HIV Ireland, Dublin, Ireland.
HSE Health Protection Surveillance Centre, Dublin, Ireland.
PLoS One. 2024 Jul 1;19(7):e0306280. doi: 10.1371/journal.pone.0306280. eCollection 2024.
BACKGROUND: In the Republic of Ireland, the COVID-19 crisis led to sexual health service closures while clinical staff were redeployed to the pandemic response. Gay, bisexual and other men who have sex with men (gbMSM) face pre-existing sexual health inequalities which may have been exacerbated. The aim of this study is to understand sexual health service accessibility for gbMSM in Ireland during the COVID-19 crisis. METHODS: EMERGE recruited 980 gbMSM in Ireland (June-July 2021) to an anonymous online survey investigating well-being and service access through geo-location sexual networking apps (Grindr/Growlr), social media (Facebook/Instagram/Twitter) and collaborators. We fit multiple regression models reporting odds ratios (ORs) to understand how demographic and behavioural characteristics (age, sexual orientation, HIV testing history/status, region of residence, region of birth and education) were associated with ability to access services. RESULTS: Of the respondents, 410 gbMSM accessed sexual health services with some or no difficulty and 176 attempted but were unable to access services during the COVID-19 crisis. A further 382 gbMSM did not attempt to access services and were excluded from this sample and analysis. Baseline: mean age 35.4 years, 88% gay, 83% previously tested for HIV, 69% Dublin-based, 71% born in Ireland and 74% with high level of education. In multiple regression, gbMSM aged 56+ years (aOR = 0.38, 95%CI:0.16, 0.88), not previously tested for HIV (aOR = 0.46, 95%CI:0.23, 0.93) and with medium and low education (aOR = 0.55 95%CI:0.35, 0.85) had lowest odds of successfully accessing services. GbMSM with HIV were most likely to be able to access services successfully (aOR = 2.68 95%CI:1.83, 6.08). Most disrupted services were: STI testing, HIV testing and PrEP. CONCLUSIONS: Service access difficulties were found to largely map onto pre-existing sexual health inequalities for gbMSM. Future service development efforts should prioritise (re)engaging older gbMSM, those who have not previously tested for HIV and those without high levels of education.
背景：在爱尔兰共和国，由于 COVID-19 危机，性健康服务关闭，而临床工作人员被重新部署到大流行应对中。男同性恋、双性恋和其他与男性发生性关系的男性（gbMSM）面临着先前存在的性健康不平等，这些不平等可能已经加剧。本研究旨在了解爱尔兰在 COVID-19 危机期间 gbMSM 的性健康服务可及性。
方法：EMERGE 通过匿名在线调查，在爱尔兰招募了 980 名 gbMSM（2021 年 6 月至 7 月），调查通过地理位置的性网络应用程序（Grindr/Growlr）、社交媒体（Facebook/Instagram/Twitter）和合作者了解幸福感和服务可及性。我们拟合了多个回归模型，报告优势比（OR），以了解人口统计学和行为特征（年龄、性取向、HIV 检测史/状况、居住地区、出生地区和教育程度）与获取服务的能力之间的关系。
结果：在受访者中，410 名 gbMSM 能够或能够获得一些性健康服务，而 176 名试图获得服务但在 COVID-19 危机期间无法获得服务。另有 382 名 gbMSM 未尝试获取服务，因此被排除在本样本和分析之外。基线：平均年龄 35.4 岁，88%为男同性恋，83%以前接受过 HIV 检测，69%居住在都柏林，71%出生在爱尔兰，74%接受过高等教育。在多元回归中，年龄在 56 岁及以上的 gbMSM（aOR=0.38，95%CI：0.16，0.88）、以前未接受过 HIV 检测（aOR=0.46，95%CI：0.23，0.93）和接受中低等教育的 gbMSM（aOR=0.55，95%CI：0.35，0.85）获得服务的可能性最低。感染 HIV 的 gbMSM 最有可能成功获得服务（aOR=2.68，95%CI：1.83，6.08）。受干扰最大的服务包括：性传播感染检测、HIV 检测和 PrEP。
结论：服务获取困难在很大程度上与 gbMSM 先前存在的性健康不平等相对应。未来的服务发展工作应优先考虑（重新）接触年龄较大的 gbMSM、以前未接受过 HIV 检测的 gbMSM 和没有高等教育的 gbMSM。
Int J Environ Res Public Health. 2022-6-7
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