Italians do it less. COVID-19 lockdown impact on sexual activity: Evidence from a large representative sample of Italian adults.

Background To explore how sexual activity was impacted by COVID-19 lockdown measures in the general adult population. Methods A cross-sectional survey was conducted on 6,003 Italian adults aged 18-74 years, representative of the Italian general population. Study subjects were recruited at the time of the Nation-wide stay-at-home order (from April 27 to May 3, 2020). We identified characteristics associated to decreased frequency of sex during lockdown, differentiating between cohabiting and non-cohabiting subjects. Results Over one third (35.3%) of Italians reported to have changed (8.4% increased and 26.9% decreased) their sexual activity during lockdown. When focusing on cohabitants (N=3,949, 65.8%), decreased sexual activity (20.7%) was more frequently reported by men (22.3%; compared to women, multivariable odds ratio=1.23; 95% confidence interval=1.05-1.44), younger (p for trend Conclusions COVID-19 lockdown drastically altered people's day-to-day life and is likely to have impacted on lifestyle habits and behavioral risk factors, including sexual attitudes and practice. This is the first national population-level study exploring changes in sexual life in this COVID-19 era. As we report sexual practice to have been affected by lockdown restrictions, we suggest these changes are to be explored beyond imposed social distancing, into mental health, social, and other determinants.