How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID)

Dema, E. et al. (2022) How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID). Sexually Transmitted Infections, (doi: 10.1136/sextrans-2022-055516) (Early Online Publication)

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Objectives: To investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic. Methods: British participants (18–59 years) completed a cross-sectional web survey 1 year (March–April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16–74 years) conducted in 2010–2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18–44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors. Results: In 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18–24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers. Conclusions: Our study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010–2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.

Item Type:Articles
Keywords:COVID-19, sexual and reproductive health, service use, condom access, risk behaviours, sexually transmitted infections.
Status:Early Online Publication
Glasgow Author(s) Enlighten ID:Mitchell, Professor Kirstin and Bosó Pérez, Raquel and Willis, Dr Malachi and Riddell, Miss Julie
Authors: Dema, E., Sonnenberg, P., Gibbs, J., Conolly, A., Willis, M., Riddell, J., Bosó Pérez, R., Copas, A. J., Tanton, C., Bonell, C., Oeser, C., Clifton, S., Unemo, M., Mercer, C. H., Mitchell, K. R., and Field, N.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Sexually Transmitted Infections
Publisher:BMJ Publishing Group
ISSN (Online):1472-3263
Published Online:18 August 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Sexually Transmitted Infections 2022
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
3048231Relationships and healthKirstin MitchellMedical Research Council (MRC)MC_UU_00022/3HW - MRC/CSO Social and Public Health Sciences Unit
3048231Relationships and healthKirstin MitchellOffice of the Chief Scientific Adviser (CSO)SPHSU18HW - MRC/CSO Social and Public Health Sciences Unit