Contraceptive usage and social barriers during the COVID-19 pandemic: a prospective cross-sectional study

Objective: To determine the frequency of contraceptive usage, the social barriers affecting their use, and the frequency of unplanned pregnancies during the COVID-19 pandemic Methodology: This is a prospective cross-sectional study carried out at the Department of Obstetrics and Gynaecology, Fazaia Ruth Pfau Medical College & PAF Hospitals from July 2020 to September 2020. All women of reproductive age attending the outpatient department were consecutively included. A pre-structured questionnaire was used for the purpose of collection of data. We obtained information regarding the use of contraception before and during the COVID-19 pandemic and the contraception methods used by these women. Furthermore, reasons for discontinuing contraception amongst those women who were using it earlier. The occurrence of pregnancy during pandemic was also noted. Results: Of the 350 women, 306 (87.4%) women practiced contraception before and 288 (82.3%) practiced it during the lockdown. Of 306 women practicing contraception before the lockdown, 265 (86.6%) continued practicing during the lockdown as well. Condom 145 (50.3%) and withdrawal method 116 (40.3%) were the most used methods amongst the 288 women practicing contraception during the lockdown. The noticeable increase in the number of those using withdrawal method was due to the lack of consultation following the fear of getting COVID (17 women, 41.5%) and no access to the clinic (14 women, 34.1%). These were the most common reasons for not using contraception, amongst the 41 women practicing contraception before the pandemic. Pregnancies were reported by 93 (26.6%) women out of whom 75 (80.6%) reported these to have been unplanned. Conclusion: The COVID pandemic has largely affected the utilization of contraceptives among women who were already practicing different contraceptive methods. Moreover, unplanned pregnancies are increasingly reported by women.

'Condoms are hard to get by': access to HIV prevention methods during lockdown of the COVID-19 epidemic in eastern Zimbabwe.

BACKGROUND: In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, health services were disrupted worldwide, including HIV prevention services. While some studies have begun to document the effects of COVID-19 on HIV prevention, little has been done to qualitatively examine how lockdown measures were experienced and perceived to affect access to HIV prevention methods in sub-Saharan Africa. OBJECTIVES: To explore how the COVID-19 pandemic was perceived to affect access to HIV prevention methods in eastern Zimbabwe. METHOD: This article draws on qualitative data from the first three data collection points (involving telephone interviews, group discussions, and photography) of a telephone and WhatsApp-enabled digital ethnography. Data were collected from 11 adolescent girls and young women and five men over a 5-month period (March-July 2021). The data were analysed thematically. RESULTS: Participants reported widespread interruption to their condom supply when beerhalls were shut down as part of a nationwide lockdown. Restrictions in movement meant that participants who could afford to buy condoms from larger supermarkets or pharmacies were unable to. Additionally, the police reportedly refused to issue letters granting permission to travel for the purpose of accessing HIV prevention services. The COVID-19 pandemic was also described to obstruct the demand (fear of COVID-19, movement restrictions) and supply (de-prioritised, stock-outs) for HIV prevention services. Nonetheless, under certain formal and informal circumstances, such as accessing other and more prioritised health services, or 'knowing the right people', some participants were able to access HIV prevention methods. CONCLUSION: People at risk of HIV experienced the COVID-19 epidemic in Zimbabwe as disruptive to access to HIV prevention methods. While the disruptions were temporary, they were long enough to catalyse local responses, and to highlight the need for future pandemic response capacities to circumvent a reversal of hard-won gains in HIV prevention.

How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID).

OBJECTIVES: To investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic. METHODS: British participants (18-59 years) completed a cross-sectional web survey 1 year (March-April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16-74 years) conducted in 2010-2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18-44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors. RESULTS: In 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18-24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers. CONCLUSIONS: Our study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010-2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.

Changes of trends in contraception in pandemic - a hospital-based study

Background: With the onset of COVID-19 pandemic, the life of humankind had changed a lot. With a change in health-care approach, contraception became a non-essential service and faced a downfall. Aims and Objective: This study objective is to find out the changes in contraceptive usage in a tertiary care center. Materials and Methods: The study is a retrospective observational study, in which contraceptive usage was compared between 2019 and 2020. Data obtained from record section of the institute were used as source. Attendance in Gynecological Outpatient Department, admission in maternity ward, and delivery rates were also compared between 2 years. Results: Total contraceptive usage was decreased by 11.1% in 2020. Long-acting reversible contraceptives or short-acting both types were decreased in 2020, but maximum decrease was barrier method condom by 25.1% and oral contraceptive pills by 24.9%. Hospital maternity ward admission was less by 7% and delivery rates by 2.4%. Only medical termination of pregnancy showed an increased trend in 2020. Conclusion: Pandemic also had caused a toll in family planning, and thus, overall decrease in usage was seen which can be detrimental to population control.

