ABSTRACT
BackgroundSARS Co-V-2 (COVID-19) mitigation strategies have resulted in limited clinical operations for sexual health services and adolescents and young adults (AYA) have received mixed messages about the risk for serious COVID-19 infection. This work describes the sexual behavior and relationship between COVID-19 risk perceptions and sexual behaviors among urban AYA during the pandemic.MethodsCross-sectional data were used from AYA enrolled across four sexual health studies in Baltimore, Maryland (USA). Participants had an active STI, HIV, or were at risk for STI/HIV. The March 16, 2020 ‘stay-at-home’ orders were used to define the pandemic period in the human subjects’ approved telephone survey. Demographics, COVID-19 risk perception, testing behavior, positivity in their social circle, and relationship/sexual behaviors data were evaluated using regression analyses.Results194 participants with a mean (sd) age of 22.7 (2.8) years were surveyed. Most were female (81%) with public health insurance (68%), 61% were in a relationship, 36% were cohabiting, 79% had sex during the stay-at-home order, 68% used some form of contraception, 39% used a condom at last sex, and 23% had STI screening during the pandemic. 51% had COVID-19 testing, and 31% and 8% experienced a COVID-19-related diagnosis or death, respectively, in their social circle. Using a 10-point Likert scale (10=most concerned), the mean concern score for contracting COVID-19 was 5.0 (3.7) and during intercourse was 3.0 (4.1). Those with COVID-19 positivity within their social circle were marginally more likely to have COVID-19 testing (adjusted OR 1.69, 95% CI 0.89 – 3.19, p = 0.107). Concern for COVID infection or COVID-19 in social circle was not associated with sexual intercourse or condom use.ConclusionUrban AYAs remain at risk for STIs and COVID-19 given community rates, low condom use, and low COVID risk perceptions. Youth-focused mitigation strategies to reduce STI/HIV and COVID-19 are warranted.
ABSTRACT
BackgroundAdolescents and young adults (AYA) who experience dating violence (DV) are at increased STI risk. Social restrictions during the COVID-19 pandemic have stressed AYA relationships and may cut them off from sources of support. AYA have been shown to respond to relationship stressors with behaviors that increase STI risk. This work examines whether relationship stressors (jealousy and worry about the relationship) exacerbate violence and STI risk among urban AYA during the COVID-19 pandemic.MethodsParticipants from four sexual and reproductive health studies in Baltimore, Maryland (USA) were invited to complete a cross-sectional telephone survey on relationship experiences/sexual behavior during the pandemic. March 16, 2020 ‘stay-at-home’ order was used to define the pandemic period. Partner support, jealousy, worry about the relationship making it through the pandemic, current DV, change in DV during pandemic, and condom use at last sex were evaluated using regression analyses. Data collection is still underway in 2021.ResultsOf 194 participants surveyed, mean (sd) age 22.7 (2.8) years, 61% were in a romantic/sexual relationship. Of these, 14% reported current TDV, 6% experienced an increase in DV, 66% did not use a condom at last sex. AYA who worried their relationship would not make it through the pandemic were more likely to experience DV (OR: 5.64, 95%CI: 1.69, 18.9). AYA who felt jealous of other people their partner was talking to/hanging out with during the pandemic were more likely to experience DV (OR: 4.51, 95%CI: 1.39, 14.6). Greater partner support was associated with experiencing less DV (OR: 0.71, 95%CI: 0.56, 0.90). Relationship stressors were not associated with condom use.ConclusionsRelationship insecurity exacerbated by the COVID-19 pandemic may increase risk for DV among AYA. As DV and STI are interconnected, romantic relationship context must be a key focus of STI prevention strategies during and after the pandemic.