HIV postexposure prophylaxis during the COVID-19 pandemic: experience from Madrid

Ferrández, Javier Sánchez-Rubio; Vélez-Díaz-Pallarés, Manuel; González, Carmen; Fenollera, P Sanmartin; Yubero, Cristina García; García-Valdecasas, María Fernández-Pacheco

doi:10.1136/sextrans-2020-054680

Cited by 15 publications

(14 citation statements)

References 2 publications

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“…There was almost a 50% reduction in PEP prescriptions in 2020 when compared to 2019 at both clinics, with a larger reduction during the lockdown periods. Our results are consistent with international studies in Spain and the UK [14]. Similar to Australia, both Spain and the UK introduced a national lockdown around mid-March 2020.…”

Section: Discussionsupporting

confidence: 91%

“…Similar to Australia, both Spain and the UK introduced a national lockdown around mid-March 2020. Sánchez-Rubio et al examined PEP prescriptions from 20 hospitals in Madrid, and they found that there was a 37% reduction in PEP prescriptions between January and May 2020 when compared to 2019, but there was a 78% reduction during the lockdown period [14]. Similarly, Junejo et al also reported an 82% reduction in PEP prescriptions four weeks before and after the lockdown in 2020 at 56 Dean Street in London [15].…”

Section: Discussionmentioning

confidence: 99%

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Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Chow

Ong

Donovan

et al. 2021

IJERPH

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Australia introduced a national lockdown on 22 March 2020 in response to the COVID-19 pandemic. Melbourne, but not Sydney, had a second COVID-19 lockdown between July and October 2020. We compared the number of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, and new HIV diagnoses during these lockdown periods. The three outcomes in 2020 were compared to 2019 using incidence rate ratio. There was a 37% and 46% reduction in PEP prescriptions in Melbourne and Sydney, respectively, with a larger reduction during lockdown (68% and 57% reductions in Melbourne’s first and second lockdown, 60% reduction in Sydney’s lockdown). There was a 41% and 32% reduction in HIV tests in Melbourne and Sydney, respectively, with a larger reduction during lockdown (57% and 61% reductions in Melbourne’s first and second lockdowns, 58% reduction in Sydney’s lockdown). There was a 44% and 47% reduction in new HIV diagnoses in Melbourne and Sydney, respectively, but no significant reductions during lockdown. The reduction in PEP prescriptions, HIV tests, and new HIV diagnoses during the lockdown periods could be due to the reduction in the number of sexual partners during that period. It could also result in more HIV transmission due to substantial reductions in HIV prevention measures during COVID-19 lockdowns.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Chow

Ong

Donovan

et al. 2021

IJERPH

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“…HIV postexposure prophylaxis (PEP) prescriptions have been used as a proxy for high-risk practices and studies have shown that there was a significant reduction in PEP prescriptions after the lockdown around March in Australia, the United Kingdom and Spain, where countries have been badly affected by COVID-19. 15 – 17 Over the study period, there was also a 33% reduction (132 in May–June vs. 88 in July–August) of PEP prescription at our service (data not shown). Consistent with these findings, other studies have reported an increase in activities with no risk for HIV and STI, such as masturbation and cybersex during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 81%

Brief Report: Changes in PrEP Use, Sexual Practice, and Use of Face Mask During Sex Among MSM During the Second Wave of COVID-19 in Melbourne, Australia

Chow

Hocking

Ong

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: A second wave of COVID-19 began in late June in Victoria, Australia. Stage 3 then Stage 4 restrictions were introduced in July–August. This study aimed to compare the use of pre-exposure prophylaxis (PrEP) and sexual practices among men who have sex with men taking PrEP between May–June (post-first lockdown) and July–August (second lockdown). Methods: This was an online survey conducted among men who have sex with men who had their PrEP managed at the Melbourne Sexual Health Centre, Australia. A short message service with a link to the survey was sent to 503 PrEP clients who provided consent to receive a short message service from Melbourne Sexual Health Centre in August 2020. Results: Of the 192 participants completed the survey, 153 (80%) did not change how they took PrEP. Of the 136 daily PrEP users, 111 (82%) continued to take daily PrEP, 3 (2%) switched to on-demand PrEP, and 22 (16%) stopped PrEP in July–August. Men generally reported that they had no partners or decreased sexual activities during second lockdown compared with post-first lockdown; the number of casual sex partners (43% decreased vs. 3% increased) and the number of kissing partners (36% decreased vs. 3% increased). Most men reported no chemsex (79%) or group sex (77%) in May–August. 10% (13/127) of men had ever worn face masks during sex in May–August. Conclusion: During the second wave of COVID-19 in Victoria, most men did not change the way they used PrEP but the majority had no risks or reduced sexual practices while one in 10 men wore a face mask during sex.

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“…For example, in a global survey of men who have sex with men (MSM), close to 20% (218/1105) reported being unable to access their HIV provider during the pandemic and half reported being unable to refill their HIV prescription remotely (820/1254). [18] In terms of HIV prevention, there has been a decline in the number of people being tested and diagnosed [15, 20-22] and the amount of pre-exposure prophylaxis (PrEP) [23, 24] and post-exposure prophylaxis dispensed[18, 25, 26], although these declines may be attributable in part to reductions in sexual activity. COVID-19 responses have resulted in interruptions to the supply chains for the distribution of both ART and PrEP, and stock-outs of medications, as one study from Indonesia described.…”

Section: Resultsmentioning

confidence: 99%

Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

Baral

Rao

Rwema

et al. 2021

Preprint

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BackgroundCOVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. We conducted a scoping review to characterize the impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.MethodsA scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from January 1st to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection and mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English.ResultsA total of 1604 published papers and 205 preprints met inclusion criteria, including 8.2% (132/1604) of published studies and 10.2% (21/205) of preprints: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (13/166) on sexual and reproductive health, and 12.1% (16/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.DiscussionCOVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. Data reviewed here suggest that effective strengthening of health systems should include investment in public health with adequate funding to ensure continuity of care for emergent and existing public health threats.

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HIV postexposure prophylaxis during the COVID-19 pandemic: experience from Madrid

Cited by 15 publications

References 2 publications

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Brief Report: Changes in PrEP Use, Sexual Practice, and Use of Face Mask During Sex Among MSM During the Second Wave of COVID-19 in Melbourne, Australia

Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

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