The Impact of COVID-19 on Sexual Behavior and Psychosocial Functioning in a Clinical Sample of Men who have Sex with Men Using HIV Pre-exposure Prophylaxis

Abstract

The purpose of this study was to evaluate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on sexual behavior, mental health, and substance use among men who have sex with men (MSM) engaged in pre-exposure prophylaxis (PrEP) care. Generalized linear mixed models and logistic mixed-effect models examined change over time for number of sexual partners, mood, and alcohol consumption. From February 29, 2020 to July 31, 2020, 177 MSM actively engaged in PrEP care were evaluated. The median age was 37 [interquartile range (IQR 30, 51]. Patients in the sample were largely representative of the clinic population and identified as White (73.0%), Black/African American (9.2%), and other race (17.2%), and 11.8% identified as Hispanic/Latino ethnicity. Men reported an average of 2.60 fewer sexual partners (95% CI −4.04, −1.40) during the pandemic compared to pre-COVID-19. Rates of depressive symptoms and alcohol use remained stable and few patients reported substance use. The reduced number of sexual partners may be explained by patients' efforts to reduce risk of exposure to COVID-19 and low rates of psychosocial symptoms may be indicative of only the highest functioning patients continuing to engage in care. Reductions in sexual partners may offset reduced engagement in care and help mitigate risk of HIV and other sexually transmitted infections (STIs).

The impact of COVID-19 non-pharmaceutical interventions on HIV care continuum in China: An interrupted time series analysis

“…A study of 177 MSM in Rhode Island, USA found that men reported an average of 2·60 fewer sexual partners (95% CI 4·04 -1·40) during the pandemic compared to pre-COVID-19. 35 We observed rapid growth in PEP prescriptions from April through December 2020. In addition, we found that the decline in PEP prescriptions during the COVID-19 pandemic occurred primarily in people aged 50 years and younger, which may be because older adults are less adaptive to this unconventional and underutilized HIV prevention measure in China.…”

Impact of COVID-19 Pandemic on Men Who Have Sex With Men That Practice Chemsex in France: Results From the National ERAS Web Survey

“…There are two possible explanations for this difference; the first is that we asked about chemsex practice only during the most recent intercourse with a man; this may have led to the proportion of chemsexers being underestimated. The second is related to the period covered by our survey (i.e., first French lockdown) where sexual practices decreased considerably ( Holloway et al, 2021 ; Rogers et al, 2022 ).…”

“…Some studies on MSM investigating the risks associated with lockdown measures and other COVID-19-related consequences highlighted a reduction in HIV consultations and interruption in PrEP and HIV testing ( Santos et al, 2021 ). Unsurprisingly, others highlighted reductions in sexual intercourse by MSM in many countries; more specifically reductions ranged from 2.6 fewer sexual partners in patients interviewed in a PrEP clinic in the United States ( Rogers et al, 2022 ) to a sixfold decrease in sexual intercourse with steady partners participating in an online survey conducted in more than 100 countries ( Holloway et al, 2021 ). The latter study also demonstrated that social distancing negatively affected both the quality of sexual life of some MSM and anxiety levels.…”

The Impact of COVID-19 Restrictions on Online Sales of HIV Self-Test Kits and Implications for HIV Prevention: Analysis of Transaction Data from a Leading E-commerce Platform in China

“…Some recent investigations have shown that more than half of men who have sex with men (MSM) reported a reduction in the number of condomless sexual intercourse, multiple sex partners, and casual sex partners at the beginning of the implementation of COVID restrictions than before COVID restrictions worldwide. 33–38 A recent study including 10,654 MSM from 20 countries also indicated that more stringent responses were associated with decreased accesses to HIVST. 8 Second, express service is the key to deliver HIVST kits from online merchants to purchasers, which was severely disrupted at the beginning of the implementation of COVID restrictions.…”