ABSTRACT
COVID-19 pandemic can affect people using HIV preexposure prophylaxis (PrEP). To assess its consequences on PrEP users' sexual behaviour and welfare, we conducted a mixed-method study. A self-administered questionnaire was given to PrEP users during scheduled consultation in Tourcoing Hospital from February to May 2021. In addition, a qualitative study included 14 participants who took part in semi-structured in-depth interviews (IDIs). Ninety-four PrEP users completed the questionnaire. During lockdown, 62% of participants continued PrEP. After lockdown release, the average number of sexual intercourses and partners increased from 6 ± 12 to 13 ± 17 intercourses/month (p < 0.001) and from 3 ± 11 to 11 ± 34 partners/month (p < 0.001). Similarly, the proportion of PrEP users who engaged in group sex, sex with alcohol or chemsex increased respectively from 28% to 55% (p < 0.001), 28% to 45% (p < 0.001) and 28% to 38% (p < 0.001). Analysis of IDIs revealed emotional deprivation and sexual frustration during the lockdown. After its release, frequent clandestine chemsex parties and curfew forcing overnight stay increased fears of intimate violence and overdoses. In conclusion, PrEP users reduced their sexual activity during the lockdown. Its release led to an increase in sexual risk-taking. Social distancing measures could favour medical and social harm of sexual risk-taking.
ABSTRACT
Both the HIV pandemic and the COVID-19 pandemic have highlighted underlying racial and socioeconomic health disparities in Louisiana, as well as in the United States. Neighborhood factors, such as community violence and social vulnerability, likely play a significant role in these disparities.The goals of this study were to examine the relationship between community violence exposure and HIV sexual risk behaviors and to examine the impact of neighborhood-level social vulnerability on HIV testing practices and COVID-19 incidence.Data from the National HIV Behavioral Surveillance System, the CDC Social Vulnerability Index (SVI) Database, and the Louisiana Department of Health were analyzed. The CDC SVI was used to measure neighborhood-level social vulnerability, which comprises four related factors: socioeconomic status, household composition and disability, minority and language, and housing characteristics and transportation.First, the relationship between community violence exposure and HIV sexual risk behaviors was examined among an age-diverse population of heterosexually active adults. A positive association was observed between community violence exposure and HIV sexual risk behaviors. Gender did not modify this relationship.Second, the relationship between neighborhood-level social vulnerability and recent HIV testing history was examined. Neighborhood-level socioeconomic status was the only social vulnerability factor observed to be associated with recent HIV testing, where individuals residing in lower socioeconomic neighborhoods had lower odds of receiving a recent HIV test than those residing in higher socioeconomic neighborhoods. This association diminished as age increased.Third, the relationship between social vulnerability and COVID-19 incidence during the first six months of the COVID-19 pandemic within Louisiana census tracts was examined. All four factors measuring social vulnerability were found to be associated with COVID-19 incidence;Louisiana census tracts with higher levels of overall social vulnerability exhibited higher levels of COVID-19 incidences. The results of this study provide further evidence that neighborhood characteristics can influence health behaviors (e.g., sexual risk behaviors), access to healthcare (e.g., HIV testing), and health outcomes (e.g., COVID-19 infections). In conclusion, future public health initiatives should focus on identifying and removing barriers to health within identified vulnerable neighborhoods. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
BACKGROUND: Sexual minority men who use drugs have high sexual HIV transmission risk. Sexual interactions may also increase COVID-19 risk.This study compared marijuana use, other illegal drugs use (i.e. cocaine/crack, methamphetamine, MDMA/ecstasy, GHB, and ketamine) and sexual behavior with casual partners among sexual minority cismen active on social networking and dating applications before and during the COVID-19 epidemic. METHODS: This cohort-control study compared 455 adult respondents (surveyed May 6th to 17th, 2020) and a matched sample selected from 65,707 respondents surveyed pre-COVID. Participants were recruited on social networking and dating applications and completed surveys online. RESULTS: The proportion reporting marijuana use declined significantly in the COVID cohort (34.5 % versus 45.7 % pre-COVID,p < .001) as did their illegal drug use (11.0 % versus 22.9 % pre-COVID, p < .001). While the number of casual partners per month was stable, the proportion reporting condomless anal sex with casual partners declined significantly during COVID (26.4 % versus 71.6 % pre-COVID, p < .001). The effect of illegal drug use (excluding marijuana) on number of casual partners per month (aRR = 1.45 pre-COVID versus 2.84, p < .01) and odds of condomless anal sex (aOR = 2.00 pre-COVID versus 5.22, p = .04) were significantly greater in the COVID cohort. CONCLUSIONS: While the proportion of participants reporting drug use and condomless anal sex with casual partners declined in the COVID cohort, the association between drug use and sexual behavior was magnified. Sexual minority men who use drugs are significantly more likely to engage in sexual behaviors that place them at risk for HIV and COVID-19 transmission.