Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK.
BMC Public Health. 2023 May 5;23(1):829. doi: 10.1186/s12889-023-15779-5.
Men and gender-diverse people who have sex with men are disproportionately affected by health conditions associated with increased risk of severe illness due to COVID-19 infection.
An online cross-sectional survey of men and gender-diverse people who have sex with men in the UK recruited via social networking and dating applications from 22 November-12 December 2021. Eligible participants included self-identifying men, transgender women, or gender-diverse individuals assigned male at birth (AMAB), aged ≥ 16, who were UK residents, and self-reported having had sex with an individual AMAB in the last year. We calculated self-reported COVID-19 test-positivity, proportion reporting long COVID, and COVID-19 vaccination uptake anytime from pandemic start to survey completion (November/December 2021). Logistic regression was used to assess sociodemographic, clinical, and behavioural characteristics associated with SARS-CoV-2 (COVID-19) test positivity and complete vaccination (≥ 2 vaccine doses).
Among 1,039 participants (88.1% white, median age 41 years [interquartile range: 31-51]), 18.6% (95% CI: 16.3%-21.1%) reported COVID-19 test positivity, 8.3% (95% CI: 6.7%-10.1%) long COVID, and 94.5% (95% CI: 93.3%-96.1%) complete COVID-19 vaccination through late 2021. In multivariable models, COVID-19 test positivity was associated with UK country of residence (aOR: 2.22 [95% CI: 1.26-3.92], England vs outside England) and employment (aOR: 1.55 [95% CI: 1.01-2.38], current employment vs not employed). Complete COVID-19 vaccination was associated with age (aOR: 1.04 [95% CI: 1.01-1.06], per increasing year), gender (aOR: 0.26 [95% CI: 0.09-0.72], gender minority vs cisgender), education (aOR: 2.11 [95% CI: 1.12-3.98], degree-level or higher vs below degree-level), employment (aOR: 2.07 [95% CI: 1.08-3.94], current employment vs not employed), relationship status (aOR: 0.50 [95% CI: 0.25-1.00], single vs in a relationship), COVID-19 infection history (aOR: 0.47 [95% CI: 0.25-0.88], test positivity or self-perceived infection vs no history), known HPV vaccination (aOR: 3.32 [95% CI: 1.43-7.75]), and low self-worth (aOR: 0.29 [95% CI: 0.15-0.54]).
In this community sample, COVID-19 vaccine uptake was high overall, though lower among younger age-groups, gender minorities, and those with poorer well-being. Efforts are needed to limit COVID-19 related exacerbation of health inequalities in groups who already experience a greater burden of poor health relative to other men who have sex with men.
男性和与男性发生性行为的性别多样化人群因 COVID-19 感染而导致重病风险增加的相关健康状况受到不成比例的影响。
2021 年 11 月 22 日至 12 月 12 日，通过社交网络和约会应用程序在英国招募男性和与男性发生性行为的性别多样化人群，对他们进行了一项关于男性和与男性发生性行为的性别多样化人群的在线横断面调查。合格的参与者包括自我认同为男性、跨性别女性或出生时被分配为男性（AMAB）的性别多样化个体，年龄≥16 岁，是英国居民，自我报告在过去一年中与 AMAB 个体发生过性行为。我们计算了自我报告的 COVID-19 检测阳性率、报告长 COVID 的比例，以及从大流行开始到调查完成（2021 年 11/12 月）的任何时间点 COVID-19 疫苗接种率。使用逻辑回归评估与 SARS-CoV-2（COVID-19）检测阳性和完全接种（≥2 剂疫苗）相关的社会人口学、临床和行为特征。
在 1039 名参与者中（88.1%为白人，中位年龄 41 岁[四分位距：31-51]），18.6%（95%CI：16.3%-21.1%）报告 COVID-19 检测阳性，8.3%（95%CI：6.7%-10.1%）报告长 COVID，94.5%（95%CI：93.3%-96.1%）在 2021 年底完全接种了 COVID-19 疫苗。在多变量模型中，COVID-19 检测阳性与英国居住国（比值比：2.22[95%CI：1.26-3.92]，英格兰与英格兰以外）和就业状况（比值比：1.55[95%CI：1.01-2.38]，当前就业与未就业）相关。完全接种 COVID-19 疫苗与年龄（比值比：1.04[95%CI：1.01-1.06]，每增加一岁）、性别（比值比：0.26[95%CI：0.09-0.72]，性别少数与顺性别）、教育程度（比值比：2.11[95%CI：1.12-3.98]，学位或以上与学位以下）、就业状况（比值比：2.07[95%CI：1.08-3.94]，当前就业与未就业）、关系状况（比值比：0.50[95%CI：0.25-1.00]，单身与有伴侣）、COVID-19 感染史（比值比：0.47[95%CI：0.25-0.88]，检测阳性或自我感知感染与无感染史）、已知 HPV 疫苗接种（比值比：3.32[95%CI：1.43-7.75]）和自我价值感低（比值比：0.29[95%CI：0.15-0.54]）相关。
在这个社区样本中，COVID-19 疫苗接种率总体较高，尽管在年龄较小的群体、性别少数群体和幸福感较差的人群中较低。需要努力限制 COVID-19 相关的健康不平等加剧，这些群体相对于其他与男性发生性行为的男性已经面临更大的健康不良负担。
