Impact of the period of anti-pandemic measures during the COVID-19 pandemic on the sexual life of adolescents and young adults in Slovakia

The aim of the research is to highlight the impact of the period of anti-pandemic measures during the COVID-19 pandemic on the sexual life of adolescents and young adults in Slovakia. At the beginning of the study, 8 participants were obtained through voluntary and random selection, with whom interviews were subsequently conducted to gain insight into their experiences regarding the pandemic's impact on their sexual life. The interviews were then analysed using narrative analysis. We focused on 11 subcategories: frequency of sexual activities, space for engaging in sexual activities, use of sex, use of masturbation and pornography, sexual communication, emotions associated with sexual activities, changes in sexual self-confidence, changes in sexual preferences, factors influencing sexual life, self-assessment of the pandemic's impact on sexual life, sexual life post-pandemic.


Introduction
In this study, we focused on examining the impact of the period of anti-pandemic measures during the COVID-19 pandemic on the sexual life of adolescents and young adults in Slovakia.Since the beginning of the pandemic, we have witnessed dramatic changes in our daily lives.In addition to the fear of illness and health restrictions, our society had to quickly adapt to new ways of social interaction.One of the areas of particular interest in relation to the pandemic is the sexual life of adolescents and young adults.
One of the significant changes caused by the pandemic was the limitation of social contact, which had an impact on the sexual behaviour of young people.Many of them were forced to change how they meet with their partners and how they express their intimacy.Although COVID-19 is becoming less of a current topic nowadays, it can still be utilized for the purposes of this study, especially from a retrospective perspective, which can highlight the differences between the periods before, during, and after the pandemic in the sexual lives of adolescents and young adults.It is important to recognize that sexual health is part of overall health and quality of life.The impact of the COVID-19 pandemic, particularly the period of anti-pandemic measures, on the sexual life of adolescents and young adults in Slovakia should therefore be subject to thorough research and analysis.

Material and Methods
In our study, we aimed to investigate how participants perceived changes in their sexual behaviour compared to the periods before and during the COVID-19 pandemic.
The research questions aimed to explore how participants perceived the impact of the anti-pandemic measures during the COVID-19 pandemic on their sexual lives.For this purpose, interviews and narrative analysis were utilized.Since narrative analysis focuses more on content and process rather than on the results themselves, the following research questions were formulated:  How do adolescents and young adults depict changes in their sexual behaviour during the COVID-19 pandemic compared to the period before the pandemic in their narratives? How do adolescents and young adults assess the impact of the pandemic on their current sexual life in their narratives?
Firstly, we began by creating an appropriate research sample.Individuals who met the requirements for participation in the study were selected, i.e., they were willing to participate in the research, aged 18-30, from Slovakia, and had any sexual experiences.A voluntary and random selection of participants was applied.Participants were approached in groups of young people on the social network Facebook.The reason for this selection was economic and time efficiency.Specifically, 42 volunteers signed up for the study, including 26 men and 16 women.Four men and four women were randomly selected through the application to maintain a balanced number for working with narrative analysis.Subsequently, personal or online meetings were conducted for the purpose of conducting interviews.The meetings began by activating the voice recorder on a mobile phone or recording a video call in the respective application.The recorded audio was transcribed into a rough transcript.This was followed by data analysis using narrative analysis, through which categories were created.Finally, participants were classified according to the relevant categories, leading to the results.
Interviews with participants were conducted from November 2023 to January 2024.The period before the pandemic was defined during the interviews for the years 2017-2018-2019.The pandemic period was defined for the years 2020-2021-2022.The majority of data were obtained directly from the periods when anti-pandemic measures were implemented, which most significantly affected the lives of participants.

Results
This section of the research presents the data obtained during interviews with participants.Narrative analysis was utilized to achieve the results.The interviews focused on the topic; they were not biographical interviews.We used open-ended questions focused on the topic.The entire interview was conducted with a subtext focused on the impact of the period of anti-pandemic measures during the COVID-19 pandemic on the sexual lives of participants.
Subsequently, an analysis of individual statements was performed, based on which subsequent categories and subcategories were created, and individual experiences were processed.
