March and April 2021, using quotas and weighting to achieve quasi-representativeness. Our analysis included sexually active participants aged 18-44 years, described as female at birth. We analysed contraception use, contraceptive switching due to the pandemic, contraceptive service access, and pregnancy plannedness. RESULTS Of 1488 participants, 1619 were at risk of unplanned pregnancy, of whom 54.1% (51.0%-57.1%) reported routinely using effective contraception in the past year. Among all participants, 14.3% (12.5%-16.3%) reported switching or stopping contraception due to the pandemic. 3.2% (2.0%-5.1%) of those using effective methods pre-pandemic switched to less effective methods, while 3.8% (2.5%-5.9%) stopped. 29.3% (26.9%-31.8%) of at-risk participants reported seeking contraceptive services, of whom 16.4% (13.0%-20.4%) reported difficulty accessing services. Clinic closures and cancelled appointments were commonly reported pandemic-related reasons for difficulty accessing services. This unmet need was associated with younger age, diverse sexual identities and anxiety symptoms. Of 199 pregnancies, 6.6% (3.9%-11.1%) scored as 'unplanned'; less planning was associated with younger age, lower social grade and unemployment. CONCLUSIONS Just under a third of participants sought contraceptive services during the pandemic and most were successful, indicating resilience and adaptability of service delivery. However, one in six reported an unmet need due to the pandemic. COVID-induced inequalities in service access potentially exacerbated existing reproductive health inequalities. These should be addressed in the post-pandemic period and beyond.
Collapse
Affiliation(s)
- Andrew J Baxter
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rebecca S Geary
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Anne Conolly
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Laura L Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | | | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | | | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
| | - Kirsten Mitchell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
3
|
Dema E, Sonnenberg P, Gibbs J, Conolly A, Willis M, Riddell J, Bosó Pérez R, Copas AJ, Tanton C, Bonell C, Oeser C, Clifton S, Unemo M, Mercer CH, Mitchell KR, Field N. How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID). Sex Transm Infect 2022; 99:261-267. [PMID: 35981863 DOI: 10.1136/sextrans-2022-055516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/16/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic. METHODS British participants (18-59 years) completed a cross-sectional web survey 1 year (March-April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16-74 years) conducted in 2010-2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18-44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors. RESULTS In 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18-24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers. CONCLUSIONS Our study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010-2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.
Collapse
Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Anne Conolly
- Institute for Global Health, University College London, London, UK.,Health and Biomedical Surveys, NatCen Social Research, London, UK
| | - Malachi Willis
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Julie Riddell
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Raquel Bosó Pérez
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Clarissa Oeser
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK.,Health and Biomedical Surveys, NatCen Social Research, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University Hospital, Orebro, Sweden
| | | | - Kirstin R Mitchell
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
| |
Collapse
|