People won’t stop having sex during lockdown, neither will their need for contraception, say health lobbies

• Many people will be cooped up with partners for extended periods of time, and they’ll likely be bored, anxious, missing the gym and maybe having as much or more sex than usual.

• And with sexual health clinics operating as appointment-only to reduce overcrowded waiting rooms, accessing contraception could be a huge challenge, Brook says.



Staying at home during a lockdown sounds like the safest kind of sex – in theory.

In reality, many people will be cooped up with partners for extended periods of time, and they’ll likely be bored, anxious, missing the gym and maybe having as much or more sex than usual.

Consequently, global sexual health organisations are decrying that Covid-19 is likely to threaten health rights.

With sexual health clinics operating as appointment-only to reduce overcrowded waiting rooms, accessing contraception could be a huge challenge, Brook says.

Brook is a national charity that offers clinical sexual health services and education and wellbeing services for young people

“Brook expects this to have a serious impact on STI and unintended pregnancy rates, at a time when STI testing/treatment and abortion services are not easily accessible,” Lisa Hallgarten, Head of Policy and Public Affairs says.

It’s equally important to remember that safe sex isn’t just about being STI and pregnancy-free, Hallgarten adds.

 

STOCK UP CONDOMS

She proposes some simple to address a shortfall in sexual and reproductive health services: Stock up on condoms; get your repeat prescription — if you use the contraceptive pill, patch or ring, check how many you have and arrange to get more if you think you have less than a month’s supply; don’t delay emergency contraception — if you are self-isolating or you have Covid-19 symptoms, you can buy emergency contraception; have a backup.

Brook also says free condoms must be made available at the pharmacies and supermarkets that will remain open.

“We are now living through a public health emergency, and clearly, there are competing priorities. But access to sexual health care and services is essential and cannot be sidelined,” Brook says.

Zara Ahmed, Adam Sonfield of Guttmacher Institute also warn that the coronavirus pandemic portends a potential fallout for sexual and reproductive health and rights

“What may be lost in the chaos among other effects and dangers is the specific impact on sexual and reproductive health and rights, both for people in the United States and around the world,” they say.

They urge policymakers, providers and advocates to be aware of the broad links between the global outbreak response and sexual and reproductive health and rights to prepare to mitigate the impact.

“Unlike the Zika virus outbreak, where sexual and mother-to-infant transmission were well established, much less is known today about these potential transmission routes for Covid-19.”

“In addition, the specific risk to pregnant women and their infants is not yet clear, but these groups are often particularly vulnerable to infectious disease threats. Therefore, many experts say an enhanced focus on primary prevention for pregnant women is warranted,” they say.

They warn of shortages of medications – such as contraceptives, antiretrovirals for HIV-Aids and antibiotics to treat STIs – due to disruptions in supply chains overall.

“China, the second-largest exporter of pharmaceutical products in the world, has shut down several drug-manufacturing plants, which has in turn caused delays at Indian factories that produce generic medicines,” they say in a statement.

Health care providers are being diverted to help address the epidemic while also being most at risk of acquiring the disease, which may create a shortage of clinicians who can provide sexual and reproductive health services.

 

PREGNANCIES

Julia Hussein of Sexual and Reproductive Matters says earlier forms of coronavirus — SARS, 2002-03 and MERS, 2012 — are known to cause adverse pregnancy outcomes, including miscarriage, prematurity, fetal growth restriction and maternal death.

“Experience of Covid-19 in pregnancy is, however, limited. In one reported case, the pregnant woman required mechanical ventilation and a cesarean section at 30 weeks gestation,” Hussein says.

“Fetal distress and pre-term delivery were reported in some other cases where infection occurred in the third trimester. Current expert opinion is that the fetus is unlikely to be exposed during pregnancy; neonatal transmission is more likely.”

She advises that pregnant women with Covid-19 respiratory illness be treated with priority because of the risk of complications although so far, there is no evidence that pregnant women are more susceptible to coronavirus than the general population.

She, however, notes that pregnancy is a risk factor for increased illness and death in the outbreaks of influenza.

“Pregnant women face special challenges because of their responsibilities in the workforce, as caregivers of children and other family members, and their requirements for regular contact with maternity services and clinical settings where the risk of exposure to infection is higher”.

Health centres are thus advised to limit pregnant women’s exposure to ill persons,

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