The Impact of Mental Health and Stress Concerns on Relationship and Sexuality Amidst the COVID-19 Lockdown

Background: Since January 23, 2020, the Chinese government has imposed restrictive measures including self-isolation, travel restrictions and lockdown of Wuhan city in order to prevent the incoming waves of COVID-19 outbreak in the country. However, the impact of mental health and stress concerns on relationship and sexuality amidst the COVID-19 lockdown was currently unclear. Aim: The cross-sectional study was designed to determine the changes in health, relationship and sexuality among the Chinese couples who lived together amid the early stages of COVID-19 pandemic in China. Methods: Participants of Chinese nationality aged >18 years were asked to complete a self-administered online questionnaire regarding sexuality behaviour and impact of event scale (IES) in March 2020. Nonrandom sampling was used for participant recruitment. Also assessed were sociodemographic data including sex, age, employment, region, sexual dysfunction, and whether participants tested positive for COVID-19. Outcomes: IES score, frequency of sexual intercourse per week, quality of usual sex life, emotional bonding and duration of relationship were measured. Results: A total of 1,139 participants (ie, 735 males and 404 females) were included in the study. Mean age and IES of participants was 33.6 +/- 9.5 years and 27.4 +/- 8.6, respectively. Being male was significantly associated with increased frequency of sexual intercourse amid the COVID-19 pandemic (P = .012). Also, participants with an IES score <26 were more likely to report that they had increased frequency of sexual intercourse per week (P < .001) and the COVID-19 pandemic had positively affected the quality of their usual sex lives (P < .001). On the other hand, participants with IES score >= 26 were more likely to report that the COVID-19 pandemic had positively affected their emotional bonding (P < .001). Clinical implications: Frequency of sexual intercourse and quality of sex life in participants who experienced high stressful impact were more likely to be affected by the COVID-19 pandemic. Strengths and limitations: This was one of the first studies to assess sexual behavior during the COVID-19 pandemic in Chinese adults. Since participants were asked to self-report their sexual behavior, this potentially introduced self-reporting and recall bias into our findings. Conclusions: Our study reported that despite the moderate-to-severe stressful impact due to the COVID-19 pandemic, the majority reported no significant changes in the frequency of their sexual intercourse per week, quality of their usual sexual lives and emotional bonding. Copyright (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.