Development of a combined model of college student alcohol-associated condomless sex

Harmful alcohol use and sexually transmitted infections (STIs) are significant public health concerns for college students. Because alcohol use and condomless sex often co-occur in this population, alcohol-associated condomless sex has been identified as a target for behavioral interventions. Existing theoretical frameworks have not garnered sufficient empirical support to serve as the foundation for interventions. The primary goal of the current study was to use a mixed-methods approach to develop a novel model of college student alcohol-associated condomless sex that combines elements from well-established health behavior theories. In Aim 1, multilevel structural regression models were estimated to predict condomless vaginal intercourse in a sample of sexually-active college student drinkers (N = 57). An Exploratory Aiminvestigated the extent to which the model estimated in Aim 1 fit sexual activity occurring prior to the COVID-19 pandemic (N = 128). Aim 2 consisted of in-depth-interviews with a sub-sample of participants (n = 18) to gather perceptions about the role of alcohol in sexual activity and identify additional constructs pertaining to college student condom use. Quantitative results demonstrated the best-fitting model explained a significant proportion of variance in condomless vaginal intercourse at the between- and within-person level. Themes derived from the in-depth-interviews identified supplemental components of condom use decision-making. Findings from both aims were synthesized to construct a preliminary combined model of alcohol-associated condomless sex. This model can be refined in future work and ultimately serve as the theoreticalfoundation from which to develop a combination alcohol-STI prevention-intervention tailored to college students. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Difficulty accessing condoms because of the COVID-19 pandemic reported by gay, bisexual and other men who have sex with men in the UK: findings from a large, cross-sectional, online survey.

BACKGROUND: COVID-19 restrictions severely reduced face-to-face sexual health services, an important access point for condoms. We examine whether gay, bisexual and other men who have sex with men (GBMSM) in the UK had difficulty accessing condoms during the first year of the pandemic, and if so, which groups were most affected. METHODS: Questions about difficulty accessing condoms were asked as part of a short, online cross-sectional survey of GBMSM undertaken November/December 2021, recruited via social media and Grindr. Eligible participants were UK-resident GBMSM (cis/trans/gender-diverse person assigned male at birth [AMAB]), aged ≥16 years who were sexually active (reported sex with men in the last year). Multivariable logistic regression was used to examine if and how reporting this outcome varied by key sociodemographic, health and behavioural factors independent of the potential confounding effect of numbers of new male sex partners. RESULTS: Of all participants (N = 1039), 7.4% (n = 77) reported difficulty accessing condoms due to the pandemic. This was higher among younger GBMSM (aged 16-29 years vs. ≥45; 12.8% vs. 4.9%; aOR: 2.78); trans/gender-diverse AMAB participants (vs. cis gender males; 24.4% vs. 6.6%; aOR = 4.86); bisexually-identifying participants (vs. gay-identifying; 11.1% vs. 6.5%; aOR = 1.78); and those without degree level education (vs. having a degree; 9.8% vs. 5.6%; aOR = 2.01). CONCLUSIONS: A minority of sexually active GBMSM reported difficulty accessing condoms because of the pandemic, however, this was more common amongst those who already experience a disproportionate burden of poor sexual health. Interventions are needed to address these inequalities in accessing this important primary STI/HIV prevention measure.

Development of a combined model of college student alcohol-associated condomless sex

