Sexually Transmitted Infection Transmission Dynamics During the Coronavirus Disease 2019 (COVID-19) Pandemic Among Urban Gay, Bisexual, and Other Men Who Have Sex With Men

Abstract

Background The impact of coronavirus disease 2019 (COVID-19) mitigation measures on sexually transmitted infection (STI) transmission and racial disparities remains unknown. Our objectives were to compare sex and drug risk behaviors, access to sexual health services, and STI positivity overall and by race during the COVID-19 pandemic compared with pre-pandemic among urban sexual minority men (MSM). Methods Sexually active MSM aged 18–45 years were administered a behavioral survey and STI testing every 3-months. Participants who completed at least 1 during-pandemic (April 2020–December 2020) and 1 pre-pandemic study visit (before 13 March 2020) that occurred less than 6 months apart were included. Regression models were used to compare during- and pre-pandemic visit outcomes. Results Overall, among 231 MSM, reports of more than 3 sex partners declined(pandemic-1: adjusted prevalence ratio 0.68; 95% confidence interval: .54–.86; pandemic-2: 0.65, .51–.84; pandemic-3: 0.57, .43–.75), substance use decreased (pandemic-1: 0.75, .61–.75; pandemic-2: 0.62, .50–.78; pandemic-3: 0.61, .47–.80), and human immunodeficiency virus/preexposure prophylaxis care engagement (pandemic-1: 1.20, 1.07–1.34; pandemic-2: 1.24, 1.11–1.39; pandemic-3: 1.30, 1.16–1.47) increased. STI testing decreased (pandemic-1: 0.68, .57–.81; pandemic-2: 0.78, .67–.92), then rebounded (pandemic-3: 1.01, .87–1.18). Nei­ther Chlamydia (pandemic-2: 1.62, .75–3.46; pandemic-3: 1.13, .24–1.27) nor gonorrhea (pandemic-2: 0.87, .46 1.62; pandemic-3: 0.56, .24–1.27) positivity significantly changed during vs pre-pandemic. Trends were mostly similar among Black vs. non-Black MSM. Conclusions We observed sustained decreases in STI risk behaviors but minimal change in STI positivity during compared with pre-pandemic. Our findings underscore the need for novel STI prevention strategies that can be delivered without in-person interactions.

The Impact of First UK-Wide Lockdown (March–June 2020) on Sexual Behaviors in Men and Gender Diverse People Who Have Sex with Men During the COVID-19 Pandemic: A Cross-Sectional Survey

“…Consistent with research from the USA, respondents from ethnic minority groups were more likely to engage in casual sex than white participants, highlighting the need for culturally relevant health promotion to reach these groups with practical risk reduction advice (Schumacher et al, 2022). Systematic review evidence suggests that MSM from minority ethnic and migrant backgrounds have increased needs surrounding HIV prevention and sexual health.…”

Characteristics of Reported Gonorrhea Diagnoses During The COVID-19 Pandemic Compared With Pre–COVID-19 Pandemic, Baltimore City, Maryland

“…Increased syndromic management during the pandemic may explain observed proportional declines in male urethral diagnoses and empiric/same day treatment. Fourth, observed declines in reported cases early in the pandemic may, in part, be due to population-level sexual behavior change 18 . This also may explain findings of no change in the frequency of reported symptomatic diagnoses during the pandemic.…”

“…Fourth, observed declines in reported cases early in the pandemic may, in part, be due to population-level sexual behavior change. 18 This also may explain findings of no change in the frequency of reported symptomatic diagnoses during the pandemic. Alternatively, observed crude declines in same-day/empiric treatment may be explained by decreased gonorrhea diagnoses at sexual health clinics, as we observed no change in same-day/empiric treatment during pandemic compared with prepandemic when adjusting for diagnosing provider.…”

Advances and challenges in sexually transmitted infections prevention among men who have sex with men in Asia

“…A study in China showed that the incidence of HIV infection, syphilis and gonorrhea dramatically declined by 13.1%, 13.8%, and 11.4% in 2020 compared with that in 2019, respectively [ 31 ], although further data related to MSM were not available. Schumacher et al [ 32 ] conducted a study among 231 MSM in US comparing the periods of during vs. prepandemic and found that reports of more than three sex partners and substance use decreased, human immunodeficiency virus/PrEP care engagement increased, STI testing decreased and then rebounded, neither Chlamydia nor gonorrhea positivity significantly changed. In addition, the findings in Amsterdam showed that incidence rates of chlamydia, gonorrhea and syphilis were significantly lower during 15 March 2020 to 15 June 2020, but nonsignificantly higher during 16 June 2020 to 15 September 2020 and during 16 September 2020 to 1 April 2021 of restrictions than in 2019 [ 33 ].…”