The Differential Impact of COVID-19 Pandemic on Sexual Behavior of Eligible Couples in Urban and Rural India

Background: Intimacy during sexual contact with a person with symptomatic or asymptomatic COVID-19 disease carries the risk of its transmission. COVID-19 has been therefore found to adversely impact the sexual behavior in people in various countries. A discussion on sexual health is often tabooed in India, leading to less research evidence from India. Aim: We tried to study and compare the impact of COVID-19 pandemic on the sexual behavior of urban- and rural-based eligible couples. Methods: Eligible couples were randomly selected from the urban and rural field practice area of a Medical College of West Bengal (India). They were interviewed using a data collection schedule for their sexual practices adopted during the pandemic. Urban vs rural sexual behavior was compared using chi-square test. Results: Majority didn’t report any change in sexual desire compared to prepandemic days. However, scope of sexual contact had significantly reduced among urbanites (P = .036); fear of contracting COVID-19 during sexual intimacy was more among them as well (P = .047). The rural respondents reported significantly higher desire for parenthood (P = .018), though their contraceptive behavior was not significantly different from the urban counterparts. Many used means other than sexual intercourse for sexual gratification, which had remained similar to the prepandemic times. Conclusion: The sexual behavior of urban and rural participants was found to be significantly different on many fronts, probably due to better COVID-19 awareness among urban residents as well as other prevalent social stigma and restrictions that were less commonly encountered in rural participants.