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P236 Examining the impact of the UK’s COVID-19 public health response on sexual behaviour and health service use among MSM
  1. A Howarth1,
  2. J Saunders1,2,
  3. D Reid1,3,
  4. I Kelly1,
  5. S Wayal1,
  6. P Weatherburn3,
  7. G Hughes2,
  8. C Mercer1
  1. 1UCL, London, UK
  2. 2Public Health England, London, UK
  3. 3London School of Hygiene and Tropical Medicine, London, UK


Background The introduction of social distancing in response to the COVID-19 pandemic led to reduced STI/HIV service provision in the UK. We investigated sexual risk behaviours among MSM and unmet need for sexual healthcare during the pandemic.

Methods A cross-sectional online survey (N=2,018) fielded via social media and dating apps (23/06–14/07/2020). We examined sexual behaviour and service use since lockdown (23/03/2020) and in the three previous months, and ‘unmet need for STI testing’ since lockdown (any new male partners and/or multiple condomless anal sex (CAS) partners without testing for STIs).

We compared behaviours over the past three months between socio-demographically equivalent sub-samples recruited via Grindr into the present survey (N=956) and a 2017 survey (N=1,918).

Results In 2020, 36.7% of participants reported new male partners and 17.3% reported multiple CAS partners since lockdown. Comparing time since lockdown vs previous three months, HIV testers were less likely to test at sexual health clinics (22.3% vs 70.2%) and more likely to use free online self-sampling services (64.3% vs 17.1%), and PrEP users were less likely to report PrEP use (21.7% vs 65.7%).

Since lockdown, 25.3% of participants had unmet need for STI testing. Unmet need was more likely among Asian vs White participants (aOR=1.76,[1.14–2.72],p=.01); living in Scotland (aOR=2.02,[1.40–2.91],p<.001) or Northern Ireland (aOR=1.93,[1.02–3.63],p=.04) vs England; and living with HIV (aOR=1.83,[1.32–2.53],p<.001).

Compared to 2017, the 2020 sub-sample were less likely to report new male partners (46.8% vs 71.1%, p<.001), multiple CAS partners (20.3% vs 30.8%, p<.001) and unmet need (32.8% vs 42.5%, p<.001) in the past three months.

Conclusion We found ongoing potential STI/HIV transmission among MSM during the initial UK lockdown, despite a reduction in sexual activity, and potential inequalities in access to sexual healthcare. These findings will support public health planning to mitigate against health risks during and after the COVID-19 response.

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