Harmful alcohol use and sexually transmitted infections (STIs) are significant public health concerns for college students. Because alcohol use and condomless sex often co-occur in this population, alcohol-associated condomless sex has been identified as a target for behavioral interventions. Existing theoretical frameworks have not garnered sufficient empirical support to serve as the foundation for interventions. The primary goal of the current study was to use a mixed-methods approach to develop a novel model of college student alcohol-associated condomless sex that combines elements from well-established health behavior theories. In Aim 1, multilevel structural regression models were estimated to predict condomless vaginal intercourse in a sample of sexually-active college student drinkers (N = 57). An Exploratory Aiminvestigated the extent to which the model estimated in Aim 1 fit sexual activity occurring prior to the COVID-19 pandemic (N = 128). Aim 2 consisted of in-depth-interviews with a sub-sample of participants (n = 18) to gather perceptions about the role of alcohol in sexual activity and identify additional constructs pertaining to college student condom use. Quantitative results demonstrated the best-fitting model explained a significant proportion of variance in condomless vaginal intercourse at the between- and within-person level. Themes derived from the in-depth-interviews identified supplemental components of condom use decision-making. Findings from both aims were synthesized to construct a preliminary combined model of alcohol-associated condomless sex. This model can be refined in future work and ultimately serve as the theoreticalfoundation from which to develop a combination alcohol-STI prevention-intervention tailored to college students. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Reviewing the rates of diagnosing Gonorrhoea in an era of COVID

P119 Table 1Drug sensitivities in 71 Neisseria gonorrhoeae infections for May 2019 using direct plating at the bedside Tested antimicrobial Drug resistance (as%) to the tested antimicrobial Azithromycin 3 Tetracycline 49 Ciprofloxacin 31 Ceftriaxone 0 Cefixime 0 Drug sensitivities in 78 Neisseria gonorrhoeae infections for May 2020 using the Copan ESwab Tested antimicrobial Drug resistance (as%) to the tested antimicrobial Azithromycin 0 Tetracycline 55 Ciprofloxacin 18 Ceftriaxone 0 Cefixime 5 ReferencesUnemo, M., Seifert, H., Hook III, E., Hawkes, S., Ndowa, F. and Dillon, J., 2019. Gonorrhoea. Nature Reviews, [online] 5(79). Available at: <https://www.nature.com/articles/s41572-019-0128-6.pdf> [Accessed 5 May 2021].Public Health England, 2019. Sexually transmitted infections and screening for Chlamydia in England, 2019. [online] Public Health England. Available at: <https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/914184/STI_NCSP_report_2019.pdf> [Accessed 5 May 2021].Fifer, H., Saunders, J., Soni, S., Sadiq, S. and FitzGerald, M., 2019. 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. International Journal of STD & AIDS, 31(1), pp.4-15.Vickerman, P., Peeling, R., Watts, C. and Mabey, D., 2005. Detection of Gonococcal Infection. Molecular Diagnosis, 9(4), pp.175-179.Ndowa, F., Lusti-Narasimhan, M. and Unemo, M., 2012. The serious threat of multidrug-resistant and untreatable gonorrhoea: the pressing need for global action to control the spread of antimicrobial resistance, and mitigate the impact on sexual and reproductive health. Sexually Transmitted Infections, 88(5), pp.317-318.Olsen, C., Schwebke, J., Benjamin, W., Beverly, A. and Waites, K., 1999. Comparison of Direct Inoculation and Copan Transport Systems for Isolation of Neisseria gonorrhoeae from Endocervical Specimens. Journal of Clinical Microbiology, 37(11), pp.3583-3585.Copan Diagnostics, 2019. Copan Liquid Based Microbiology. [online] Copanusa.com. Available at: Madjunkov, M., Dviri, M. and Librach, C., 2020. A comprehensive review of the impact of COVID-19 on human reproductive biology, assisted reproduction care and pregnancy: a Canadian perspective. Journal of Ovarian Research, 13(1).World Health Organisation, 2021. WHO Coronavirus (COVID-19) Dashboard. [online] Covid19.who.int. Available at: <https://covid19.who.int/> [Accessed 5 May 2021].Han, ., Tan, M., Turk, E., Sridhar, D., Leung, G., Shibuya, K., Asgari, N., Oh, J., García-Basteiro, A., Hanefeld, J., Cook, A., Hsu, L., Teo, Y., Heymann, D., Clark, H., McKee, M. and Legido-Quigley, H., 2020. Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe. The Lancet, 396(10261), pp.1525-1534.Kuitunen, I. and Ponkilainen, V., 2021. COVID-19-related nationwide lockdown did not reduce the reported diagnoses of Chlamydia trachomatis and Neisseria gonorrhoeae in Finland. Sexually Transmitted Infections, pp.sextrans-2020-054881.Cusini, M., Benardon, S., Vidoni, G., Brignolo, L., Veraldi, S. and Mandolini, P., 2020. Trend of main STIs during COVID-19 pandemic in Milan, Italy. Sexually Transmitted Infections, 97(2), pp.99-99.Steffen, R., Lautenschlager, S. and Fehr, J., 2020. Travel restrictions and lockdown during the COVID-19 pandemic—impact on notified infectious diseases in Switzerland. Journal of Travel Medicine, 27(8).Rodríguez, I. and Hernández, Y., 2020. Sexually Transmitted Diseases during the COVID-19 pandemic: a focus on syphilis and gonorrhoea in Cuba. Public Health in Practice, p.100072.Li, W., Li, G., Xin, C., Wang, Y. and Yang, S., 2020. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in China. The Journal of Sexual Medicine, 17(7), pp.1225-1228.Crane, M., Popovic, A., Stolbach, A. and Ghanem, K., 2020. Reporting of sexually transmitted infections during the COVID-19 pandemic. Sexually Transmitted Infections, 97(2), pp.101-102.British Association for Sexual Health and HIV, 2020. BASHH Guidance on Sex, Social Distancing and COVID-19. [online] Available at: <https://members.bashh.org/Covid-19> [Accessed 11 May 2021].Unemo, M. and Shafer, W., 2014. Antimicrobial Resistance in Neisseria gonorrhoeae in the 21st Century: Past, Evolution, and Future. Clinical Microbiology Reviews, 27(3), pp.587-613.Chernesky, M., Castriciano, S., Jang, D. and Smieja, M., 2006. Use of Flocked Swabs and a Universal Transport Medium To Enhance Molecular Detection of Chlamydia trachomatis and Neisseria gonorrhoeae. Journal of Clinical Microbiology, 44(3), pp.1084-1086.Graveling, E., Venkatesh, H. and Banerjee, N., 2021. Evaluation of Sigma Transwab® in Liquid Amies Transport Medium for Neisseria gonorrhoeae Culture. [online] Available at: <http://file:///C:/Users/evtw/Downloads/EV0537%20(2).pdf> [Accessed 5 May 2021].Astill, N., Wallace, H., Phyu, K., Coates, M., Inns, H., Wilson, J. and Page, E., 2021. Sensitivity of COPAN E-swab versus direct inoculation for culture of Neisseria gonorrhoeae (NG). [online] Available at: <https://www.bhiva.org/file/NpJyojfInOrtq/P48.pdf> [Accessed 5 May 2021].Gumede, L., Radebe, F., Nhlapo, D., Maseko, V. and Kufa-Chakezha, T., 2017. Evaluation of the Copan eSwab®, a liquid-based microbiology transport system, for the preservation of Neisseria gonorrhoeae at different temperatures. Southern African Journal of Infectious Diseases, 32(3), pp.96-99.van der Veer, B., Hoebe, C., Dukers-Muijrers, N., van Alphen, L. and Wolffs, P., 2020. Men and Women Have Similar Neisseria gonorrhoeae Bacterial Loads: a Comparison of Three Anatomical Sites. Journal of Clinical Microbiology, 58(11).Buchan, B., Olson, W., Mackey, T. and Ledeboer, N., 2014. Clinical Evaluation of the Walk-Away Specimen Processor and ESwab for Recovery of Streptococcus agalactiae Isolates in Prenatal Screening Specimens. Journal of Clinical Microbiology, 52(6), pp.2166-2168.Hyndman, I., Nugent, D., Whitlock, G., McOwan, A. and Girometti, N., 2021. COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK. Sexually Transmitted Infections, pp.sextrans-2020-054768.

