Sexual behaviour and STI Incidence in sexually active MSM living with HIV in times of COVID-19. Open Forum Infectious Diseases
Mugglin and Hamusonde et al. evaluated changes in sexual behavior, satisfaction and incidence of sexually transmitted infections among men who have sex with men (MSM) related to restrictions due to the COVID-19 pandemic.
All MSM from the Swiss HIV Cohort Study who reported sex with occasional partners were asked to complete an online questionnaire regarding their sexual behavior. Questions assessed aspects such as the number of sexual partners, attendance of sex parties, frequency of chemsex, traveling for sex, and overall satisfaction with their sexual life. In addition, the authors evaluated trends of STIs incidences between January 2018 and June 2022.
The questionnaire was completed by 205 participants. Their median age was 49 years, 90% were White, and 96% had a suppressed HIV viral load. Compared to the area prior to the COVID-19 pandemic, 63% reported having less occasional partners, 22% reported no change, and 14% had more occasional partners during the pandemic. The proportion of individuals who attended sex parties declined from 33% to 5%, and the proportion of individuals who traveled abroad for sex at least once per month decreased from 26% before to 9% during the pandemic. Whereas 73% of individuals reported being satisfied with their sexual life prior to the COVID-19 related restrictions, this proportion decreased to 57% during the pandemic. In contrast, attending private sex parties, traveling for sex within Switzerland and practicing chemsex remained unchanged. Similarly, incidences of chlamydia, gonorrhea and syphilis infections remained stable throughout the study period.
In summary, the study shows that although sexual activity somewhat decreased during COVID-19 related restrictions, people responded very differently to those measures. This heterogeneity is nicely illustrated by the substantial proportion of individuals who reported an increase in the number of non-steady partners, which might explain why STI incidence did not decrease during the studied period. These findings highlight that a better understanding of the drivers of sexual behavior among PWH is needed to tailor STI prevention programs.