This study on gay and bisexual men in Australia shows that while COVID-19 outbreak-related measures led to fewer sexual partners, there was a decline in condom and pre-exposure prophylaxis use.
COVID-19 has not just caused significant mortality, but it has also disrupted the healthcare system, including the delivery of care for existing conditions like HIV, and influenced HIV prevention efforts.
Australia is among the few nations that have conducted regular behavioral surveillance of gay and bisexual men (GBM) over the past 25 years. These surveys provide vital information for healthcare policymakers, play a vital role in HIV prevention, and help to further our understanding of how various behavioral changes affect HIV prevention and treatment.
However, the COVID-19 outbreak affected both HIV surveillance methods and the behavior of at-risk populations like GBM. This report, published in the journal AIDS and Behavior, explores the influence of COVID-19 on surveillance methods and the behavior of high-risk populations.
COVID-19 Had a Significant Impact on HIV-Related Behavior
The study included survey data from 2017 to 2021. It divided the data outcomes into four 12-month groups. Three of these groups were from the pre-COVID era, and one was from the COVID-19 era, when measures like social distancing, travel restrictions, and lockdowns were implemented.
COVID-19 impacted both the manner in which surveillance measures were conducted and the HIV prevention measures taken by GBM. The researchers noted that the epidemic resulted in the implementation of online surveys. This resulted in a broader outreach.
Where COVID-19’s influence on HIV prevention measures was concerned, the results were mixed. For example, 88.1% of participants reported social distancing, and 52.1% reported having fewer sex partners. Thus, far fewer GBM reported having more than 10 male partners in the previous 6 months during the COVID era compared to the pre-COVID era.
COVID-19 also did not negatively influence HIV treatment, which remained practically unchanged. However, HIV testing in the last 12 months saw a significant decline (69.2% from July 2019 to June 2020 vs. 56.6% from July 2020 to June 2021). There was also a statistically significant decline in reported use of pre-exposure prophylaxis (PrEP) in the previous 6 months, which is now a more significant HIV prevention method in the GBM population in Australia than condoms.
The Bottom Line
To sum up, the COVID-19 epidemic significantly impacted the sexual behavior of GBM. Although the epidemic resulted in a decline in the number of sex partners and a decline in casual sex, it also caused fewer GBMs to use condoms, and PrEP usage also dropped. Additionally, the study found that younger men (below 25 years old) were more likely to be affected by these changes. Hence, there is a need to focus on younger GBM to prevent declines in HIV testing, condom use, and PrEP use in this specific group.
The study did have some limitations in that the surveys are anonymous, which does not allow for assessment of individuals’ responses over time, and they focus on GBM at HIV risk, which may not be entirely representative of the entire GBM population in Australia.
Source:
Holt, M., Chan, C., Broady, T. R., Mao, L., MacGibbon, J., Rule, J., Wilcock, B., Prestage, G., & Bavinton, B. R. (2022). Adjusting behavioural surveillance and assessing disparities in the impact of COVID-19 on gay and bisexual men’s HIV-Related behaviour in Australia. AIDS and Behavior, 27(2), 518–534. https://doi.org/10.1007/s10461-022-03788-1
