The following is a summary of “Unwanted sexual activity among United States women early in the COVID-19 pandemic,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Lindau, et al.

In stressful situations, like a pandemic, the female sex is less prevalent, and birth rates follow suit. However, some women may participate in a sexual activity purely for socioeconomic security maintenance when resources are limited or external conditions are dangerous. Unwanted sex may signify sexual behavior in exchange for financial security. For a study, researchers sought to examine patterns and correlations of undesired sex among American women early in the COVID-19 epidemic, which was defined as having sex more frequently than desired.

In April 2020, 3,200 English-speaking women (with an 88% cooperation rate) between the ages of 18 and 90 were recruited from a research panel for the National US Women’s Health COVID-19 Study. Racial and ethnic subgroups were the sociodemographic groups of interest, and the quota strata ensured adequate sample sizes in these groups. Early on in the epidemic, patterns of sexual behavior were described, including unwanted sex. Open-ended answers to a question about “how the coronavirus epidemic is affecting your sex life” were evaluated using traditional content analysis to clarify further women’s experiences reporting unwelcome sex. In addition, logistic regression analyses were used to model the odds of unwanted sex by a pandemic-related change in health-related socioeconomic risk factors after adjusting for sociodemographic characteristics, self-reported health, and pre-pandemic health-related socioeconomic risks factors, such as food insecurity, housing instability, utility and transportation difficulties, and interpersonal violence.

Although 7% of women became active and 7% of women stopped being sexually active during the epidemic, the percentage of women who were sexually active early on (51%) was roughly the same as in the 12 months before the pandemic (52%). In the initial epidemic, 11% of sexually active women were engaging in uninvited sex. In comparison to other women, women who had unwanted sex had rates of anxiety, sadness, and traumatic stress symptoms, and each of the five socioeconomic risk variables for health that were evaluated was about two times higher (P<.001). Also, women who reported having more sex since the pandemic were 5 times more likely than other women to report doing so (65% vs 13%; P<.001) and 6 times more likely to use emergency contraception (18% vs. 3%; P<.001). Women who reported having sex that was not requested frequently talked about having “more sex,” having sex to satisfy their partner’s requirements, having a diminished libido or interest in sex because of mood changes brought on by the pandemic, and having sex because they were afraid of spreading the virus. The probabilities of undesired sex among sexually active women were higher among those with 1 pre-pandemic health-related socioeconomic risk factor (adjusted odds ratio, 2.0; 95% CI, 1.1-3.8) & 2 or more (adjusted odds ratio, 6.0; 95% CI, 3.4-10.6) compared to those without these risk factors. Early in the pandemic, sexually active women with any health-related socioeconomic risk factor were more likely to experience unwelcome sex than those who did not (adjusted odds ratio, 2.7; 95% CI, 1.7-4.3).

Early in the COVID-19 pandemic, more than one in ten US women who were sexually active had unwanted sex. Women who were socioeconomically at risk were more likely than other women to engage in unwanted sex, especially if they were experiencing new or worsened mobility issues due to the pandemic. The goal of the pandemic response and recovery process should be to reduce the risks that unwanted sexual activity and related social and health problems pose to women.