Aids Healthcare Foundation, Global Program, Los Angeles, USA.
Aids Healthcare Foundation, Brazilian Program, Recife, Brazil; Oswaldo Cruz Foundation, Recife, PE, Brazil.
Braz J Infect Dis. 2021 Sep-Oct;25(5):101617. doi: 10.1016/j.bjid.2021.101617. Epub 2021 Aug 30.
Mobility restrictions and overloaded health services during the COVID-19 pandemic compromised services dedicated to the prevention and care of HIV and other sexually transmitted infections (STI). In this study, we present client's responses to standardized questionnaires applied during the COVID-19 pandemic period as part of the strategy to measure impacts on social and sexual vulnerability, access to STI prevention services, and access to STI care.
The questionnaires included variables on sociodemographics, behavior, risk perception, prevention attitudes, barriers to service-based HIV rapid test, reasons for taking an HIV self-test, and access to health services for STI diagnosis and treatment. We explored demographic variables associated with income reduction, reduced access to HIV/STI testing/treatment and increased vulnerability to HIV/STI.
847 participants responded to the study questionnaire between May 2020 and January 2021. Most were young, cisgender male, and 63% self-reported as men who have sex with men. Income reductions were reported by 50%, with 30% reporting a decline over 50% of total income. An increase in heavy episodic drinking (>5 doses) was reported by 18%; 7% reported more sexual partners and 6% reported using condoms less often. Difficulties in obtaining HIV tests, tests for other STI and treatment for STI were reported by 5%, 6% and 6%, respectively. Lower schooling was significantly associated with income reduction (p = 0.004) and with reduced access to HIV/STI testing or STI treatment (p = 0.024); employment status was associated with income reduction (p < 0.001) and increased vulnerability to HIV/STI (p = 0.027). Having access to an expedite test result, avoiding physical attendance in health units during the pandemic, and undertaking the test with privacy with a trusted person were reported as motivators for HIV self-test.
Our findings are relevant to promote service improvements tailored to subgroups more likely to struggle with detrimental effects during and after the COVID-19 pandemic.
在 COVID-19 大流行期间，行动受限和医疗服务超负荷，使专门用于预防和治疗艾滋病毒和其他性传播感染（STI）的服务受到影响。在这项研究中，我们展示了在 COVID-19 大流行期间，作为衡量社会和性脆弱性、获得 STI 预防服务和获得 STI 护理影响的策略的一部分，对客户在标准化问卷中的回答。
问卷包括社会人口统计学、行为、风险认知、预防态度、基于服务的 HIV 快速检测障碍、进行 HIV 自我检测的原因以及获得性传播感染诊断和治疗的卫生服务等变量。我们探讨了与收入减少、减少 HIV/STI 检测/治疗机会和增加 HIV/STI 易感性相关的人口统计学变量。
2020 年 5 月至 2021 年 1 月期间，847 名参与者对研究问卷做出了回应。大多数参与者是年轻的顺性别男性，63%自我报告为男男性行为者。50%的人报告收入减少，30%的人报告收入减少超过总收入的 50%。18%的人报告重度间歇性饮酒（>5 剂）增加；7%的人报告性伴侣增加，6%的人报告避孕套使用频率降低。5%、6%和 6%的人分别报告难以获得 HIV 检测、其他 STI 检测和 STI 治疗。较低的受教育程度与收入减少显著相关（p=0.004），与减少 HIV/STI 检测或 STI 治疗机会相关（p=0.024）；就业状况与收入减少相关（p<0.001），与 HIV/STI 易感性增加相关（p=0.027）。报告的 HIV 自我检测动机包括获得快速检测结果、在大流行期间避免亲自到卫生单位就诊、并与信任的人私下进行检测。
我们的研究结果与促进服务改进相关，以适应在 COVID-19 大流行期间和之后可能面临不利影响的亚组。
