Transient Changes in Pre-Exposure Prophylaxis Use and Daily Sexual Behaviour after the Implementation of COVID-19 Restrictions Among Men Who Have Sex with Men
Abstract
Introduction: We assessed how the Dutch restrictions of 15-March-2020 affected sexual behaviour, pre-exposure prophylaxis (PrEP) and condom use among PrEP-users from the Amsterdam PrEP demonstration project.
Methods: We used data on (1) PrEP use, (2) anal sex acts and (3) condom use, per partner type (steady [SP], known casual [KCP], unknown casual [UCP]), collected daily through a mobile application used between 1-December-2019 and 30-June-2020. We compared the period before versus after 15-March-2020 with respect to average proportion of days per week at which each endpoint was reported (multilevel logistic regression) and average proportion of anal sex acts covered by PrEP and/or condoms (bivariate probit regression). We evaluated whether the difference in sex acts were also observed before versus after the same date in the previous year.
Findings: We included data from 136 MSM. After 15-March-2020, the proportion of days with anal sex increased with SP (OR=1·26;95%CI=1·10-1·44) and decreased with KCP (OR=0·73;95%CI=0·64-0·82) and UCP (OR=0·54;95%C=0·48-0·61), while these changes were not seen (SP/KCP) or less apparent (UCP) during the previous year. Shifts in partner types were most profound immediately after 15-March-2020, while returning to pre-restriction levels mid-May-2020. The proportion of days with PrEP use decreased from 74% before to 58% after 15-March-2020 (p<0·001). After 15-March-2020, PrEP coverage of sex acts decreased with UCP (β=-0·36;95%CI=-0·72-0·00),…
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