Reassessing the Importance of PrEP Use Given Reduced Sex During the COVID-19 Pandemic: Perspectives From a Sample of Young Sexual Minority Men

Abstract

Research has begun to examine sexual behavior during the COVID-19 pandemic using quantitative methods, but less is known about the context surrounding these changes using qualitative methods, including corresponding changes in risk reduction methods. This qualitative study, guided by the Integrated Behavioral Model, examines the pandemic's impact on PrEP adherence among young men who have sex with men in Chicago. PrEP-using participants from a cohort study were recruited into a 90-day diary study measuring sexual behaviors and PrEP use. Between April and September 2020, a subset of participants was recruited for qualitative interviews (n = 28) exploring prevention strategies, including the impact of the pandemic. Although most were highly adherent pre-pandemic, many took fewer pills or discontinued during the pandemic due to decreased sex. Findings suggest the importance of counseling for PrEP reinitiation as “seasons of HIV risk” increase, as well as use of telehealth as a facilitator of PrEP use throughout the pandemic.

Changes in HIV Prevention and Sexual Experiences During the COVID-19 Pandemic: A Mixed-Methods Study

“…1,8 There has been some qualitative work in this area, which highlights different experiences in different populations and settings. 7,21,22 For instance, Zapata et al 22 documented logistical barriers and biased medical staff as impediments to young sexual minority men who tried to access PrEP using the pandemic. Corneli et al 21 found, similar to our results, that Black cis men and cis women reported maintaining PrEP as a habit or stopping PrEP when they had fewer or no partners because of the pandemic.…”

“…2 The pandemic resulted in decreases in use of STI/HIV prevention tools, such as HIV pre-exposure prophylaxis and routine testing, 2–6 and in reduction of sexual practices themselves. 2,3,7 Since the removal of nearly all COVID-19 mitigations, the nation has seen an increase in STI testing and diagnoses. 1,8…”

“…2 The pandemic resulted in decreases in use of STI/HIV prevention tools, such as HIV pre-exposure prophylaxis and routine testing, [2][3][4][5][6] and in reduction of sexual practices themselves. 2,3,7 Since the removal of nearly all COVID-19 mitigations, the nation has seen an increase in STI testing and diagnoses. 1,8 Although these changes in prevention are at this point well-documented, [2][3][4][5][6] it is unclear whether they were solely because of the lack of access to health care, were individuallevel responses to changes in sexual experiences over the course of the pandemic, or more likely, the combination of both.…”

A Retrospective Comparison of HIV Pre-exposure Prophylaxis (PrEP) Outcomes Between a Pharmacist-led Telehealth Clinic and In-person Clinic in a Veteran Population

“…Limited evidence suggests that text messaging services and mobile applications are low burden tools that can improve adherence to PrEP [ 28 , 29 ]. Patients are generally willing to utilize these applications to streamline their care [ 30 ]. As previously mentioned, the fact that only veterans in the telehealth clinic were enrolled in the Annie App may confound the results of this study.…”