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

Abstract

The global COVID-19 pandemic resulted in strict social distancing measures restricting close physical contact. Men (cis and trans) and other gender diverse people who have sex with men (MGDSM) are at higher risk of sexually transmitted infections (STIs) and may have experienced changes in sexual behavior during government restrictions on social and sexual contact. We aimed to examine self-reported sexual behavior of MGDSM during the first UK-wide lockdown to identify the characteristics of the individuals who might most require sexual health promotion and clinical support. In April–May 2020, we conducted an online survey of MGDSM, promoted on social media and Grindr. Our exploratory approach used descriptive analysis to identify self-reported changes in sexual behavior and performed regression analyses to identify correlates of casual sex during the lockdown. A total of 1429 respondents completed the survey: mean age 36 years, 84% White, 97% male or trans male, 98% assigned male sex at birth, 2% female or non-binary, 65% degree educated or higher. During the lockdown, 76% reported not having any casual sex partners. While the majority reported reduced casual sex, 3% reported an increase in casual sex with one person and 2% with three or more people (group sex). About 12% of the sample engaged in casual sex with only one person and 5% with four or more sexual partners during the lockdown. Reporting casual sex during lockdown was associated with: lower level of education OR = 2.37 [95% CI 1.40–4.01]; identifying as a member of an ethnic minority OR = 2.27[1.40–3.53]; daily usage of sexual networking apps OR = 2.24[1.54–3.25]; being less anxious about contracting SARS-CoV-2 through sex OR = 1.66[1.12–2.44]; using PrEP before lockdown OR = 1.75[1.20–2.56]; continuing to use PrEP OR = 2.79[1.76–4.57]; and testing for STIs during lockdown OR = 2.65[1.76–3.99]. A quarter of respondents remained sexually active with casual partners, indicating a need to provide STI screening services and health promotion targeted to groups most likely to have need over this period. Future research is required to better understand how to support sexual and gender minorities to manage sexual risk in the context of pandemic public health initiatives.

Understanding sexual health service access for gay, bisexual and other men who have sex with men in Ireland during the COVID-19 crisis: Findings from the EMERGE survey

“…The authors highlight the role of remote testing services, which were limited in Ireland at the time, underlining the role of service diversification in responding to shocks. Another UK study found that sub-groups of men and gender diverse people who have sex with men maintained or increased sexual behaviour, and (in contrast with our results) that younger people were more likely to have sexual health need during the early stages of the COVID-19 crisis [ 6 , 40 ].…”

The impact of COVID-19 on sexual risk behaviour for HIV acquisition in east Zimbabwe: An observational study

“…The restrictions on social gatherings–which included limits on wedding attendance ( Fig 1 )–together with the negative economic impact of the epidemic, probably explain the observed reductions in young females’ marriage and onset of sexual activity. For males, our finding of only a short-lived reduction in SRB early in the Covid-19 epidemic matches results from studies of MGDSM in high income countries [ 15 – 17 ].…”

“…Much of the existing evidence is focused on men (cis and trans) and other gender-diverse people who have sex with men (MGDSM) populations in high-income countries with the general finding that risk behaviours, or sexual activity more broadly, declined dramatically early on in the Covid-19 pandemic in 2020 [ 15 – 17 ]. One study examined changes to sexual risk behaviour amongst the general population in Panama, with 28.8% of participants reporting a decrease in casual sex and 68.6% reporting no change [ 18 ].…”

Mpox diagnosis history, behavioural risk modification, and vaccination uptake in gay, bisexual, and other men who have sex with men in the UK: findings from a large, online community cross-sectional survey (RiiSH-Mpox) undertaken November/December 2022

“…Changes to sexual behaviour have been reported among GBMSM in the UK during periods of COVID-19 restrictions, however, there has been limited evidence exploring behavioural modification in response to the 2022 mpox outbreak. While sexual mixing outside of households generally persisted through COVID-19 pandemic waves (19,23), studies noted swift rebounds in sexual risk behaviour following easing of social restrictions (18). Our findings support other evidence of behavioural modification among GBMSM during the mpox outbreak, as UK surveillance data show a concurrent, but temporary decline in lymphogranuloma venereum (LGV) and Shigella species, infections that primarily circulate in the dense, interconnected sexual networks associated with mpox transmission (10, 24).…”