COVID-19 Had Limited Effect on Prevalence of HIV, STI Diagnosis Rates

Incidence rates and diagnoses of HIV and sexually transmitted infections (STIs) were found to not increase or decrease during the COVID-19 pandemic in men who have sex with men (MSM) living with HIV who reside in Switzerland, according to a study published in Open Forum Infectious Diseases.

Restrictions of mask gatherings, physical distancing, and hand-washing were all encouraged by the Swiss government in February of 2020 to limit the spread of COVID-19. Restrictions nationwide were enacted between March 16 and April 27, 2020. This study aimed to investigate the changes in “sexual behavior, fear and attitudes towards COVID-19 restrictions and [STI] incidence among sexually active MSM.”

The study used the SHCS for data, which is a prospective cohort study that includes 70% of patients in the country that receive antiretroviral therapy (ART). The cross-sectional study required MSM who had occasional partners in at least 1 of the 2 study visits to fill out an online questionnaire in the period between January 6 and June 30 in 2021. Recall periods included before and during the COVID-19 pandemic.

Changes in sexual behavior, including number of sexual partners, attending sex parties, frequency of chemsex, traveling for sex, and fears and concerns regarding sex were all assessed. All diagnosed STIs were reported by patients between January 2018 and June 2022 during regular cohort visits.

There were 205 MSM who completed the questionnaire. The median age was 49 years, 90% were White, and time on ART had a median length of 10 years; 96% reported having a suppressed viral load.

A total of 63% of participants reported less occasional partners whereas 22% reported no change and 14% reported they saw more occasional partners during the COVID-19 pandemic when compared with before. Attendance at public sex parties, crusings and traveling abroad for sex at least once per month was found to decrease during the pandemic (33% to 5%, 26% to 13%, 26% to 9% respectively).

However, the proportion of men who attended private sex parties, traveled for sex within Switzerland, and practicing chemsex did not change significantly. A total of 44% reported less attendance of sex parties whereas 9% reported more attendance; 25% reported less chemsex whereas 9% practiced more.

Less sexual satisfaction was reported in 43% of participants compared with 38% who reported no change and 22% who experienced increased sexual satisfaction. The proportion of men who reported sexual satisfaction decreased from 73% to 57% overall. STI incidence remained stable during the study period for the 3 analyzed STIs of chlamydia, gonorrhea, and syphilis.

There were some limitations to this study. The sample size was relatively small at 205. The self-administered questionnaires are also subject to recall bias, changes in COVID-19 restrictions during the study period, and access to vaccines. Recall bias could not be evaluated.

The researchers concluded that the results of the study revealed behavioral heterogeneity in MSM living with HIV. “Future research,” they said, “should aim at gaining a more differentiated insight in sexually active mSM allowing to understand why some increased their sexual activity despite governmental restrictions and health threats while others reduced it.”

Reference

Mugglin C, Hamusonde K, Salazar-Vizcaya L, et al. Sexual behavior and StI incidence in sexually active MSM living with HIV in times of COVID-19. Open Forum Infect Dis. Published online July 27, 2023. doi:10.1093/ofid/ofad399