Categories and subcategories of narrative analysis: During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on his sexual life, Karol expressed that his sex life was less frequent as he noticed a decrease in sexual energy.However, he lived with his girlfriend, so he had enough privacy for sexual activities and tried to be more creative in sex.He mentioned that he used masturbation less frequently.With his partner, they used more non-verbal communication of a sexual nature during the pandemic.In case they were not together, he often used sexting or exchanged photos.Karol claimed that he associated positive emotions with sexual activities and looked forward to them.Among other things, he noticed a positive change in his sexual self-confidence.His preferences did not change during the pandemic.The most significant factor influencing his sexuality was considered to be quarantine and measures.He expressed that the pandemic had both positive and negative impacts on his sexual life.As a positive aspect, he valued more time with his girlfriend and improvement in sexual activities.As a negative aspect, he perceived the impact of the pandemic on his mental health, starting medication that affected his sexual energy.At the time of the study, he is satisfied with his sexual life.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on his sexual life, Milan expressed that the frequency of his sexual activities, specifically masturbation and watching pornography, increased during the pandemic.He lived alone, so he had enough space and privacy for these activities.Since he was single and had no opportunities for sex, he did not engage in it.During the pandemic, he mainly experienced negative emotions towards his sexuality, feeling disappointment and anger towards his excessive masturbation and missing having a girlfriend.His confidence did not change due to the pandemic; even before the pandemic, he felt sexually less confident.His preferences did not change during the pandemic.The most significant factor influencing his sexuality was perceived isolation and measures, which resulted in more time spent at home.Milan evaluates the overall impact of the pandemic on his sexuality negatively; the measures prevented him from actively seeking a partner and caused an increased frequency of masturbation, which persists to this day.Currently, he is frustrated with his sexual life.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on his sexual life, Dávid expressed that the frequency of his sexual activities was not as frequent as before the pandemic, but there wasn't a significant change.Due to his profession, the measures did not apply to him, so he could travel to see his girlfriend at any time, allowing them enough space and privacy for sex.He mentioned that he hardly used pornography or masturbation during the pandemic.In terms of sexual communication with his partner, they engaged in conversations focused on sexual topics in personal contact, and when apart, they communicated through sexting and video calls.He looked forward to sexual activities and perceived them emotionally stronger.His confidence changed when there was a longer distance from his girlfriend; he felt less confident due to his lower endurance, but due to accumulated sexual energy, he felt more dominant during sex.He did not perceive any factors influencing his sexuality during the pandemic.He evaluated the impact of the pandemic on his sexual life positively; he had more space to spend time with his girlfriend and try new things in the realm of sex.Currently, he is satisfied with his sexual life.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on his sexual life, Peter expressed that the frequency of his sexual activities did not change.He had enough space and privacy for these activities.During the pandemic, he was single, so he only used masturbation without pornography.He did not feel any significant emotional reaction towards his sexual activities during the pandemic, nor did he perceive a change in his confidence.He perceived quarantine and measures as the most significant factor influencing his sexual life.He evaluated the impact of the pandemic rather positively; it opened up opportunities for him to meet people online, and after the pandemic, he could experiment with multiple sexual partners and gain experiences.Currently, he is satisfied with his sexual life; he has one girlfriend with whom he has regular sex.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on her sexual life, Sofia expressed that the frequency of her sexual activities did not change as she had been in a long-term relationship.
The pandemic caused a change in the area of privacy, so she and her partner preferred shorter sexual encounters in places they did not previously seek out, but they still tried not to limit themselves in sex.During the pandemic, she used masturbation as frequently as sex.She did not discuss sexual topics with her partner.During the pandemic, she experienced negative emotions towards sexual activities, particularly stress about being caught and frustration about the upcoming longer period without sex.According to her, her confidence did not change.Among the most significant factors, she mentioned the measures that caused a lack of privacy.She evaluated the impact of the pandemic both positively and negatively.As a positive aspect, she mentioned that she and her partner started to appreciate each other more.Negatively, she rated feelings of frustration after a period without sex.Sofia stated that she is currently satisfied with her sexual life and has no issues.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on her sexual life, Nina expressed that the frequency of her sexual activities increased compared to the period before the pandemic.
