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Impact of the early 2020 COVID-19 crisis and lockdown on PrEP use among men who have sex with men (MSM) in France
  1. Marion Di Ciaccio1,2,
  2. Virginie Villes1,
  3. David Michels1,3,
  4. Stéphane Morel1,3,
  5. Rosemary M Delabre1,
  6. Daniela Rojas Castro1,4,
  7. Annie Velter5
  1. 1 Community-based Research Laboratory, Coalition PLUS, Pantin, France
  2. 2 Groupe de Recherche en Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
  3. 3 AIDES, Pantin, France
  4. 4 Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
  5. 5 Santé Publique France, Saint-Maurice, France
  1. Correspondence to Dr Marion Di Ciaccio, Coalition PLUS, Pantin, France; mdiciaccio{at}


Objective To describe changes in pre-exposure prophylaxis (PrEP) use during and following the COVID-19 lockdown in France (March–May 2020) and identify the factors associated with PrEP discontinuation among men who have sex with men (MSM) after the lockdown.

Methods Data from the, an anonymous, cross-sectional internet survey among MSM in July 2020, were analysed. Among respondents who were using PrEP prior to the lockdown, a binary logistic regression model was used to compare participants who were still taking PrEP (current PrEP users) with those who were not taking PrEP at the time of the survey (former PrEP users).

Results Among 8345 respondents, 946 were PrEP users before the lockdown, of whom 58.8% (n=556) reported stopping PrEP during the lockdown and 15.4% (n=146) were not using PrEP at the time of the survey. Among the 556 who stopped PrEP during lockdown, 86.5% (n=481) reported no sexual activity; 76.8% (n=427) restarted PrEP after lockdown. Former PrEP users were more likely to be younger, not living with a stable male sexual partner, report moderate anxiety, report increased psychoactive drug use during the lockdown, and report not having tested for HIV or STI since the end of the lockdown because they did not know where to go, preferred to wait or for another reason. Reporting fewer male sexual partners in the last 6 months was also significantly associated with being a former PrEP user.

Conclusions MSM adapted PrEP use to their sexual activity during and after the French lockdown. After the lockdown, discontinued PrEP occurred more often among MSM who had fewer sexual partners and had mental health vulnerabilities. These factors could also be predictive of PrEP discontinuation in a more general context. PrEP users should be informed on how to safely stop/start PrEP and on the use of other prevention tools to reduce potential risk exposure during PrEP discontinuation.

  • pre-exposure prophylaxis
  • men
  • COVID-19
  • treatment adherence and compliance

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Handling editor Jamie Scott Frankis

  • Contributors AV designed and supervised the data collection for ERAS-COVID-19 study and supervised the analysis. MDC and VV conducted the analysis and wrote the paper under the supervision and advice of DRC, RMD, SM and DM. AV is responsible for the overall content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.