P236 Examining the impact of the UK’s COVID-19 public health response on sexual behaviour and health service use among MSM

Howarth, A.; Saunders, J.; Reid, D.; Kelly, I.; Wayal, S.; Weatherburn, P.; Hughes, G.; Mercer, C.

BackgroundThe introduction of social distancing in response to the COVID-19 pandemic led to reduced STI/HIV service provision in the UK. We investigated sexual risk behaviours among MSM and unmet need for sexual healthcare during the pandemic.MethodsA cross-sectional online survey (N=2,018) fielded via social media and dating apps (23/06–14/07/2020). We examined sexual behaviour and service use since lockdown (23/03/2020) and in the three previous months, and ‘unmet need for STI testing’ since lockdown (any new male partners and/or multiple condomless anal sex (CAS) partners without testing for STIs).We compared behaviours over the past three months between socio-demographically equivalent sub-samples recruited via Grindr into the present survey (N=956) and a 2017 survey (N=1,918).ResultsIn 2020, 36.7% of participants reported new male partners and 17.3% reported multiple CAS partners since lockdown. Comparing time since lockdown vs previous three months, HIV testers were less likely to test at sexual health clinics (22.3% vs 70.2%) and more likely to use free online self-sampling services (64.3% vs 17.1%), and PrEP users were less likely to report PrEP use (21.7% vs 65.7%).Since lockdown, 25.3% of participants had unmet need for STI testing. Unmet need was more likely among Asian vs White participants (aOR=1.76,[1.14–2.72],p=.01);living in Scotland (aOR=2.02,[1.40–2.91],p<.001) or Northern Ireland (aOR=1.93,[1.02–3.63],p=.04) vs England;and living with HIV (aOR=1.83,[1.32–2.53],p<.001).Compared to 2017, the 2020 sub-sample were less likely to report new male partners (46.8% vs 71.1%, p<.001), multiple CAS partners (20.3% vs 30.8%, p<.001) and unmet need (32.8% vs 42.5%, p<.001) in the past three months.ConclusionWe found ongoing potential STI/HIV transmission among MSM during the initial UK lockdown, despite a reduction in sexual activity, and potential inequalities in access to sexual healthcare. These findings will support public health planning to mitigate against health risks during and after the COVID-19 response.