Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
The Kirby Institute, UNSW Sydney, Sydney, Australia.
AIDS Behav. 2023 Feb;27(2):518-534. doi: 10.1007/s10461-022-03788-1. Epub 2022 Jul 27.
COVID-19 has disrupted sexual behaviour and access to health systems. We adapted regular HIV behavioural surveillance of gay and bisexual men (GBM) in Australia in response to COVID-19, assessed the impact on the profile of the sample, the participants' HIV-related behaviour, and whether COVID-19 may have accentuated existing disparities in the Australian HIV epidemic. Data collected from five states during July 2017-June 2021 were included (N = 31,460). The emphasis on online recruitment after COVID-19 led to smaller sample sizes, greater geographic reach, and a higher proportion of bisexual-identifying participants. Most participants (88.1%) reported physical distancing and 52.1% had fewer sex partners due to COVID-19. In the COVID-19-affected rounds (July 2020-June 2021), the number of male partners, recent HIV testing and pre-exposure prophylaxis (PrEP) use all fell, and HIV risk among the smaller group of participants who reported casual sex increased. COVID-related changes were generally more pronounced among GBM aged under 25 years, participants from suburbs with fewer gay residents, and bisexual men. These groups should be prioritised when encouraging GBM to reengage with HIV testing services and effective prevention methods, like condoms and PrEP.
新冠疫情扰乱了性行为模式并影响了人们获取卫生系统服务的机会。我们针对新冠疫情调整了澳大利亚男同性恋和双性恋男性（GBM）的常规艾滋病毒行为监测，评估了这对样本特征、参与者艾滋病毒相关行为的影响，以及新冠疫情是否可能加剧了澳大利亚艾滋病毒流行中的现有差异。本研究纳入了 2017 年 7 月至 2021 年 6 月期间来自澳大利亚五个州的数据（N=31460）。新冠疫情后，我们更加强调在线招募，这导致样本量更小、地理覆盖范围更广、双性恋身份的参与者比例更高。大多数参与者（88.1%）报告采取了保持社交距离措施，52.1%的参与者因新冠疫情而减少了性伴侣数量。在受新冠疫情影响的轮次（2020 年 7 月至 2021 年 6 月）中，男性性伴侣数量、最近的艾滋病毒检测和暴露前预防（PrEP）使用率均有所下降，报告偶尔发生性行为的较小群体中的艾滋病毒风险增加。在年龄在 25 岁以下的 GBM、同性恋居民较少的郊区的参与者以及双性恋男性中，与新冠相关的变化通常更为明显。在鼓励 GBM 重新参与艾滋病毒检测服务和有效的预防方法（如避孕套和 PrEP）时，应优先考虑这些群体。
