O04.4 Measuring impacts of COVID-19 on sexual and reproductive health service use in Britain: findings from a large, quasi-representative survey (Natsal-COVID)

Abstract

Background Sexual and reproductive health (SRH) services in Britain shifted rapidly in response to COVID-19 and the first national lockdown. We investigated SRH service access and unmet need in Britain in the 4-months following lockdown (23/03/2020) to inform service delivery during and after the pandemic. Methods 6,657 participants aged 18–59 years completed a web-panel survey (29/07/2020–10/08/2020). Quota-based sampling and weighting enabled a quasi-representative population sample. We estimated the prevalence of reported SRH service access and failed access, and calculated age-adjusted odds ratios (aOR) for sexually-experienced (≥1 sexual partner/lifetime; n=3,065) and sexually-active (≥1 sexual partner/past year; n=2,752) participants aged 18–44 years. Results 20.8% (95%CI:19.3%-22.3%) of sexually-experienced participants reported accessing ≥1 SRH service in the 4-months from lockdown. 9.7% (8.6%-10.8%) reported being unable to access a service they needed, though many of these participants (76.4%) also reported successful access. 14.8% (13.1%-16.6%) of sexually-experienced women reported accessing contraception services since lockdown, and this was more likely for younger women (OR, 18–24 vs. 35–44 years: 2.96 (1.95 – 4.49)). Among sexually-active participants, 4.8% (4.0%-5.7%) reported accessing STI-related services (STI/HIV testing and follow-up care) and this was higher in those aged 18–24 years (10.1%). Participants reporting any new condomless partner(s) since lockdown were more likely to report accessing STI-related services (aOR, men: 23.77 (11.55–48.92), women: 10.53 (3.94–28.15)) and, amongst men, to report a failed attempt (aOR 13.32 (5.39–32.93)). Among those reporting STI testing (n=106), 33.4% (24.1%-44.2%) did so online, 31.5% (22.0%-42.9%) by phone, 43.9% (33.4%-55.0%) in-person, and 14.8% (8.3%-25.2%) via video consultation. Conclusion Our findings are consistent with SRH services in Britain adapting rapidly in response to COVID-19 and prioritising access for those in need. However, a significant proportion of participants reported difficulty accessing care, suggesting that services may need to adapt further to address and prevent a backlog of need among some high-risk groups.