Accessing needed sexual health services during the COVID-19 pandemic in British Columbia, Canada: a survey of sexual health service clients

Abstract

ObjectivesWe assessed COVID-19 pandemic impacts on accessing needed sexual health services, and acceptability of alternative service delivery models, among sexual health service clients in British Columbia (BC), Canada.MethodsWe administered an online survey on 21 July–4 August 2020 to clients using a provincial STI clinic or internet-based testing service, GetCheckedOnline, in the year prior to March 2020. We used logistic regression to identify factors associated with having unmet sexual health needs (ie, not accessing needed services) during March–July 2020 and the likelihood of using various alternative service models, if available.ResultsOf 1198 survey respondents, 706 (59%) reported needing any sexual health service since March 2020; of these 706, 365 (52%) did not access needed services and 458 (66%) had avoided or delayed accessing services. GetCheckedOnline users (univariate OR (uOR)=0.62; 95% CI 0.43 to 0.88) or clients with more urgent needs (eg, treatment for new STI, uOR 0.40 (95% CI 0.21 to 0.7)) had lower odds of unmet sexual health needs. The most common factors reported for avoiding or delaying access were public messaging against seeking non-urgent healthcare (234/662, 35%), concern about getting COVID-19 while at (214/662, 32%) or travelling to (147/662, 22%) a clinic or lab and closure of usual place of accessing services (178/662, 27%). All factors were positively associated with having unmet sexual health needs, with public messaging showing the strongest effect (adjusted OR=4.27 (95% CI 2.88 to 6.42)). Likelihood of using alternative sexual health service models was high overall, with the most appealing options being home self-collection kits (634/706, 90%), receiving test kits or antibiotics at home (592/700, 85%) and express testing (565/706, 80%).ConclusionsOf BC sexual health service clients needing services during March–July 2020, many had unmet needs. Offering alternative service delivery methods may help to improve access during and beyond the COVID-19 pandemic.

Uptake of Mpox vaccination among transgender people and gay, bisexual and other men who have sex with men among sexually-transmitted infection clinic clients in Vancouver, British Columbia

“…We used established recruitment methods to invite STI clinic clients who had previously consented to be contacted for research to participate in this survey (∼20% of all clinic clients). [13] , [14] A generic e-mail invitation to the survey was sent to all consenting clients who visited the clinic between June 1, 2019 and May 31, 2022, with a link to the online survey landing page which outlined the additional eligibility criteria (age 16 years and older and able to complete a survey in English) and provided the information needed for informed consent. Proceeding to start the survey was considered provision of informed consent, and all participants starting the survey were offered the opportunity to enter a prize draw for a $200 VISA gift card.…”

Interrupted Access to and Use of Family Planning Among Youth in a Community‐Based Service in Zimbabwe During the First Year of the COVID‐19 Pandemic

“…Since the COVID-19 pandemic began, commentaries (Hussein 2020;Aly et al 2020;Kumar, Malviya, and Sharma 2020;Hall et al 2020) and empirical studies on the impacts of COVID-19 on SRH have emerged (Gilbert et al 2021;Bolarinwa 2021;Lewis et al 2021a;Both, Castle, and Hensen 2021;Yarger et al 2021;Endler et al 2021;Balachandren et al 2022;Steiner et al 2021). Some studies, such as ours, found that access to contraception became difficult during lockdowns (Balachandren et al 2022), and others focused specifically on the impact on adolescents and young people (Lewis et al 2021a;Both, Castle, and Hensen 2021;Yarger et al 2021;Steiner et al 2021).…”

“… 2020 ) and empirical studies on the impacts of COVID‐19 on SRH have emerged (Gilbert et al. 2021 ; Bolarinwa 2021 ; Lewis et al. 2021a ; Both, Castle, and Hensen 2021 ; Yarger et al.…”

“It was horrible for that community, but not for the way we had imagined”: A qualitative study of family physicians’ experiences of caring for communities experiencing marginalisation during COVID-19

“…Additionally, many routine primary care visits have been deferred and primary care services have been operating at reduced capacity throughout the pandemic. While availability of services strongly determines access, other factors, such as individuals' comfort in accessing health services during a pandemic and messaging around limiting interactions with health services, likely played a role as well ( Gilbert et al., 2021 ; Rawaf et al., 2020 ). As patients return to their routine care, FPs' identification of the health impacts on communities experiencing marginalisation, including increased rates of infections and late diagnoses of terminal illnesses, suggests that how ‘essential care’ is framed, including what is deemed ‘essential’, during a pandemic can have harmful consequences.…”