COVID-19 restrictions and changing sexual behaviours in MSM in London, UK

A recent article in the journal Sexually Transmitted Infections has looked at changes in behaviour in MSM in London during the Covid 19 pandemic. The study was web-based and only among HIV-negative MSM in a large urban setting.

Objectives: The COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services.

Methods: This was a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended  a sexual health and HIV clinic in London in August 2020. They collected data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown.

Results: 814 MSM completed the questionnaire: 75% were PrEP users; three quarters reported they have been sexually active, about half  had sex outside their household. The majority reported fewer partners than prior to lockdown. Interestingly 73% had discussed COVID-19 transmission risks with their sexual partners.

One out of five reported guilt for breaching COVID-19 restrictions and three out of four implemented one or more changes to their sexual behaviour. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of sexual health services than non-PrEP users.

Conclusions: COVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to sexual health services provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.

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