Like many important aspects of health and wellbeing, sexual reproductive health (SRH) has been greatly affected by the COVID-19 pandemic. Measuring and monitoring SRH is crucial given the potential for drastic changes in people’s behaviours and in the delivery of SRH services.

The initial response to COVID-19 involved a rapid contraction of SRH services, with many halted (e.g asymptomatic STI testing) and only people with the severest symptoms seen face-to-face. During the first nationwide lockdown (from 23rd March 2020), UK citizens were effectively banned from intimate contact with anyone outside their household for a three-month period. The Natsal-COVID study aims to provide high-quality data to assess how these measures impacted sexual and reproductive health.

For further information about the study please contact Professor Nigel Field or Professor Kirstin Mitchell.

Methodology & Questionnaires

Web-panel survey

The Natsal-COVID study team has worked with Ipsos MORI to run two web-panel surveys. We used quota-based sampling and weighting with the aim of obtaining a quasi-representative sample of the British population.

Wave 1 was conducted in July 2020 and surveyed 6,500 people aged 18-59 years across Britain to capture data on sexual behaviour, sexual relationships and service use during the four months following the first national lockdown in March 2020.

Wave 2 was conducted from 27 March to 26 April 2021 and surveyed 6,500 participants aged 18-59 years one year after the start of the first UK lockdown with the aim to capture data on the longer-term impacts of the pandemic. Data were collected for key SRH outcomes, including chlamydia/HIV testing, pregnancy and abortion, and intimate partner violence. Wave 2 included 2000 individuals who also participated in Wave 1 to enable both longitudinal and cross-sectional comparisons.

Qualitative interviews

We carried out qualitative follow-up interviews with 45 survey participants who agreed to re-contact. Qualitative interviews were conducted with survey participants who reported:

  • sexual activity with someone in a different household during the first lockdown and subsequent restrictions
  • difficulties accessing  sexual and reproductive health services.
  • relational difficulties with their partner

By using quotas, we ensured variation by age, gender, ethnicity and region of Britain.

Read the published paper about the methodology of Natsal-COVID Wave 1 here, and of the Natsal-COVID Wave 2 paper here.

Please note that the survey weights described in the technical report have been subsequently updated. Please refer to the Natsal-COVID methods paper for information on final weighting.

Publications

Papers published from Natsal-COVID

  • 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) – here
  • Sexual and Reproductive Health in Britain During the First Year of the COVID-19 Pandemic: National Population Survey (Natsal-COVID Study) – here
  • Initial impacts of the COVID-19 pandemic on sexual and reproductive health service use and unmet need in Britain: findings from a quasi-representative survey (Natsal-COVID) – here
  • Impacts of COVID-19 on sexual behaviour in Britain: findings from a large, quasi-representative survey (Natsal-COVID) – here
  • Intimate physical contact between people from different households during the COVID-19 pandemic: a mixed-methods study from a large, quasi-representative survey (Natsal-COVID) – here
  • Initial impacts of COVID-19 on sex life and relationship quality in steady relationships in Britain: findings from a large, quasi-representative survey (Natsal-COVID) – here
  • Access to and quality of sexual and reproductive health services in Britain during the early stages of the COVID-19 pandemic: a qualitative interview study of patient experiences – here
  • Balancing risk, intimacy and (non)compliance: a qualitative study of sex across household during COVID-19 social restrictions – here
  • Scotland report: Sexual and reproductive health in Scotland during the first year of the COVID pandemic (March 2020 – March 2021) – here
  • 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) – here

  • Methodology of Natsal-COVID Wave 1: a large, quasi-representative survey with qualitative follow-up measuring the impact of COVID-19 on sexual and reproductive health in Britain – here

Infographics & Presentations

  • See the numerous presentations from BASHH/BHIVA 2021 here and BASHH 2022 here.

Preliminary findings webinar (wave 1)

This video presentation is from the Natsal-COVID study webinar on November 30th and shows the study’s preliminary findings. ​These describe changes in sexual partnerships and practices, impacts on SRH services and on relationships, and the extent to which intimacy needs have affected COVID risk.

Key findings (survey waves 1 and 2) presented at the STI & HIV 2021 World Conference (July 2021)

This video is a recording of the presentation given by members of the Natsal-COVID study team, for the BASHH symposium during the STI & HIV 2021 World Conference, July 2021.

You can also access Natsal-COVID abstracts and posters from the BASHH/BHIVA 2021 and BASHH 2022 conferences.

Access the data

Access the data