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O05.4 Changes in MSM’s sexual activity, PrEP use, and access to HIV/STI testing during and after the first Dutch COVID-19 lockdown
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  1. P Adam1,2,
  2. E Op de Coul3,
  3. W Zuilhof4,
  4. P Zantkuijl4,
  5. C Den Daas5,6,
  6. J De Wit2,5
  1. 1Institute For Prevention and Social Research (IPSR), Utrecht, Netherlands
  2. 2UNSW Sydney, Centre for Social Research in Health, Sydney, Australia
  3. 3National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  4. 4Soa Aids Nederland, Amsterdam, The Netherlands
  5. 5Utrecht University, Interdisciplinary Social Science, Utrecht, The Netherlands
  6. 6University of Aberdeen, Aberdeen, UK

Abstract

Background The COVID-19 pandemic and associated lockdowns have impacted MSM’s sexual activity and access to HIV/STI-related services. This study among MSM in the Netherlands assesses COVID-19-induced changes in numbers of sex partners, condomless anal intercourse (CAI), PrEP use, and HIV/STI testing.

Methods From July 20th to September 11th 2020, MSM were recruited via social media to complete an online survey. 2182 respondents (Mage=40 years) provided data on their sexual activity in 3 bimesters before the first lockdown (T1 Jan.–Feb.), during the lockdown (T2 mid-March-mid-May) and after the lockdown (T3 June–July). PrEP use and HIV/STI testing were reported per semester.

Results The mean number of sex partners decreased by 39% between T1 and T2 and remained 12% lower at T3 than at T1. The number of CAI partners decreased by 36% between T1 and T2, and at T3 was similar to T1. A majority (62%) of PrEP users stopped using PrEP at some point because of COVID-19, of which 73% subsequently resumed PrEP. A fifth (20%) of respondents postponed/missed appointments for STI testing and 16% postponed/missed appointments for HIV testing. Only 39% of these respondents caught up on missed testing. Self-sampling/testing accounted for 1% of HIV testing and 1.2% of STI testing in the last semester before COVID-19 (past 7–12 months), and 5.5% and 2.7% respectively in the first semester with COVID-19 (past 0–6 months).

Conclusion Sexual behaviours that put MSM at risk of STI or HIV acquisition were significantly reduced during the first lockdown. However, reengagement in sexual activity and CAI was rapid in the two months after the lockdown. Resumption of PrEP use after an interruption was more frequent than catching up on HIV/STI testing. Further promoting self-sampling/testing may contribute to mitigating the adverse impact of a succession of lockdowns and periods of easing of restrictions.

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