Identifying STI risk groups based on behavioral and psychological characteristics among heterosexuals during the COVID-19 pandemic.

van Wees, Daphne A; Godijk, Noortje G; den Daas, Chantal; Kretzschmar, Mirjam E E; Heijne, Janneke C M

BACKGROUND Measures to reduce Coronavirus disease (COVID-19) transmission may impact sexual health. We aimed to examine the impact of COVID-19 on sexual behavior and sexually transmitted infection (STI) testing, and to characterize individuals who were at high STI risk. METHODS Dutch heterosexual males and females who participated in a cohort study in 2016-2018 were invited to fill out two questionnaires again in 2020 (age 21-28 years). We used behavioral and psychological data from: pre-lockdown (September 2019-February 2020), lockdown (March-May 2020), and post-lockdown (June-August 2020). Behavior change was compared between subgroups identified with latent class analysis. RESULTS Four latent classes were identified (n = 238). Individuals in class 1 (48% of study population) and 2 (36%) were at low STI risk, and reported mostly steady partnerships. Individuals in class 3 (9%) and 4 (7%) reported multiple casual partners pre-lockdown. Class 4 was characterized by lower condom use and health goals, negative infection prevention attitudes, and higher impulsiveness compared to class 3. Furthermore, same/increased partner numbers during lockdown (class 3 = 18%, class 4 = 56%) and post-lockdown (class 3 = 36%, class 4 = 42%) compared to pre-lockdown was often reported. Of individuals who wanted an STI test during the pandemic, 62% in class 3 and 56% in class 4 did not get tested, mainly because they were unable to get an appointment. CONCLUSIONS A subgroup of individuals, characterized by low health goals, negative infection prevention attitudes, and high impulsiveness, engaged in high risk behavior during the pandemic. Identifying these individuals may help provide appropriate health care during strict lockdowns and after relaxation of measures.