Sexual Behavior and Its Determinants During COVID-19 Restrictions Among Men Who Have Sex With Men in Amsterdam

Abstract

Objective: To investigate the impact of Dutch COVID-19 restrictions on sexual behavior and HIV/sexually transmitted infection (STI) acquisition among men who have sex with men (MSM) participating in the Amsterdam Cohort Studies (ACS) on HIV in Amsterdam. Methods: ACS participants complete a questionnaire on sexual behavior and are tested for HIV/STI biannually. They may also be tested at the STI clinic in-between study visits. On May 29, 2020, ACS participants were invited to complete an online questionnaire on health, COVID-19 risk perceptions, and sexual behavior. Determinants of reporting casual sex partners (CSP) during COVID-19 restrictions were examined using logistic regression. Results: Of 683 MSM, 353 (52%; median age, 47 years; interquartile range, 38–53 years) completed the questionnaire. Since COVID-19, 73% reported a reduction in the number of CSP. CSP during COVID-19 restrictions were reported by 133 MSM (38%) and, in multivariable analysis, was associated with not having a college/university degree, being single, lower perceived importance of avoiding COVID-19, number of CSP before COVID-19, and current preexposure prophylaxis use (P < 0.05 for all). During COVID-19 restrictions, no HIV infections were diagnosed, and the STI positivity rate was 8%. Conclusion: Since COVID-19, the number of CSP decreased among MSM, and there may have been a temporary reduction in HIV/STI transmission. Some MSM were not fully compliant to social distancing regulations and reported CSP, which was related to prior sexual behavior and low perceived importance of avoiding COVID-19. For these men, it is important to maintain accessible HIV/STI-related testing and care during times of lockdown.

The Impact of COVID-19 Pandemic on Sexually Transmitted Infections

“…Thirty eight percent of the participants reported casual sexual partners during the restrictions, which was related to prior sexual behaviour and low perceived importance of avoiding COVID-19. 10 These results are in line with other studies from Australia, USA and China. 8,9,11 In Australia, MSM reported an 84% reduction in sex with other men between April 4 and April 29, 2020.…”

Transient Changes in Preexposure Prophylaxis Use and Daily Sexual Behavior After the Implementation of COVID-19 Restrictions Among Men Who Have Sex With Men

“…Some authors suggest that reductions in casual sex may have reduced HIV and STI transmission, and preliminary evidence would suggest this to be the case. 17 , 18 However, if changes in casual sex are only short-term, their impact on STI incidence will be limited. It is indeed possible that because restrictions were implemented and much was unknown regarding severity and transmission of COVID-19, the perceived threat and severity of SARS-CoV-2 infection increased and led to the sudden change in behavior.…”

Positive Impacts of the COVID-19 Pandemic and Public Health Measures on Healthcare

“…The Dutch public health measures in response to the pandemic effectively changed risky behaviour, indirectly driving STD and HIV transmission downward in a short period of time, with an 8% positivity rate of bacterial STDs during COVID-19 restrictions versus 19% before the pandemic. There were also no HIV infections diagnosed between March and June 2020 in Amsterdam [81] .…”