Although she lived with her parents during the pandemic, she had enough privacy for sexual activities.She did not engage in sex during the pandemic, only used masturbation and pornography.In terms of sexual communication, she exchanged sexually suggestive photos with her partner.She experienced positive emotions associated with her sexual activities and looked forward to them.During the pandemic, Nina experienced a decrease in her sexual confidence, mainly influenced by her surroundings.Her preferences did not change in isolation.She identified the measures and quarantine as the most significant factors influencing her sexuality.Nina also evaluated the impact of the pandemic both positively and negatively.As a positive aspect, she mentioned the opportunity to get to know her new partner better, while as a negative aspect, she mentioned insufficient experience in the sexual domain compared to her peers.Currently, she is satisfied with her sexual life.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on her sexual life, Martina expressed that the frequency of her sexual activities significantly decreased during the pandemic.Although she used masturbation more frequently, due to the measures and a breakup with her partner, she experienced a lack of sexual intercourse.She had adequate space for sexual activities.Before the breakup with her partner, she engaged in sexting and video calls as part of sexual communication.She mostly experienced positive emotions related to sex and appreciated it more.She felt a negative impact of the pandemic on her sexual confidence; due to low activity, she felt less attractive.Martina's preferences changed in that she started using sexual video calls with her partner, which she did not prefer before.She identified measures and quarantine as the most significant factor.Martina also perceived the impact of the pandemic on her sexual life both positively and negatively.As a positive aspect, she mentioned that it helped her to separate from a dysfunctional relationship, and abstinence from sex also benefited her.She rated the intensity of sexual activities negatively.Currently, she is satisfied with her sexual life and has a new partner.
During the interview regarding the impact of the period of anti-pandemic measures during the pandemic on her sexual life, Lucia expressed that her sexual activities had a decreased frequency.Her privacy for sexual activities was also limited depending on whether her parents were at home or not.She preferred sex over masturbation, but she was able to satisfy her needs during the pandemic also through self-pleasure, especially when the need was greater.She and her partner occasionally discussed sexual topics in personal communication, or occasionally used sexting.She evaluated her emotions towards sexual activities positively, enjoying sex more and appreciating it more.The pandemic had a negative impact on her sexual confidence; she felt less experienced and less good in sex.Lucia rated quarantine and isolation, among other things, as the most significant factors affecting her sexuality, including school obligations.Lucia evaluates the impact of the pandemic on her sexual life negatively; partly due to the pandemic, she broke up with her boyfriend, lost the opportunity for sexual intercourse, and masturbated more, which she was not completely satisfied with.At the time of the survey, Lucia is satisfied with her sexual life, she has a new relationship, and she even stated that it is better than before the pandemic.
Here are the results of our study: Based on the research findings, we concluded that due to various factors, half of the participants experienced a decrease in sexual activities during the pandemic.For one-quarter of the participants, the frequency of sexual activities remained the same, and for another quarter, it increased.
From the research results, we can state that the majority of participants, specifically 62%, had enough privacy for any sexual activities.Only 38% of participants stated that their sexual activities were significantly limited due to a lack of privacy.
Based on the research results, we concluded that 25% of participants used sex as a form of sexual activity as often as before the pandemic, so the pandemic did not affect them in this regard.38% of participants had sex less frequently due to various factors, and 37% of participants had no sex at all.Not a single participant reported having sex more frequently than before the pandemic.
From our research, we found that half of the participants used masturbation as a form of sexual activity during the pandemic at the same rate as before.25% of participants masturbated more during the pandemic, while 25% masturbated less.
The results of our research revealed that 37% of participants did not engage in sexual communication due to various factors.63% of people used sexual communication with partners, whether in person or via the internet, through sexting and video calls.
The research results show that as many as 62% of participants had positive emotions related to sexual activities, mostly feelings of joy.25% of people in the study reported negative emotions associated with sexual activities, especially stress and frustration.Only one participant stated that they had no emotions toward sexual activities.
Based on the results, we can conclude that 25% of participants experienced an increase in sexual confidence.
There was no change in three participants, and in three participants, sexual confidence decreased.We found that decreased confidence occurred in women.
The results indicate that due to various factors, 75% of participants experienced changes in sexual preferences during the pandemic.Only 25% of people stated that there was no change in their preferences.
Based on the obtained results, we concluded that almost all participants, specifically 87%, cited pandemic-related measures, quarantine, and isolation as the main factor affecting their sexual life.Only one participant stated that there was no significant factor influencing their sexual life during the pandemic.
The study showed that half of the participants perceived both positive and negative impacts of the pandemic on their sexual life.A quarter viewed the pandemic's impact on their sexuality negatively, and a quarter positively.Among the most significant positives were improved communication with partners, while the most significant negatives included more frequent masturbation.
According to the research, after the pandemic, the majority of participants, 87%, are satisfied with their sexual life.Only one person expressed dissatisfaction with their current sexual life.

