TY - JOUR
T1 - Transient Changes in Preexposure Prophylaxis Use and Daily Sexual Behavior After the Implementation of COVID-19 Restrictions Among Men Who Have Sex With Men
AU - Jongen, Vita W
AU - Zimmermann, Hanne M L
AU - Boyd, Anders
AU - Hoornenborg, Elske
AU - van den Elshout, Mark A M
AU - Davidovich, Udi
AU - van Duijnhoven, Yvonne T H P
AU - de Vries, Henry J C
AU - Prins, Maria
AU - Schim van der Loeff, Maarten F
AU - Coyer, Liza
AU - Amsterdam PrEP Project team in the HIV Transmission Elimination Amsterdam (H-TEAM) Initiative
N1 - Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/8/15
Y1 - 2021/8/15
N2 - BACKGROUND: We assessed how the Dutch restrictions imposed on March 15, 2020, affected sexual behavior, preexposure prophylaxis (PrEP), and condom use among PrEP users in Amsterdam.METHODS: We used data on (1) PrEP use, (2) anal sex acts, and (3) condom use, per partner type [steady partners (SPs), known casual partners (KCPs), and unknown casual partners (UCPs)], collected daily through a mobile application used between December 1, 2019, and June 30, 2020. We compared the period before versus after March 15, 2020, regarding average proportion of days per week at which each end point was reported and average proportion of anal sex acts covered by PrEP and/or condoms.RESULTS: We included data from 136 men who have sex with men. After March 15, 2020, the proportion of days with anal sex increased with SPs [odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.10 to 1.44) and decreased with KCPs (OR = 0.73; 95% CI = 0.64 to 0.82) and UCPs (OR = 0.54; 95% CI = 0.48 to 0.61). Shifts in partner types were most profound immediately after March 15, 2020, whereas returning to prerestriction levels mid-May 2020. The proportion of days with PrEP use decreased from 74% before to 58% after March 15, 2020 (P < 0.001). After March 15, 2020, PrEP use during sex decreased with UCPs (β = -0.36; 95% CI = -0.72 to 0.00) but not with SPs and KCPs. Condom use during sex decreased with KCPs (β = -0.36; 95% CI = -0.67 to 0.04) and UCPs (β = -0.24; 95% CI = -0.46 to 0.03) but not with SPs.CONCLUSIONS: MSM decreased sex with casual partners and increased sex with SP, but changes were transient. Decreases in sex acts with casual partners paralleled decreases in PrEP use. However, condom use during sex with casual partners decreased, indicating the importance of continued sexual health services, including sexually transmitted infections screening and PrEP care, during COVID-19 restrictions.
AB - BACKGROUND: We assessed how the Dutch restrictions imposed on March 15, 2020, affected sexual behavior, preexposure prophylaxis (PrEP), and condom use among PrEP users in Amsterdam.METHODS: We used data on (1) PrEP use, (2) anal sex acts, and (3) condom use, per partner type [steady partners (SPs), known casual partners (KCPs), and unknown casual partners (UCPs)], collected daily through a mobile application used between December 1, 2019, and June 30, 2020. We compared the period before versus after March 15, 2020, regarding average proportion of days per week at which each end point was reported and average proportion of anal sex acts covered by PrEP and/or condoms.RESULTS: We included data from 136 men who have sex with men. After March 15, 2020, the proportion of days with anal sex increased with SPs [odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.10 to 1.44) and decreased with KCPs (OR = 0.73; 95% CI = 0.64 to 0.82) and UCPs (OR = 0.54; 95% CI = 0.48 to 0.61). Shifts in partner types were most profound immediately after March 15, 2020, whereas returning to prerestriction levels mid-May 2020. The proportion of days with PrEP use decreased from 74% before to 58% after March 15, 2020 (P < 0.001). After March 15, 2020, PrEP use during sex decreased with UCPs (β = -0.36; 95% CI = -0.72 to 0.00) but not with SPs and KCPs. Condom use during sex decreased with KCPs (β = -0.36; 95% CI = -0.67 to 0.04) and UCPs (β = -0.24; 95% CI = -0.46 to 0.03) but not with SPs.CONCLUSIONS: MSM decreased sex with casual partners and increased sex with SP, but changes were transient. Decreases in sex acts with casual partners paralleled decreases in PrEP use. However, condom use during sex with casual partners decreased, indicating the importance of continued sexual health services, including sexually transmitted infections screening and PrEP care, during COVID-19 restrictions.
KW - Adult
KW - COVID-19/prevention & control
KW - Condoms
KW - Homosexuality, Male
KW - Humans
KW - Male
KW - Middle Aged
KW - Pre-Exposure Prophylaxis
KW - SARS-CoV-2
KW - Safe Sex
KW - Sexual Behavior
KW - Sexual and Gender Minorities
KW - Sexually Transmitted Diseases/drug therapy
KW - PREP
KW - RISK
KW - men who have sex with men
KW - COVID-19
KW - preexposure prophylaxis
KW - HIV
KW - sexual behavior
KW - prevention and control
U2 - 10.1097/QAI.0000000000002697
DO - 10.1097/QAI.0000000000002697
M3 - Article
C2 - 34229327
SN - 1525-4135
VL - 87
SP - 1111
EP - 1118
JO - Jaids-journal of Acquired Immune Deficiency Syndromes
JF - Jaids-journal of Acquired Immune Deficiency Syndromes
IS - 5
ER -