Change of sexual behavior among men who have sex with men before, during and after COVID-19 pandemic in China: a cross-sectional study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

HIV Infections*/epidemiology ; HIV Infections*/prevention & control ; Sexual and Gender Minorities* ; COVID-19*/epidemiology ; Substance-Related Disorders*/epidemiology; Male ; Humans ; Homosexuality, Male ; Cross-Sectional Studies ; Pandemics ; Sexual Behavior ; Sexual Partners ; China/epidemiology ; Risk-Taking

Introduction: The COVID-19 epidemic control and prevention strategies affected people's sexual activities and behaviors. Little was known about long-term effects of COVID-19 prevention and control strategies on sexual behaviors among men who have sex with men (MSM). This study aimed to examine changes in risky sexual behaviors of MSM before and after the local epidemic.
Methods: An online survey was conducted nationwide from June 1 to June 10, 2022. MSM aged 16 years and above, residing in China were recruited through convenience sampling. A generalized estimating equation model with modified Poisson regression was used to analyze changes in multiple sexual partners, unprotected sex, mobility for sexual activity, and recreational substance use before and after the local epidemic.
Results: Compared to the pre-pandemic (36.5%), the prevalence of multiple sexual partners (11.5%) significantly decreased during the local epidemic and then increased after the local epidemic (25.2%) but remained lower than pre-pandemic, as did the prevalence of unprotected sex (31.1%, 19.4%, and 26.1%), mobility for sexual activity (7.5%, 2.8%, and 4.1%) and recreational substance use (47.7%, 27.2%, and 39.5%). Compared to the pre-pandemic, higher declines in the prevalence of risky sexual behaviors during the local epidemic existed among MSM living without a regular partner (44% decrease in unprotected sex and 46% in recreational substance use), with a bachelor's degree and above (70% decrease in multiple sex partners, 39% in unprotected sex, 67% in mobility for sexual activity and 44% in recreational substance use), higher incomes (70% decrease in multiple sex partners), self-identified gay or bisexual/unsure (38-71%), and HIV infection (49-83% decrease respectively in these four indicators). After the local epidemic, the declines in the above indicators compared to the pre-pandemic were correspondingly. And higher declines existed among MSM living without a regular partner (8% decrease in unprotected sex and 13% in recreational substance use), with a bachelor's degree and above (33% decrease in multiple sex partners), higher incomes (55% decrease in mobility for sexual activity), self-identified gay (51% decrease in mobility for sexual activity), and HIV infection (32%, 68%, 24% decrease respectively in unprotected sex, mobility for sexual activity and recreational substance use).
Conclusions: Risky sexual behaviors reduced considerably during the local epidemic, then seemed rebounded after the outbreak but wouldn't return to pre-pandemic levels. More attention should be paid to vulnerable people with lower socio-economic status, HIV-positive, and sexual minorities for sustained HIV and COVID-19 prevention.
(© 2023. BioMed Central Ltd., part of Springer Nature.)

AIDS Behav. 2022 Oct;26(10):3451-3458. (PMID: 35445993)
J Acquir Immune Defic Syndr. 2021 Mar 1;86(3):288-296. (PMID: 33230027)
Front Psychiatry. 2022 Aug 18;13:949077. (PMID: 36061280)
J Psychiatr Res. 2022 Oct;154:198-202. (PMID: 35952518)
Lancet. 2020 Jul 4;396(10243):63-70. (PMID: 32505220)
World Psychiatry. 2020 Jun;19(2):130-131. (PMID: 32394549)
AIDS Behav. 2023 Feb;27(2):518-534. (PMID: 35895148)
AIDS Behav. 2020 Oct;24(10):2764-2765. (PMID: 32382824)
J Acquir Immune Defic Syndr. 2020 Nov 1;85(3):309-315. (PMID: 32740374)
Int J Environ Res Public Health. 2018 May 24;15(6):. (PMID: 29795013)
Sex Transm Infect. 2022 Aug;98(5):346-352. (PMID: 34544888)
BMC Public Health. 2022 Jan 28;22(1):189. (PMID: 35086497)
J Int AIDS Soc. 2021 Oct;24 Suppl 6:e25800. (PMID: 34713583)
World J Methodol. 2022 Sep 20;12(5):350-364. (PMID: 36186746)
J Acquir Immune Defic Syndr. 2021 May 1;87(1):639-643. (PMID: 33512848)
Infect Dis Poverty. 2020 Sep 4;9(1):127. (PMID: 32887643)
JMIR Mhealth Uhealth. 2020 Jan 24;8(1):e14800. (PMID: 32012086)
Sex Med Rev. 2022 Oct 1;10(4):714-753. (PMID: 37051956)
China CDC Wkly. 2022 Jan 28;4(4):74-75. (PMID: 35186372)
Lancet. 2016 Jul 9;388(10040):198-206. (PMID: 27411880)
Am J Epidemiol. 2004 Apr 1;159(7):702-6. (PMID: 15033648)
Clin Infect Dis. 2022 Aug 24;75(1):e1137-e1144. (PMID: 35169833)
Cult Health Sex. 2023 Sep;25(9):1147-1163. (PMID: 36336339)
AIDS Behav. 2020 Jul;24(7):2024-2032. (PMID: 32350773)
BMC Infect Dis. 2019 Nov 27;19(1):1000. (PMID: 31775654)
Sex Res Social Policy. 2023;20(2):438-452. (PMID: 34457080)
Front Public Health. 2022 Oct 14;10:981649. (PMID: 36311572)
AIDS Behav. 2021 Jan;25(1):73-84. (PMID: 32737817)

2021-ZHCH330-001 Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences

Keywords: COVID-19; China; HIV; Local epidemic; Men who have sex with men; Sexual behavior

Date Created: 20230810 Date Completed: 20230814 Latest Revision: 20231121

20231215

PMC10416525

10.1186/s12879-023-08488-2

37563554