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)

Pam Sonnenberg; Dee Menezes; Lily Freeman; Karen J. Maxwell; David Reid; Soazig Clifton; Clare Tanton; Andrew Copas; Julie Riddell; Emily Dema; Raquel Bosó Pérez; Jo Gibbs; Mary-Clare Ridge; Wendy Macdowall; Magnus Unemo; Chris Bonell; Anne M. Johnson; Catherine H. Mercer; Kirstin Mitchell; Nigel Field

doi:10.1136/bmjopen-2021-055284

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)

Pam Sonnenberg^*, Dee Menezes, Lily Freeman, Karen J. Maxwell, David Reid, Soazig Clifton, Clare Tanton, Andrew Copas, Julie Riddell, Emily Dema, Raquel Bosó Pérez, Jo Gibbs, Mary-Clare Ridge, Wendy Macdowall, Magnus Unemo, Chris Bonell, Anne M. Johnson, Catherine H. Mercer, Kirstin Mitchell, Nigel Field

^*Corresponding author for this work

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Abstract

Objectives: Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020.

Methods: The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH.

Results: Of 6654 participants aged 18-59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54; 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34; 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks.

Conclusions: Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.

Original language	English
Article number	e055284
Number of pages	13
Journal	BMJ Open
Volume	12
Issue number	2
DOIs	https://doi.org/10.1136/bmjopen-2021-055284
Publication status	Published - 9 Feb 2022

Keywords

COVID-19
epidemiology
public health
sexual medicine
pandemics
humans
middle aged
communicable disease control
young adult
SARS-CoV-2
adolescent
adult
female
sexual partners

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/bmjopen-2021-055284

Sonnenberg, P. et al (2022) 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)
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/
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Cite this

Sonnenberg, P., Menezes, D., Freeman, L., Maxwell, K. J., Reid, D., Clifton, S., Tanton, C., Copas, A., Riddell, J., Dema, E., Bosó Pérez, R., Gibbs, J., Ridge, M.-C., Macdowall, W., Unemo, M., Bonell, C., Johnson, A. M., Mercer, C. H., Mitchell, K., & Field, N. (2022). 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). BMJ Open, 12(2), Article e055284. https://doi.org/10.1136/bmjopen-2021-055284

@article{da5a6ead29444a96852ec15a7388fd4c,

title = "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)",

abstract = "Objectives: Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020.Methods: The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH.Results: Of 6654 participants aged 18-59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54; 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34; 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks.Conclusions: Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures. ",

keywords = "COVID-19, epidemiology, public health, sexual medicine, pandemics, humans, middle aged, communicable disease control, young adult, SARS-CoV-2, adolescent, adult, female, sexual partners",

author = "Pam Sonnenberg and Dee Menezes and Lily Freeman and Maxwell, {Karen J.} and David Reid and Soazig Clifton and Clare Tanton and Andrew Copas and Julie Riddell and Emily Dema and {Bos{\'o} P{\'e}rez}, Raquel and Jo Gibbs and Mary-Clare Ridge and Wendy Macdowall and Magnus Unemo and Chris Bonell and Johnson, {Anne M.} and Mercer, {Catherine H.} and Kirstin Mitchell and Nigel Field",

year = "2022",

month = feb,

day = "9",

doi = "10.1136/bmjopen-2021-055284",

language = "English",

volume = "12",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "2",

}

Sonnenberg, P, Menezes, D, Freeman, L, Maxwell, KJ, Reid, D, Clifton, S, Tanton, C, Copas, A, Riddell, J, Dema, E, Bosó Pérez, R, Gibbs, J, Ridge, M-C, Macdowall, W, Unemo, M, Bonell, C, Johnson, AM, Mercer, CH, Mitchell, K & Field, N 2022, '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)', BMJ Open, vol. 12, no. 2, e055284. https://doi.org/10.1136/bmjopen-2021-055284

TY - JOUR

T1 - 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)

AU - Sonnenberg, Pam

AU - Menezes, Dee

AU - Freeman, Lily

AU - Maxwell, Karen J.

AU - Reid, David

AU - Clifton, Soazig

AU - Tanton, Clare

AU - Copas, Andrew

AU - Riddell, Julie

AU - Dema, Emily

AU - Bosó Pérez, Raquel

AU - Gibbs, Jo

AU - Ridge, Mary-Clare

AU - Macdowall, Wendy

AU - Unemo, Magnus

AU - Bonell, Chris

AU - Johnson, Anne M.

AU - Mercer, Catherine H.

AU - Mitchell, Kirstin

AU - Field, Nigel

PY - 2022/2/9

Y1 - 2022/2/9

N2 - Objectives: Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020.Methods: The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH.Results: Of 6654 participants aged 18-59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54; 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34; 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks.Conclusions: Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.

AB - Objectives: Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020.Methods: The Natsal-COVID web-panel survey (July-August 2020) used quota-sampling and weighting to achieve a quasi-representative population sample. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH.Results: Of 6654 participants aged 18-59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18-24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54; 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34; 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks.Conclusions: Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.

KW - COVID-19

KW - epidemiology

KW - public health

KW - sexual medicine

KW - pandemics

KW - humans

KW - middle aged

KW - communicable disease control

KW - young adult

KW - SARS-CoV-2

KW - adolescent

KW - adult

KW - female

KW - sexual partners

U2 - 10.1136/bmjopen-2021-055284

DO - 10.1136/bmjopen-2021-055284

M3 - Article

C2 - 35140158

AN - SCOPUS:85124312548

SN - 2044-6055

VL - 12

JO - BMJ Open

JF - BMJ Open

IS - 2

M1 - e055284

ER -

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)

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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