Effects of the COVID-19 pandemic on the sexual and mental health of adolescent and adult men who have sex with men and transgender women participating in two PrEP cohort studies in Brazil: COBra study protocol

Abstract

IntroductionThe COVID-19 pandemic and its control measures have impacted health and healthcare provision in various levels. Physical distancing measures, for instance, may affect sexual health, impacting access to HIV prevention supplies and changing sexual behaviour, as well as mental health, increasing feelings of unsafety and weakening community support ties. These effects can be worsened among socially marginalised groups, such as men who have sex with men (MSM) and transgender women (TGW). Brazil is among the countries most affected by COVID-19 in the world, where control measures have been inconsistently implemented. We aim to investigate the effects of the COVID-19 pandemic on the sexual and mental health of adolescent and adult MSM and TGW in Brazil.MethodsConvergent mixed-method prospective cohort study, nested in two ongoing HIV pre-exposure prophylaxis (PrEP) cohorts in Brazil, named PrEP1519 and Combina. Participants will be invited to answer, at baseline and after 6 months, a questionnaire about the effects of the COVID-19 pandemic on sexual behaviour, HIV prevention and mental health. Data on HIV infection and sexually transmitted infections (STI) will be collected as part of routine follow-up from the cohorts. Main outcome measures (HIV infection, STI and depression symptoms) will be observed within 12 months after baseline. Sample size is estimated at 426 participants. Complementarily, 50 participants will be invited to in-depth interviews through video calls or interactive voice response, and 20 will be invited to chronicle their lives during the pandemic through digital diaries. Triangulation will be done across qualitative methods and with the quantitative data.Ethics and disseminationThe study was approved by Research Ethics Committees from the Brazilian Universities coordinating the study. Findings will be published in scientific journals and presented at meetings. Informative flyers will be elaborated to communicate study findings to participants and key stakeholders.

Análise da saúde mental da população LGBTQIA+ frente à pandemia da COVID-19

“…Analisando o grupo LGBTQIA+ de forma geral, percebeu-se, com o isolamento social imposto pela pandemia, um aumento do preconceito vivenciado pela comunidade, especificamente a propensão a conflitos familiares que podem levar a diversos tipos de violência, além do abuso de drogas. Nesse contexto, o aumento do estresse devido ao isolamento social com a família foi apontado por diversos estudos, principalmente os que analisaram jovens gays e transexuais (Cerqueira-Santos, et al, 2021;Bordiano, et al, 2021;Suen, et al, 2020;Ferraz, et al, 2021;Kauss, et al, 2021;Septarini, et al, 2021). A vulnerabilidade das pessoas LGBTQIA+ frente à pandemia foi percebida em estudos nos quais os resultados apontaram para uma diminuição da conexão com a comunidade (Suen, et al, 2020;Ruprecht, et al, 2021;Kamal, et al, 2021;.…”

Trends in risk behaviors and sexually transmitted infections among youth presenting to a sexually transmitted infection clinic in the United States, 2013–2017

“…26,27 The impact of the pandemic on sexual health among AYA specifically is less clear, but emerging data suggests the negative impacts on AYA are greater than older groups. 28,29 More research is needed in this population, as well as innovative interventions to address increases in condomless sex and multiple partners in the context of the pandemic, where virtual outreach will likely play a larger role than pre-pandemic. [30][31][32][33][34] The limitations of this study are important to note.…”

Seroprevalence of anti-SARS-CoV-2 antibodies and factors associated with infection among adolescent men who have sex with men and transgender women in Salvador, Brazil

“…This is a cross-sectional design conducted before COVID-19 vaccination was available, and used data from the ANRS-COBra Study, a mixed-method study [ 16 ] nested in PrEP1519, an ongoing demonstration study of the effectiveness of PrEP conducted in three Brazilian cities – Salvador, Belo Horizonte, and São Paulo – from 2019 to 2021. Inclusion criteria in the cohort were AMSM and ATGW aged 15–19 years at enrollment, who had at least one sexual intercourse with another cisgender man or transgender woman and reported spending most of their time in the cities where the study takes place (i.e., living, studying, working, or residing in one of the study sites).…”