P446 Decreased Sex Partnerships but No Change in Gonorrhea/Chlamydia Prevalence among Gay, Bisexual and Other Men-Who-Have-Sex-with-Men (MSM) during the COVID-19 Pandemic

ABSTRACT

BackgroundCOVID-19 mitigation measures may indirectly impact sexually transmitted infection (STI) transmission. Social distancing may impact number/type of sex partnerships and access to STI testing and treatment. The objective was to compare the number of reported sex partnerships and gonorrhea and chlamydia prevalence pre- and during-pandemic among a cohort of gay, bisexual and other men-who-have-sex-with-men (MSM) in Baltimore, Maryland, a U.S. city with sustained STI epidemics.MethodsThis study was nested in a cohort study of sexually active MSM aged 18–45, and included participants who had at least one study visit after March 13, 2020 (during-pandemic) and ≤ six months between their first during-pandemic and last pre-pandemic visit. Wilcoxon and McNemar tests for paired data were used for statistical testing.ResultsAmong 417 MSM enrolled in the cohort, 220 (52.8%) were included. 213 (96.8%) had a visit between April 6-June 30, 2020 (during-pandemic1);185 (84.1%) had a visit between July 1-September 30, 2020 (during-pandemic2), including seven who missed the during-pandemic1 visit. The majority were Black (73.2%) and aged 24–35 (56.4%);42% were living with HIV. Compared to pre-pandemic, the median number of total and casual male sex partners (past three months) significantly declined during-pandemic1 and during-pandemic2 (Total partners pre-pandemic 2.0 (range 0–75);during-pandemic1 1.0 (0–25), p<0.0001;during-pandemic2 1.0 (0–20) p<0.0001;Casual partners pre-pandemic 1.0 (0–75);during-pandemic1 0.0 (0–25) p<0.0001, during-pandemic2 1.0 (0–20), p=0.004). Among those tested both pre- and during-pandemic2, (n=96) STI prevalence was similar (gonorrhea 14.1% vs. 15.8%, p=0.847;chlamydia 7.0% vs. 9.5%, p=0.527).ConclusionsAlthough overall and casual sex partnerships declined significantly during- compared to pre-pandemic, STI prevalence was similar. The observed decreased sex partnerships may not have substantially altered transmission dynamics or were offset by increased prevalence due to limited access to testing/treatment. Improved understanding of how COVID-19 mitigation measures alter STI transmission dynamics is needed.