ABSTRACT
Introduction Men and gender diverse people who have sex with men (MGDSM) are at higher risk of sexually transmitted infections (STIs). COVID-19 related lockdown restrictions at the beginning of the pandemic might have altered their sexual behaviours and thus their susceptibility to STIs. We examined the impact of the first UK-wide lockdown on sexual behaviours and explored factors related to casual sexual activity at the time when it was discouraged by official guidelines. Methods In April-May 2020, we conducted an online 40-item survey, promoted on social media and Grindr, which assessed engagement in various sexual activities, anxiety about COVID- 19 and relevant demographic factors. We performed regression analyses to identify changes in sexual behaviour during the lockdown and characteristics of those who engaged in casual sex. Results Out of 1429 respondents (mean age=36, 84% White), 76% reported not having any casual sex, 12% engaged in casual sex with only one person and 5% with four or more sexual partners during lockdown. Reporting casual sex during lockdown was associated with: lower level of education OR=2.37[95%CI:1.40-4.01];identifying as a member of an ethnic minority OR=2.27[1.40-3.53];more frequent (daily) usage of sexual networking apps OR=2.24[1.54-3.25];being less anxious about contracting COVID-19 through sex OR=1.66[1.12-2.44];using PrEP before lockdown OR=1.75 [1.20-2.56];continuing to use PrEP OR=2.79[1.76-4.57];and testing for STIs during lockdown OR=2.65[1.76-3.99]. Discussion Three-quarters of respondents ceased sexually activity with casual sex partners and those sexually active were also more likely to use PrEP and utilise sexual health screening, which may partially explain the temporary decline in STIs.
ABSTRACT
BackgroundIn response to the COVID-19 pandemic, a lockdown was imposed in England March-June 2020, requiring people to cease outside physical contact except for essential reasons. A study was conducted to understand the impact on mental and sexual wellbeing among Male and Gender-Diverse People who have Sex with Men.MethodsA structured anonymous survey was conducted online, advertised via social media using a convenience sampling approach. Participants were asked about use of sexual health interventions and sexual networking apps, sexual behaviour and COVID-19. Qualitative interview participants were purposively sampled from survey participants who provided contact details for that purpose.ResultsN=1429 MGDPSM completed the survey (March-July 2020). N=15 survey respondents who reported having casual sex partners during lockdown participated in an interview (August 2020-February 2021). N=331 (26.5%) reported feeling anxious about COVID-19 more than half of the time. N=155 (12.1%) reported 1 casual sex partner during lockdown, and n=156 (12.2%) reported 2+. N=1014 (77.6%) reported decreasing their number of casual sex partners during lockdown. This was not associated with COVID-19 anxiety (Chi-square=0.82 p=0.36) or belief about being infected (Chi-square=1.77 p=0.41). Qualitative findings suggest desire to comply with guidance was a key motivator in reducing casual partner numbers, and that this was facilitated by using COVID-19 risk-reduction strategies such as having virtual sex.ConclusionThe majority of survey respondents reduced casual partner numbers. This may be explained by desire to adhere to physical distancing measures which was not measured but which emerged as a key motivator among interviewees. As the pandemic continues alongside growing lockdown fatigue, future research is needed to identify and monitor motivations to reduce casual partner numbers during future physical distancing requirements, and to ensure health promotion highlights self-protective strategies available to MGDPSM.