Discussion
Our primary research goal was to obtain a sufficient number of participants.We achieved this through the social network Facebook, where we approached groups of young people and asked questions like: "Are you 18-30 years old?", "Are you from Slovakia?", "Are you willing to talk about your sex life?", and similar questions.Thus, we selected volunteers.Subsequently, we randomly selected 4 women and 4 men from the volunteers using an online application.This selection was primarily used for the efficiency of the research, as we worked with people willing to cooperate.These individuals were aged 19-29 and from Slovakia.
The main research goal was to gather necessary data based on research questions: "1.How do adolescents and young adults narrate changes in their sexual behaviour during the COVID-19 pandemic compared to the period before the pandemic?"and "2.How do adolescents and young adults evaluate the impact of the pandemic on their current sexual life in narratives?"In this qualitative study, data collection from participants occurred through questions focused on their sex life in my presence, through face-to-face meetings, or online video calls to prevent incorrect answers or misunderstanding of questions.
Research questions: "1.How do adolescents and young adults narrate changes in their sexual behaviour during the COVID-19 pandemic compared to the period before the pandemic?"and "2.How do adolescents and young adults evaluate the impact of the pandemic on their current sexual life in narratives?" were examined through interviews and subsequently narrative analysis Frequency of Sexual Activities: Our study found that half of the participants reported a decrease in the frequency of sexual activities during the pandemic.This result is consistent with the research "Changes in Sexual Behavior during the COVID-19 Pandemic" by Smith et al. (2020) [6], which showed that the pandemic had a negative impact on people's sex lives.Comparing with previous research supports the consistency of our finding.
Space for Performing Sexual Activities: The majority of participants in our study reported having enough privacy for sexual activities.This result aligns with the research "Sexual Behaviour during COVID-19 Lockdowns" by Johnson et al.
(2021) [7], which also found that most people had enough privacy even during the pandemic.This finding suggests that a lack of privacy may not be the main factor influencing sexual life during the pandemic.
Use of Sex: Our research found that the pandemic affected the use of sex for most participants.This result is consistent with the study "Sexual Behaviour Changes during COVID-19" by Brown et al. (2020) [8], which also documented a decline in the use of sex during the pandemic.Comparison with previous studies provides additional support for this change in sexual behaviour.
Use of Masturbation, Pornography: Our study found that half of the participants used masturbation at the same rate as before the pandemic, which is consistent with the study "The Impact of COVID-19 on Sexual Behaviours" by White et al.
(2020) [9], which also documented stable use of masturbation during the pandemic.These findings suggest that masturbation can be an important form of sexual satisfaction, especially during periods of limited contact with partners.
Sexual Communication: In our study, the majority of participants used sexual communication with partners, which is consistent with the study "Sexual Communication during the COVID-19 Pandemic" by Black et al. (2021) [10], which also found increased use of sexual communication during the pandemic.These findings suggest that communication can be a key tool for maintaining sexual relationships even during periods of restricted personal contact.
Emotions Associated with Sexual Activities: Our study found that the majority of participants expressed positive emotions toward sexual activities, which is consistent with the study "Emotional Responses to Sexual Activity during COVID-19" by Garcia et al. (2021) [11], which also documented a predominance of positive emotions associated with sexual activities.These results indicate that sexual activities can be an important source of emotional satisfaction, even during times of increased stress and uncertainty.
Change in Sexual Confidence: Our study found that some participants exhibited a change in their sexual confidence, which is consistent with the study "Changes in Sexual Confidence during the COVID-19 Pandemic" by Martinez et al.
(2020) [12], which also documented a change in perceived confidence among some individuals.These findings suggest that the pandemic can have various psychological consequences on individuals' sexual self-esteem.
Change in Sexual Preferences: In our study, we observed a change in sexual preferences among most participants, which is consistent with the study "Changes in Sexual Preferences during COVID-19 Lockdowns" by Johnson et al. (2021) [13], which also documented a change in preferences among most respondents.These results indicate that the pandemic can affect not only the frequency but also the nature of people's sexual activities.
Factors Influencing Sexual Life: Our study found that the main factor influencing participants' sexual life was antipandemic measures, which is consistent with the study "Factors Influencing Sexual Behaviour during COVID-19 Pandemic" by Wang et al. (2020) [14], which also identified measures as the main factor influencing sexual life during the pandemic.These findings emphasize the importance of social measures in shaping sexual behaviour during the pandemic.
