Seroconversion rate of SARS-CoV-2 IgG antibodies and dating behaviour in HIV-PrEP users in a German metropolis during the COVID-19 pandemic

Abstract

Background At the beginning of the COVID-19 pandemic, when mortality was high, social distance was the only option to prevent transmission of SARS-CoV-2 and prohibit uncontrolled spreading. As the impact of social distancing on sexual behavior was unclear, we aimed to assess the influence of sexual risk behavior on SARS-CoV-2 seroconversion in HIV pre-exposition prophylaxis (PrEP) users after declaration of the pandemic. Methods Prospective study on SARS-CoV-2 IgG-antibody seroconversion rate over time in men having sex with men (MSM) using PrEP at a single tertiary university hospital in Munich, Germany, during quarterly (Q) routine HIV-PrEP visits over 1 year per participant (May 2020 - September 2021). Seroconversion was defined as at least one positive anti-nucleocapsid (anti-N) SARS-CoV-2 IgG antibody test as surrogate for past infection. In addition, sexually transmitted infections (STIs), personal estimated risk behavior and sexual contacts were assessed. Results Seroconversion rate during the full observation period was 7.3% (9/124 subjects) by September 2021. Percentage of subjects with symptomatic STIs ( T. pallidum, N. gonorrhoeae, C. trachomatis and M. genitalium) was 18.7% in Q3-20, 8.1% in Q4-20, 11.1% in Q1-21, 11.6% in Q2-21 and 9.5% in Q3-21. Perception of subjective threat of SARS-CoV-2 infection and adequacy of preventive measures decreased during the observation period. However, self-reported sex behavior remained stable during the observation period. Conclusions Our cohort showed low proportion of PrEP-users with anti-N IgG by September 2021, comparable to the local incidence. Sexual behavior in this cohort did not change, despite local recommendations for social distancing.

Sexual behaviours among MSM during the first COVID-19 lockdown not associated with risk of COVID-19 infection

“…This contrasts with what was found in a 2021 German study of PrEP users, which found no change in sexual behavior compared to pre-pandemic, but a similar rate of seroconversion as that of the general population. 17 Other studies from the United States that recruited through dating applications suggested that MSM did not change their sexual behavior or even increased the number of sexual partners during the pandemic, but that may re ect that these populations were recruited from those actively on dating applications during the pandemic. 9,10 Another study from the US found age related differences in sexual behavior during the pandemic, with younger MSM having large decreases in testing and PrEP use, but only small reductions in numbers of sexual partners.…”

“…As HIV PrEP-exposure prophylaxis (PrEP) is almost exclusively taken by people with multiple sexual partners, some studies have taken advantage of existing PrEP cohorts to investigate how the pandemic investigated sexual risk taking. 1,[16][17][18][19][20] However, these studies suffered from lack of a comparable population cohort to understand whether risk was elevated in PrEP cohorts compared to other populations with similar demographic characteristics. In our study, we were able to integrate people taking PrEP into an existing population level seroprevalence study (Corona Immunitas) to better examine and compare the in uence of sexual behavior on the COVID-19 pandemic on this population.…”