Sexual health service adaptations to the coronavirus disease 2019 (COVID‐19) pandemic in Australia: a nationwide online survey

Phillips, Tiffany R; Fairley, Christopher K; Donovan, Basil; Ong, Jason J.; McNulty, Anna; Marshall, Lewis; Templeton, David J; Owen, Louise; Ward, Alison; Gunathilake, Manoji; Russell, Darren; Langton-Lockton, Julian; Bourne, Christopher; Martin, Sarah; Chow, Eric P F

doi:10.1111/1753-6405.13158

Cited by 20 publications

(27 citation statements)

References 15 publications

(28 reference statements)

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“…The number of male sex partners, recent HIV testing and PrEP use all fell substantially after COVID-19 emerged, although longer-term trends in these indicators appeared unaffected after adjusting for variations in sampling. HIV treatment and viral suppression were sustained at high levels, and did not seem to be affected by COVID-19, reflecting the quick response of HIV-positive people and clinical services to sustain access to treatment, such as using telehealth consultations [ 41 ]. Although the overall proportion of GBM reporting casual sex fell after COVID-19, among those who continued to have casual sex, the proportion reporting condomless sex with a risk of HIV transmission increased, linked to the drop in PrEP coverage.…”

Section: Discussionmentioning

confidence: 99%

Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia

et al. 2022

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COVID-19 has disrupted sexual behaviour and access to health systems. We adapted regular HIV behavioural surveillance of gay and bisexual men (GBM) in Australia in response to COVID-19, assessed the impact on the profile of the sample, the participants’ HIV-related behaviour, and whether COVID-19 may have accentuated existing disparities in the Australian HIV epidemic. Data collected from five states during July 2017–June 2021 were included (N = 31,460). The emphasis on online recruitment after COVID-19 led to smaller sample sizes, greater geographic reach, and a higher proportion of bisexual-identifying participants. Most participants (88.1%) reported physical distancing and 52.1% had fewer sex partners due to COVID-19. In the COVID-19-affected rounds (July 2020–June 2021), the number of male partners, recent HIV testing and pre-exposure prophylaxis (PrEP) use all fell, and HIV risk among the smaller group of participants who reported casual sex increased. COVID-related changes were generally more pronounced among GBM aged under 25 years, participants from suburbs with fewer gay residents, and bisexual men. These groups should be prioritised when encouraging GBM to reengage with HIV testing services and effective prevention methods, like condoms and PrEP.

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Section: Discussionmentioning

confidence: 99%

Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia

et al. 2022

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“…These disruptions may be due to the different lockdown measures and restrictions in different settings, including the closure of public transport, restrictions on private vehicles' movement, closure of sexual health services, and suspension of non-emergency services during the lockdown periods, which may have impacted individuals access to 9 of 12 HIV testing [18,[22][23][24]. However, the reductions in HIV testing in our study were likely due to the changes in individuals' behaviours or attitudes instead of structural disruptions, because Australian sexual health clinics remained open and provided HIV/STI services during the lockdown periods [25]. As the COVID-19 pandemic continues, an alternative approach to scaling up HIV testing would be required.…”

Section: Discussionmentioning

confidence: 82%

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Chow

Ong

Donovan

et al. 2021

IJERPH

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Australia introduced a national lockdown on 22 March 2020 in response to the COVID-19 pandemic. Melbourne, but not Sydney, had a second COVID-19 lockdown between July and October 2020. We compared the number of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, and new HIV diagnoses during these lockdown periods. The three outcomes in 2020 were compared to 2019 using incidence rate ratio. There was a 37% and 46% reduction in PEP prescriptions in Melbourne and Sydney, respectively, with a larger reduction during lockdown (68% and 57% reductions in Melbourne’s first and second lockdown, 60% reduction in Sydney’s lockdown). There was a 41% and 32% reduction in HIV tests in Melbourne and Sydney, respectively, with a larger reduction during lockdown (57% and 61% reductions in Melbourne’s first and second lockdowns, 58% reduction in Sydney’s lockdown). There was a 44% and 47% reduction in new HIV diagnoses in Melbourne and Sydney, respectively, but no significant reductions during lockdown. The reduction in PEP prescriptions, HIV tests, and new HIV diagnoses during the lockdown periods could be due to the reduction in the number of sexual partners during that period. It could also result in more HIV transmission due to substantial reductions in HIV prevention measures during COVID-19 lockdowns.

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“…Our data were collected before the start of the COVID-19 pandemic (the first Australian cases of COVID-19 were identified in January 2020), and therefore, we are unable to comment on any changes in sexual practices among heterosexuals due to the pandemic. However, previous studies have shown that there was a reduction in self-reported sexual activities and asymptomatic HIV/STI screening in heterosexuals during the COVID-19 pandemic in Australia [ 34 , 35 , 36 ]. Ongoing behavioural surveillance is warranted among heterosexuals in order to understand STI and HIV risk and to inform best clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Oral, Vaginal and Anal Sexual Practices among Heterosexual Males and Females Attending a Sexual Health Clinic: A Cross-Sectional Survey in Melbourne, Australia

Phillips

Constantinou

Fairley

et al. 2021

IJERPH

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Sex practices among heterosexuals are not well studied. We aimed to explore sexual practices among heterosexuals attending a sexual health clinic. This cross-sectional survey was conducted at Melbourne Sexual Health Centre between March and April 2019. Data were collected on kissing, oral sex (fellatio or cunnilingus), vaginal sex, anal sex and rimming in the previous 3 months. Univariable and multivariable logistic regression analyses were performed to examine the associations between engaging in anal sex and other sex practices. There were 709 participants (333 men; 376 women) who were eligible and completed the survey (response rate was 24.6%). In the past 3 months, most participants had had vaginal sex (n = 677; 95.5%), with a mean of 3.0 (standard deviation (SD): 3.9) vaginal sex partners, and half reported engaging in condomless vaginal sex in the past 3 months (n = 358; 50.1%). A total of 135 (19.0%) participants had had anal sex, with a mean of 1.3 (SD: 1.0) anal sex partners, with 63.5% (n = 94) engaging in any condomless anal sex in the past 3 months. Most participants (n = 637, 89.8%) had received oral sex in the past 3 months; this proportion did not differ by age group or gender. Women (n = 351, 93.4%) were more likely to perform oral sex than men (n = 275; 82.6% men) (p < 0.001) and to have received rimming (26.6% women vs. 12.6% men; p < 0.001). Men were more likely to have performed rimming (25.5% men vs. 9.3% women; p < 0.001). After adjusting for age, number of partners and sexual practice, anal sex was associated with being ≥35 years (adjusted odds ratio (aOR): 2.3; 95% CI: 1.2–4.2), receiving rimming (aOR: 3.8; 95% CI: 2.4–6.0) and performing rimming (aOR: 2.8; 95% CI: 1.8–4.6). Rimming and anal sex are practiced by one-fifth or more of heterosexuals. Older heterosexuals were more likely to engage in anal sex and to perform rimming. Future research should consider the benefits of testing extragenital sites where appropriate.

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Sexual health service adaptations to the coronavirus disease 2019 (COVID‐19) pandemic in Australia: a nationwide online survey

Cited by 20 publications

References 15 publications

Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia

Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Oral, Vaginal and Anal Sexual Practices among Heterosexual Males and Females Attending a Sexual Health Clinic: A Cross-Sectional Survey in Melbourne, Australia

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