Africa ‘not on track to reach 2030 HIV/AIDS targets’

Speed read Researchers estimated the likelihood of 38 African countries reaching 2030 HIV/AIDS targets The chances of reaching HIV testing or condom use targets are less than 30 per cent As COVID-19 takes centre stage, Africa cannot afford to not fight HIV/AIDS, says an expert [NAIROBI] The likelihood of African countries reaching HIV testing and condom use targets by 2030 is only 12.1 per cent and 28.5 per cent respectively, making the need for more testing and treatment a priority, a modelling study suggests. The Joint United Nations Programme on HIV/AIDS (UNAIDS) launched ambitious targets in 2014 to end the AIDS epidemic by 2030 by achieving 95 per cent diagnosis and 95 per cent of people with HIV taking medications against the disease. Stuart Gilmour, St. Luke’s International University In 2019, there were 690,000 AIDS-related deaths and 1.7 million new infections, with young women and adolescent girls accounting for about 25 per cent of new infections in Sub-Saharan Africa despite making up about ten per cent of the population, according to UNAIDS.

A Retrospective Study of the Incidence of Bacterial Sexually Transmitted Infection (Chlamydia and Gonorrhea) in the Mississippi Delta Before and During the COVID-19 Pandemic

Background: Sexually transmitted infections (STIs), such as gonorrhea and chlamydia infections, are prevalent worldwide, in the United States, and in Mississippi (MS). The COVID-19 pandemic has impacted the healthcare system, particularly in disadvantaged areas such as the MS Delta.Methods: A retrospective analysis of medical records of three clinics in the MS Delta was conducted during pre-COVID-19 (July 2019 to September 2019) and in the same months (July 2020 to September 2020) during COVID-19 in 2020. Patients tested for STIs were identified using infection diagnosis codes. We calculated percentages and means for demographic variables, changes between the two years, and computed the percentage of patients who tested positive for each year.Results: Out of the 25 patients tested for STIs, 11 were tested in 2019 and 14 in 2020. Among those tested in 2019 compared to 2020, patients were younger (average age: 34.3 years in 2019 vs. 29.6 years in 2020), had a larger percentage of females (81.2% in 2019 vs. 50.0% in 2020) and African Americans (72.7% in 2019 vs. 57.1% in 2020), and more were uninsured (27.3% in 2019 vs. 42.9% in 2020). Of the three clinics, clinic #1 tested most patients (72.7% in 2019 vs. 64.3% in 2020). Among the tested patients, 0% had confirmed positive results in 2019 and 21.4% in 2020. The incidence of positive results in 2020 was 7.1% for chlamydia and 14.3% for gonorrhea.Conclusion: The incidence of gonorrhea and chlamydia increased during COVID-19 in 2020. So, it is of paramount importance to encourage increased testing and targeted interventions for high-risk groups for STIs.

Sex work and COVID-19 pandemic: Sexual and mental health of a sample of sex workers from Colombia

Introduction: In different countries, women sex workers have been stigmatized and discriminated against causing mental and sexual health problems in them. However, it is unknown how the pandemic and social distancing have impacted on their health. The objective of this descriptive research was to evaluate psychosocial factors, mental health, strategies for safe sexual practices, attitudes towards HIV and sexuality during the confinement period. Method: 98 female sex workers from three sectors of Bogota participated, who responded to psychometric scales on mental and sexual health. Results: More than 60% of the participants indicate feeling abandonment of the state, low clientele and little or no economic income;emotional involvement, a tendency to present negative attitudes towards sexuality, positive attitudes towards condom use, HIV testing and a high tendency to use persuasion strategies when the client refuses to use protection. Conclusions: Mental and sexual health problems continue and intensify in pandemic for sex workers in Colombia, which continues to be a national challenge that requires efficient and effective intervention from the economic and psychosocial aspects. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) Introduccion: En diversos paises las mujeres trabajadoras sexuales han sido estigmatizadas y discriminadas, lo que causa en ellas problemas de salud mental y sexual. No obstante, se desconoce como la pandemia por COVID-19 y el distanciamiento social han impactado en su salud. El objetivo de la presente investigacion, de tipo descriptivo, fue evaluar factores psicosociales, la salud mental, las estrategias para practicas sexuales con proteccion, las actitudes hacia el VIH y la sexualidad durante el periodo de confinamiento. Metodo: Participaron 98 mujeres trabajadoras sexuales de tres sectores de la Bogota, quienes respondieron a escalas psicometricas en salud mental y sexual. Resultados: Mas del 60 % de las participantes indican sentir abandono estatal, baja clientela y poco o ningun ingreso economico;afectacion emocional, una tendencia a presentar actitudes negativas frente a la sexualidad, actitudes favorables hacia el uso del condon, las pruebas de deteccion del VIH y una alta tendencia a emplear estrategias de persuasion cuando el cliente se niega a usar proteccion. Conclusiones: Las problematicas en salud mental y sexual se mantienen e intensifican en pandemia para las trabajadoras sexuales en Colombia, lo cual sigue siendo un reto a escala nacional que requiere una intervencion eficaz y efectiva desde lo economico y psicosocial. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Research news in clinical context

