Disruptions of sexually transmitted and blood borne infections testing services during the COVID-19 pandemic: accounts of service providers in Ontario, Canada

Abstract

Background Since the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due to their designation as “non-essential” health services. As a result, many individuals wanting to access sexual healthcare continued to have unmet sexual health needs throughout the pandemic. In response to this, sexual health service providers have adopted alternative models of testing, such as virtual interventions and self-sampling/testing. Our objective was to investigate service providers’ experiences of disruptions to STBBI testing during the COVID-19 pandemic in Ontario, Canada, and their acceptability of alternative testing services. Methods Between October 2020-February 2021, we conducted semi-structured virtual focus groups (3) and in-depth interviews (11) with a diverse group of sexual health service providers (n = 18) including frontline workers, public health workers, sexual health nurses, physicians, and sexual health educators across Ontario. As part of a larger community-based research study, data collection and analysis were led by three Peer Researchers and a Community Advisory Board was consulted throughout the research process. Transcripts were transcribed verbatim and analysed with NVivo software following grounded theory. Results Service providers identified the reallocation of public health resources and staff toward COVID-19 management, and closures, reduced hours, and lower in-person capacities at sexual health clinics as the causes for a sharp decline in access to sexual health testing services. Virtual and self-sampling interventions for STBBI testing were adopted to increase service capacity while reducing risks of COVID-19 transmission. Participants suggested that alternative models of testing were more convenient, accessible, safe, comfortable, cost-effective, and less onerous compared to traditional clinic-based models, and that they helped fill the gaps in testing caused by the pandemic. Conclusions Acceptability of virtual and self-sampling interventions for STBBI testing was high among service providers, and their lived experiences of implementing such services demonstrated their feasibility in the context of Ontario. There is a need to approach sexual health services as an essential part of healthcare and to sustain sexual health services that meet the needs of diverse individuals.

Impact of COVID-19 on access to and delivery of sexual and reproductive healthcare services in countries with universal healthcare systems: A systematic review

“…Studies in Australia found reduced STI consultations before lockdown compared to during lockdown [73] a move toward telehealth for testing services [62,74]. Similarly, sexual health providers in Canada emphasised severe reductions in the availability of sexually transmitted and blood-borne infection testing due to government deployment of staff toward the COVID-19 response; thus, some clinics closed or adopted fewer hours [75]. This study reported the adoption of two models of care: 1) a "quick clinic" for asymptomatic patients to self-test for gonorrhoea and chlamydia at the clinic, but not for tests that require blood (e.g., HIV); and 2) a virtual clinic which replaced most in-person testing services, with few exceptions for high-risk clients; virtual clinics were seen as largely acceptable across participants [75].…”

‘It’s not as good as the face‐to‐face contact’: A sociomaterialist analysis of the use of virtual care among Canadian gay, bisexual and queer men during the COVID‐19 pandemic

“…Although some qualitative studies have been conducted exploring the experiences of virtual care during COVID‐19 from the perspective of health‐care providers (Downing et al., 2021; James et al., 2021; Van Citters et al., 2021; Zhao et al., 2021), only a few studies have adequately described the experiences of service users (Baraitser & Lupton, 2023; Triantafillou et al., 2021; Vilendrer et al., 2022). There is also limited scholarship exploring the virtual care experiences of gay, bisexual and queer men (GBQM) during COVID‐19 in Canada (Gilbert et al., 2022; Ryu et al., 2023).…”

Visits to Sexually Transmitted Infection Clinics in Italy from January 2016 to November 2021: A Multicenter, Retrospective Study

“…Another potential effect of the COVID-19 pandemic could be the closure of important sexual and reproductive health centers: staff and public resources had to be reallocated to tackle the pandemic, leaving “non-essential” services neglected [ 23 ]. The temporary closure of some sexual health services, due to their designation as “non-essential”, negatively impacted the patients, some of whom had unmet sexual health needs for the duration of the stricter measure of lockdown.…”