Toller Erausquin Jennifer, Tan Rayner K J, Uhlich Maximiliane, Francis Joel M, Kumar Navin, Campbell Linda, Zhang Wei Hong, Hlatshwako Takhona G, Kosana Priya, Shah Sonam, Brenner Erica M, Remmerie Lore, Mussa Aamirah, Klapilova Katerina, Mark Kristen, Perotta Gabriela, Gabster Amanda, Wouters Edwin, Burns Sharyn, Hendriks Jacqueline, Hensel Devon J, Shamu Simukai, Marie Strizzi Jenna, Esho Tammary, Morroni Chelsea, Eleuteri Stefano, Sahril Norhafiza, Yun Low Wah, Plasilova Leona, Lazdane Gunta, Marks Michael, Olumide Adesola, Abdelhamed Amr, López Gómez Alejandra, Michielsen Kristien, Moreau Caroline, Tucker Joseph D
Department of Public Health Education, University of North Carolina-Greensboro, Greensboro, North Carolina, USA.
Dermatology Hospital of Southern Medical University, Guangzhou, China.
Clin Infect Dis. 2022 Aug 24;75(1):e991-e999. doi: 10.1093/cid/ciac102.
There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium.
Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence.
Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy.
Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.
迄今为止，关于2019冠状病毒病（COVID-19）第一波疫情期间性与生殖健康（SRH）变化的证据有限。为填补这一空白，我们的团队作为全球联盟的一部分，组织了一项多国横断面在线调查。
联盟研究团队在30个国家进行了在线调查。抽样方法包括便利抽样、在线样本库抽样和具有人群代表性的抽样。主要结果包括性行为、伴侣暴力和SRH服务利用情况，我们比较了缓解COVID-19政策措施实施前3个月和实施期间的情况。我们对主要结果进行了荟萃分析，并对证据的确定性进行了分级。
在4546名有临时伴侣的受访者中，3374人（74.4%）的避孕套使用情况保持不变，640人（14.1%）报告使用量下降。与COVID-19措施实施前（15887人中的1469人，9.3%）相比，在COVID-19措施实施期间，报告遭受身体或性伴侣暴力的受访者较少（15144人中的1063人，7.0%）。COVID-19措施阻碍了避孕套（10790人中的933人，8.7%）、避孕药具（8175人中的610人，7.5%）和人类免疫缺陷病毒/性传播感染（HIV/STI）检测（1965人中的750人，30.7%）的获取。荟萃分析的汇总估计表明，在COVID-19措施实施期间，32.3%（95%置信区间[CI]，23.9%-42.1%）需要进行HIV/STI检测的人获取检测受阻，4.4%（95%CI，3.4%-5.4%）经历了伴侣暴力，5.8%（95%CI，5.4%-8.2%）减少了与临时伴侣使用避孕套的情况（每个结果的证据确定性为中等）。在检查国家收入水平、样本量和抽样策略的敏感性分析中，荟萃分析结果具有稳健性。
开放科学方法对于作为应急响应一部分组织研究是可行的。COVID-19的第一波疫情影响了全球不同地区的SRH行为和服务获取情况。