Correspondence to Prof Stefano Rusconi, DIBIC Luigi Sacco, University of Milan, Milan, Italy;stefano.rusconi@unimi.it Treatment regimens for HIV or Hepatitis C Virus do not need to be altered during Paxlovid administration for COVID-19 Treatment with Paxlovid (nirmatrelvir/ritonavir 300/100 mg two times per day for 5 days) is expected to play an important role in patients with mild-to-moderate COVID-19 who are at risk of disease progression. The change to HPV screening is less likely to miss invasive cancer than previous estimates The move away from combined cytology plus human papillomavirus (HPV) testing to HPV testing alone has raised concerns that cases of cervical cancer may be missed among those with a negative HPV test. Investigators in the USA studied the prevalence of invasive cervical cancer in women with a PAP-positive/HPV-negative cotest where a diagnosis would not have occurred as a consequence of symptoms or clinical examination.

Factors associated with access to condoms and sources of condoms during the COVID-19 pandemic in South Africa.

BACKGROUND: Evidence has shown that the prescribed lockdown and physical distancing due to the novel coronavirus disease 2019 (COVID-19) have made accessing essential health care services much more difficult in low-and middle-income countries. Access to contraception is an essential service and should not be denied, even in a global crisis, because of its associated health benefits. Therefore, it is important to maintain timely access to contraception without unnecessary barriers. Hence, this study examines the factors contributing to limited access to condoms and sources of condoms during the COVID-19 pandemic in South Africa. METHODS: This study used the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM) wave 1 survey dataset. The NIDS-CRAM is a nationally representative survey of the National Income Dynamics Survey (NIDS) conducted via telephone interview during COVID-19 in the year 2020. This is the first secondary dataset on COVID-19 conducted by NIDS during pandemic. A total of 5304 respondents were included in the study. Data were analysed using frequencies distribution percentages, chi-square test and multivariable logistic regression analysis. RESULTS: Almost one-quarter (22.40%) of South Africans could not access condoms, and every 7 in 10 South Africans preferred public source of condoms during the COVID-19 pandemic. Those who were from other population groups [AOR = 0.37; 95% CI = 0.19-0.74] and those who were in the third wealth quintile [AOR = 0.60; 95% CI = 0.38-0.93] had lower odds of having access to condoms while those respondents who were aged 25-34 [AOR = 0.48; 95% CI = 0.27-0.83] and those with a secondary level of education and above [AOR = 0.24; 95% CI = 0.08-0.71] were less likely to prefer public source of condom. CONCLUSIONS: This study concludes that there was limited access to condoms during the COVID-19 pandemic and that the preferred source of condoms was very skewed to public sources in South Africa. Strategic interventions such as community distribution of free condoms to avert obstruction of condom access during the COVID-19 pandemic or any future pandemics should be adopted.

Early impact of COVID-19 social distancing measures on reported sexual behaviour of HIV pre-exposure prophylaxis users in Wales.

OBJECTIVES: To describe the early impact of COVID-19 and associated control measures on the sexual behaviour of pre-exposure prophylaxis (PrEP) users in Wales. METHODS: Data were obtained from an ecological momentary assessment study of PrEP use and sexual behaviour. Participants were individuals accessing PrEP through the National Health Service (NHS) sexual health clinics across four health boards in Wales. Weekly data documenting condomless sex in the preceding week were analysed between 03/02/2020 and 10/05/2020. The introduction of social distancing measures and changes to sexual health clinics in Wales occurred on the week starting 16/03/2020. Two-level logistic regression models were fitted to condomless sex (yes/no) over time, included an indicator for the week starting 16/03/2020, and were extended to explore differential associations by relationship status and sexual health clinic. RESULTS: Data were available from 56 participants and included 697 person-weeks (89% of the maximum number that could have been obtained). On average, 42% of participants reported condomless sex in the period prior to the introduction of social distancing measures and 20% reported condomless sex after (OR=0.16, 95% CI 0.07 to 0.37, p<0.001). There was some evidence to suggest that this association was moderated by relationship status (OR for single participants=0.09, 95% CI 0.06 to 0.23; OR for not single participants=0.46, 95% CI 0.16 to 1.25). CONCLUSIONS: The introduction of social distancing measures and changes to PrEP services across Wales was associated with a marked reduction in reported instances of condomless sexual intercourse among respondents, with a larger reduction in those who were single compared with those who were not. The long-term impact of COVID-19 and associated control measures on this population's physical and mental health and well-being requires close examination.