Own Assessment of the Impact of the Pandemic on Sexual Life: Our study showed that participants had mixed feelings about the impact of the pandemic on their sexual life, which is consistent with the study "Perceptions of the Impact of COVID-19 on Sexual Behaviour" by Jones et al. (2021) [15], which also documented differences in perceptions of the impact of the pandemic on people's sexual life.These results suggest that the pandemic can have a complex and individually diverse impact on individuals' sexual life.
Sexual Life after the Pandemic: Our study found that the majority of participants (87%) expressed satisfaction with their sexual life after the pandemic.This finding is consistent with the study "Sexual Life after the COVID-19 Pandemic" by Lee et al. (2022) [16], which documented a high level of satisfaction with sexual life after the pandemic among most respondents.These findings suggest that despite disruptions caused by the pandemic, many people were able to adapt and restore their sexual life to a higher level of satisfaction.
Comparing our findings with these studies provides a comprehensive view of the impact of the pandemic on sexual life and supports the consistency of some findings across different contexts.
Significant limitations of the research include the representativeness of the research sample.Given the limited sample size and the use of a qualitative approach, our study may suffer from inadequate representation of the population.Some groups, such as older people or those with limited internet access, may have been underrepresented.Another significant limitation of the research is self-assessment.Data obtained through interviews may be influenced by respondents' subjective perceptions and may differ from their actual behaviour.Some questions regarding intimate topics may have been sensitive and caused response bias.We also perceive the timeframe of the research as a limitation; our study focused on sexual life during the period of anti-pandemic measures of the COVID-19 pandemic, but the data were collected retrospectively, which could again cause information bias.
Among the recommendations, we suggest expanding the research sample, including data from different age groups, socioeconomic strata, and geographic areas.Another recommendation is to use a combination of methods.In addition to qualitative methods such as interviews or observations, it would be beneficial to use quantitative methods such as online questionnaires to better understand sexual experiences during the pandemic and overcome possible limitations of self-assessment.It would also be appropriate to conduct long-term monitoring to understand the long-term effects of the pandemic on sexual life.It is important to conduct repeated measurements and monitor changes in behaviour and perception over a longer period after the end of the pandemic.

Conclusion
The main aim of the research was to explore how individuals perceive the impact of the anti-pandemic measures during the pandemic on their sexual lives.Through qualitative research methods, interviews, and narrative analysis, we sought to delve deeper into participants' individual experiences with the pandemic's influence on their sexual lives.Interviews were conducted with the intention of gathering information necessary for narrative analysis.Two interviews were conducted in person, while six were conducted via online video calls.
The research revealed several interesting findings.The majority of participants expressed satisfaction with their sexual lives during and after the pandemic, indicating their ability to adapt to new circumstances.We observed a decrease in the frequency of sexual activities among half of the participants during the pandemic.At the same time, most of them reported having enough privacy for sexual activities.Changes in the use of sex, masturbation, and pornography were also identified, with half of the participants reporting stable masturbation habits.Sexual communication emerged as a crucial tool for maintaining sexual relationships, highlighting its importance during limited personal contacts.Emotions associated with sexual activities were predominantly positive.Some participants expressed changes in their sexual confidence and preferences.The main factor influencing sexual lives was the anti-pandemic measures.Comparison with other studies confirmed the consistency of our findings.
Through this study, we aimed to highlight individuals' individual experiences with the impact of anti-pandemic measures on their sexual lives.Our results contribute to future research on this topic.In the future, it would be appropriate to focus on other age groups and perhaps utilize quantitative research methods.

Compliance with ethical standards
. The aim was to understand how individuals experience and evaluate their own sexual life during and after the pandemic.Through interviews, we aimed to gather necessary data based on open-ended questions.Questions were also created based on previous research: Study on the Impact of COVID-19-Related Restrictions on the Sexual Behaviour of the Spanish Population (Ballester-Arnal et al., 2022) [1], Love in the Time of the COVID-19 Pandemic: Preliminary Results of an Online Survey Conducted during the Quarantine in Italy (Cocci et al., 2020) [2], Investigating Sexual and Relationship Changes during COVID-19(Gauvin et al., 2020)  [3], The Impact of COVID-19 on Women's Sexual Behaviour(Yuksel & Ozgor, 2020) [4], Impact of COVID-19 on Sexual Life -Meta-analysis(Delcea et al., 2020)  [5].The interview was supplemented with custom questions necessary to obtain relevant data.Based on the interviews, we created 11 subcategories belonging to 4 categories.These categories include: Time and Space, Content and Form, Attitude towards Sexuality, and Impact and Consequences.

Table 1
List of participants