Triggers of change in sexual behavior among people with HIV: The Swiss U = U statement and Covid-19 compared. Journal of Infectious Diseases
Hamusonde et al. aimed to investigate the impact of 2 external factors (termed “triggers” herein) which might influence sexual behavior: (1) the Swiss U = U statement (“trigger of relief”), and (2) the COVID-19 social distancing (“trigger of restriction”). For this purpose, they investigated over 20 years of long-term trajectories in condom use and occasional partnership among people with HIV in the Swiss HIV Cohort Study (SHCS).
Trajectories of condom use were assessed among 2’212 men who have sex with men (MSM) and 2’417 heterosexuals (HET). Trajectories of occasional partnership were assessed among 5’617 MSM and 6’356 HET.
Since the publication of the Swiss Statement in 2008, consistent condom use with an HIV-negative stable partner declined from over 90% to around 30% in 2021. Consistent condom use with an HIV-positive stable partner declined from over 50% to around 10%. The long-term trajectories in condom use were remarkably similar between MSM and HET.
Consistent condom use with occasional partners declined following the Swiss Statement with a more pronounced decrease among MSM. Occasional partnership frequencies were consistently higher among MSM than HET with stable levels until the COVID-19 pandemic. Shortly after the onset of the COVID-19 pandemic, there was a marked decline in the frequency of occasional partnership among MSM.
In sum, this study shows that overall external triggers of relief and restriction had a marked impact on sexual behavior among people with HIV.