Impact of COVID-19 on income, prevention attitudes, and access to healthcare among male clients in a Sexually Transmitted Infections clinic

Abstract

Background Mobility restrictions and overloaded health services during the COVID-19 pandemic compromised services dedicated to the prevention and care of HIV and other sexually transmitted infections (STI). In this study, we present client's responses to standardized questionnaires applied during the COVID-19 pandemic period as part of the strategy to measure impacts on social and sexual vulnerability, access to STI prevention services, and access to STI care. Methods The questionnaires included variables on sociodemographics, behavior, risk perception, prevention attitudes, barriers to service-based HIV rapid test, reasons for taking an HIV self-test, and access to health services for STI diagnosis and treatment. We explored demographic variables associated with income reduction, reduced access to HIV/STI testing/treatment and increased vulnerability to HIV/STI. Results 847 participants responded to the study questionnaire between May 2020 and January 2021. Most were young, cisgender male, and 63% self-reported as men who have sex with men. Income reductions were reported by 50%, with 30% reporting a decline over 50% of total income. An increase in heavy episodic drinking (>5 doses) was reported by 18%; 7% reported more sexual partners and 6% reported using condoms less often. Difficulties in obtaining HIV tests, tests for other STI and treatment for STI were reported by 5%, 6% and 6%, respectively. Lower schooling was significantly associated with income reduction ( p = 0.004) and with reduced access to HIV/STI testing or STI treatment ( p = 0.024); employment status was associated with income reduction ( p < 0.001) and increased vulnerability to HIV/STI ( p = 0.027). Having access to an expedite test result, avoiding physical attendance in health units during the pandemic, and undertaking the test with privacy with a trusted person were reported as motivators for HIV self-test. Conclusions Our findings are relevant to promote service improvements tailored to subgroups more likely to struggle with detrimental effects during and after the COVID-19 pandemic.

18 months on: an interrupted time series analysis investigating the effect of COVID-19 on chlamydia and gonorrhoea testing and test positivity at the Gold Coast, Australia

“…Routine sexual health screening decreased during the COVID-19 pandemic worldwide. [13][14][15][16] In Australia, a study from Melbourne showed a 68% reduction in asymptomatic screening related to COVID. 16 In our study, CT and NG testing dropped by 30% and 23% respectively during COVID-19.…”

Self-reported condom use among Washington State residents prior to and during the COVID-19 pandemic: a cross-sectional analysis of BRFSS data

“…Other research on condom use during the pandemic is inconsistent, with some studies showing lower prevalence of condom use during the pandemic,4 9 12 13 and others showing no change 10 11 14–16. Our primary results suggest that condom use may be resilient to the deep societal changes of the COVID-19 pandemic.…”

“…We used Poisson regression to calculate unadjusted, survey-weighted prevalence ratios (PRs) comparing prevalence of condom use during the two time periods, and we also calculated PRs adjusted for age, income, rurality, health insurance status, relationship status and children present in the home. These factors were selected a priori based on previous studies 9 10 13 16. We assessed potential effect modification by rurality and HIV risk behaviour using an alpha level of 0.05.…”

“…For example, a study in Brazil found that socioeconomic factors were associated with increased vulnerability to STIs, with individuals who were unemployed more likely to have an increased number of sexual partners and decreased condom use during the pandemic. 13 This same study, which took place in an HIV clinic, suggests that high HIV risk may be an important factor associated with decreased condom use as well. 13 …”

“…Few studies examine changes in condom use during the pandemic, but most prior studies on this topic focused on specific populations, such as heterosexual young people4 9–11 or men who have sex with men 12–14. These studies show that condom use decreased most among single people and those in casual relationships, which suggests that the decline in condom use may be attributable to a decrease in casual encounters 9 12 15.…”