O05.4 Changes in MSM’s sexual activity, PrEP use, and access to HIV/STI testing during and after the first Dutch COVID-19 lockdown

Abstract

26.1% (19.1%-34.5%). Discomfort with using online/telephone services was more common amongst those not receiving STIrelated services 26.0% (17.4%-36.9%) than for contraception services 6.7% (3.4%-12.8%).Interviewees described how some services were unavailable, while others were disrupted. Many were offered and received alternatives to in-person service (e.g. telephone/online) and some had to use different contraceptive methods. Most understood attempts to limit SARS-CoV-2 transmission and found alternatives convenient, though others saw them as inferior due to interaction limitations. Tenacity was required to access some services. Several participants described how they had avoided or deprioritised their own needs. Fears of contracting COVID-19 and of judgement for having sex against restrictions deterred help-seeking. Conclusion While some people were unable to access an anticipated service, many were offered alternatives with varied consequences. Services may need to adapt further to improve access by offering efficient face-to-face and remote provision while emphasising lack of judgement and validating help seeking.

PrEP Use in Times of COVID-19 in the Netherlands: Men Who Have Sex With Men (MSM) on PrEP Test Less for HIV and Renal Functioning During a COVID-19 Related Lockdown

“…This reduction is particularly remarkable because of the high testing rates of the participants in this cohort before the COVID-19 pandemic (92.0% and 80.9% completed testing for HIV and renal functioning in the past 3 months respectively). Other studies conducted in the Netherlands have found similar reductions in testing for HIV and STIs [ 6 , 11 , 21 ]. Xiridou et al conducted a modeling study on the effect of decreased testing among MSM in the Netherlands, during the pandemic [ 18 ].…”

“…A study conducted in Rotterdam, the Netherlands, found a reduction in the number of HIV tests completed, lower positivity rates, and an increase in late presentation to clinical care [ 21 ]. Similar trends are described for prevention [ 5 , 6 , 11 ]. The majority of longitudinal PrEP studies in the Netherlands facilitate access to PrEP and testing [ 5 , 6 ].…”

“…The trend we found for continued PrEP use and relatively low testing rates during the COVID-19 pandemic is in accordance with findings from other studies. For example, Adam et al’s study on behavior and sexual health of MSM in the Netherlands during the pandemic found that participants re-engaged in sexual activity and PrEP use rapidly after lockdown restrictions ended, but were slower in returning to STI and HIV testing [ 11 ]. This trend is surprising because PrEP care was scaled down but accessible for PrEP users throughout the lockdown period in the Netherlands (March to May 2020) [ 22 ].…”

“…For example, studies from the USA and South Africa report reduced access to PrEP [ 8 – 10 ] while studies conducted in Australia show that access to PrEP remains relatively stable [ 3 , 4 ]. Simultaneously, studies on PrEP use in Wales, Australia, and the Netherlands, report reductions in PrEP use during the COVID-19 pandemic [ 3 – 6 , 11 , 12 ]. However, these studies do not report whether this reduction was due to a change in PrEP regimen, for example from daily to on-demand PrEP use [ 3 , 5 ].…”

“…Behavioral factors such as regular HIV and STI testing and sexual behavior including chemsex (i.e., sexualized substance use), condom use, and sex with (casual) partners have also been assessed in the context of the pandemic [ 3 – 7 , 9 , 11 , 13 , 18 ]. Reduced condom use in general [ 2 ], and in combination with PrEP use [ 4 ], has prompted investigation into condom use during the pandemic.…”