Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
J Acquir Immune Defic Syndr. 2021 May 1;87(1):639-643. doi: 10.1097/QAI.0000000000002640.
The coronavirus disease 2019 (COVID-19) pandemic has had unforeseen consequences on the delivery of HIV and sexually transmitted disease (STD) prevention services. However, little is known about how the pandemic has impacted pre-exposure prophylaxis (PrEP)-using men who have sex with men (MSM).
Data come from an online cohort of PrEP-using MSM in the Southern United States from October 2019 to July 2020. Participants were administered 10 surveys in total, including 1 ad hoc survey specifically on COVID-19. We conducted a cross-sectional analysis of this ad hoc survey (n = 56) and present changes in sexual behaviors and utilization of and access to sexual health services. Using linear mixed-effect regression models, we also analyzed data from the larger cohort and document how sexual behaviors and PrEP use varied longitudinally across several months.
A fifth of participants discontinued or changed how often they take PrEP because of COVID-19. A quarter of the cohort documented challenges when attempting to access PrEP, HIV testing, or STD testing. For all sexual behaviors examined longitudinally-number of male sexual partners, anal sex acts, condomless anal sex, and oral sex (all measured in the past 2 weeks)-there was a decrease from February to April followed by an increase from April to June.
Our findings suggest reduced access to and utilization of STD and HIV services coupled with a continuation of behaviors which confer STD/HIV risk. Ensuring appropriate delivery of STD/HIV prevention services during this pandemic is imperative.
2019 年冠状病毒病（COVID-19）大流行对艾滋病毒和性传播疾病（STD）预防服务的提供产生了意想不到的后果。然而，人们对大流行如何影响与男性发生性关系的男男性行为者（MSM）使用暴露前预防（PrEP）知之甚少。
数据来自 2019 年 10 月至 2020 年 7 月美国南部使用 PrEP 的 MSM 的在线队列。参与者总共接受了 10 项调查，包括一项专门针对 COVID-19 的特别调查。我们对这项特别调查（n=56）进行了横断面分析，并介绍了性行为的变化，以及对性健康服务的利用和获取情况。我们还使用线性混合效应回归模型分析了更大队列的数据，并记录了性行为和 PrEP 使用在几个月内如何随时间变化。
五分之一的参与者因 COVID-19 而停止或改变了服用 PrEP 的频率。四分之一的队列记录了在尝试获取 PrEP、HIV 检测或 STD 检测时遇到的挑战。对于所有纵向检查的性行为-性伴侣数量、肛交行为、无保护的肛交和口交（所有在过去 2 周内测量）-从 2 月到 4 月有所减少，然后从 4 月到 6 月有所增加。
我们的研究结果表明，获得和利用 STD 和 HIV 服务的机会减少，同时继续存在导致 STD/HIV 风险的行为。在这一大流行期间，确保适当提供 STD/HIV 预防服务至关重要。
