COVID-19 impact on bacterial sexually transmitted infections in England between 1 January 2019 and 31 December 2020

Charles, Hannah; Ratna, Natasha; Thorn, Louise; Sonubi, Tamilore; Sun, Suzy; Mohammed, Hamish; Folkard, Kate; Sinka, Katy

doi:10.1136/sextrans-2021-055262

Cited by 10 publications

(11 citation statements)

References 4 publications

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“…In [24]. A decrease of 40% was observed in the United States (− 59% in women vs − 63% in men) when comparing the pandemic period (from March to June 2020) and the preceding baseline period for chlamydia and gonorrhoea [25].…”

Section: Discussionmentioning

confidence: 98%

Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020

et al. 2022

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Background Diagnoses of bacterial sexually transmitted infections (STIs) have increased in France since the 2000s. The main strategy to control STI transmission is recommending/facilitating access to condom use, testing, and antibiotic treatments. Aim This study analyses the evolution of STI testing in the private sector in France from 2006 to 2020. Methods National health insurance reimbursement data were used to determine numbers and rates of individuals aged ≥ 15 years tested for diagnoses of chlamydia, gonorrhoea and syphilis in the private sector in France and to describe their evolution from 2006 to 2020. Results Upward tendencies in testing were observed from 2006 to 2019 for all three STIs. The highest testing rates were identified in people aged 25‒29-years old. The observed testing-increase from 2017 to 2019 was twice as high in young people (< 25 years old) as in older people. In 2019, chlamydia, gonorrhoea and syphilis testing rates were respectively 45.4 (+ 21% since 2017), 41.3 (+ 60%), and 47.2 (+ 22%) per 1,000 inhabitants. For all STIs combined, the number of tested individuals decreased by 37% between March and April 2020 during the first COVID-19 epidemic wave and lockdown in France. Conclusion Improvements found in STI testing rates may have resulted from better awareness, especially among young people and health professionals, of the importance of testing, following prevention campaigns. Nevertheless, testing levels remain insufficient considering increasing diagnoses. In 2020, the COVID-19 pandemic had a considerable impact on STI testing. Partner notification and offering diverse testing opportunities including self-sampling are essential to control STI epidemics particularly in exposed populations.

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Section: Discussionmentioning

confidence: 98%

Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020

et al. 2022

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“…Research suggests that behaviours with increased risk of STIs and HIV (hereon for brevity ‘sexual risk behaviour’), after an initial decrease during the first national lockdown, tended to fluctuate in line with social restrictions 4 5. National surveillance data on STI testing for the general population showed a 52%–59% decrease in testing in March/April 2020 (vs March/April 2019) 6. Testing levels recovered as restrictions were eased and plateaued as restrictions were reintroduced in October 2020.…”

Section: Introductionmentioning

confidence: 99%

Sexual behaviour, STI and HIV testing and testing need among gay, bisexual and other men who have sex with men recruited for online surveys pre/post-COVID-19 restrictions in the UK

et al. 2023

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ObjectivesWe examined sexual behaviour, sexually transmitted infection (STI) and HIV testing and testing need, and identified associated factors, among gay, bisexual and other men who have sex with men (GBMSM) in the UK after COVID-19 restrictions ended, and compared these with ‘pre-pandemic’ estimates.MethodsWe analysed survey data from GBMSM (N=1039) recruited via social media and Grindr in November–December 2021. We then compared Grindr-recruited 2021 participants (N=437) with those from an equivalent survey fielded in March–May 2017 (N=1902). Questions on sexual behaviour and service use had lookback periods of 3–4 months in both surveys. Unmet testing need was defined as reporting any new male and/or multiple condomless anal sex (CAS) partners without recent STI/HIV testing. Participants were UK residents, GBMSM, aged ≥16 years who reported sex with men in the last year. Multivariable logistic regression identified associated sociodemographic and health-related factors with unmet STI/HIV testing need in 2021, and then for 2017/2021 comparative analyses, adjusting for demographic differences.ResultsIn 2021, unmet STI and HIV testing need were greater among older GBMSM (aged ≥45 years vs 16–29 years; adjusted OR (aOR): 1.45 and aOR: 1.77, respectively), and lower for pre-exposure prophylaxis (PrEP) users (vs non-PrEP users; aOR: 0.32 and aOR: 0.23, respectively). Less unmet STI testing need was observed among HIV-positive participants (vs HIV-negative/unknown; aOR: 0.63), and trans and non-binary participants (vs cisgender male; aOR: 0.34). Between 2017 (reference) and 2021, reported sexual risk behaviours increased: ≥1 recent new male sex partner (72.1%–81.1%, aOR: 1.71) and ≥2 recent CAS partners (30.2%–48.5%, aOR: 2.22). Reporting recent STI testing was greater in 2021 (37.5%–42.6%, aOR: 1.34) but not recent HIV testing, and there was no significant change over time in unmet STI (39.2% vs 43.7%) and HIV (32.9% vs 39.0%) testing need.DiscussionComparable community surveys suggest that UK resident GBMSM may have engaged in more sexual risk behaviours in late 2021 than pre-pandemic. While there was no evidence of reduced STI/HIV service access during this time, there remained considerable unmet STI/HIV testing need.

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“…For STIs/HIV, primary prevention aims to prevent infection occurring at all (eg, condoms), while secondary prevention involves detection/treatment of infection before disease manifestations (eg, testing for and treating early chlamydia or HIV infection, or cervical cancer screening to detect abnormal cells and cervical intraepithelial neoplasia caused by infection with high-risk human papillomavirus) 1. Such interventions remained important during the COVID-19 pandemic because potentially risky sexual activity continued despite lockdowns,2 and STI/HIV diagnoses nearly regained pre-pandemic levels by the end of 2020 3. Different population groups experienced significant health inequalities during the pandemic due to the direct impacts of COVID-19, as well as impacts on the wider health system and society 4.…”

Section: Introductionmentioning

confidence: 99%

How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID)

et al. 2022

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ObjectivesTo investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic.MethodsBritish participants (18–59 years) completed a cross-sectional web survey 1 year (March–April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16–74 years) conducted in 2010–2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18–44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors.ResultsIn 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18–24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers.ConclusionsOur study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010–2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.

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COVID-19 impact on bacterial sexually transmitted infections in England between 1 January 2019 and 31 December 2020

Cited by 10 publications

References 4 publications

Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020

Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020

Sexual behaviour, STI and HIV testing and testing need among gay, bisexual and other men who have sex with men recruited for online surveys pre/post-COVID-19 restrictions in the UK

How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID)

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