Changes in HIV Prevention and Sexual Experiences During the COVID-19 Pandemic: A Mixed-Methods Study

Area of Science:

• Public Health
• Epidemiology
• Sexual Health

Background:

• COVID-19 pandemic disrupted access to sexual transmitted infection (STI) and HIV services.
• Changes in healthcare access and behavior impacted STI/HIV rates.
• Understanding decision-making during the pandemic is vital for addressing rising STI/HIV rates.

Purpose of the Study:

• To investigate how individuals navigated HIV prevention strategies, specifically pre-exposure prophylaxis (PrEP) use, during the COVID-19 pandemic.
• To understand the relationship between sexual practices, PrEP adherence, and pandemic-related behaviors.

Main Methods:

• Online surveys and one-on-one interviews were conducted with patients with a history of PrEP use.
• Participants reported on sexual activity and PrEP use during two distinct pandemic periods (Nov 2020-Jan 2021 and Feb-June 2021).
• Study conducted at a federally-qualified health center serving sexual and gender minority health in Chicago, 2021.

Main Results:

• Most participants maintained or increased their number of sexual partners and PrEP use throughout the pandemic.
• PrEP use was often maintained as a habit, independent of fluctuating sexual practices.
• COVID-19 prevention behaviors influenced sexual activity, especially before vaccine availability.

Conclusions:

• PrEP users often align HIV prevention with sexual exposure, establishing long-term adherence.
• Maintaining PrEP use as a habit is a key strategy for HIV prevention.
• Reducing financial and access barriers is essential for improving PrEP uptake and STI testing rates.