How the disruption in STI care due to the COVID-19 pandemic could lead to increased STI transmission among MSM in the Netherlands: a mathematical modelling study.

Xiridou, Maria; Heijne, Janneke; Adam, Philippe; Op de Coul, Eline; Matser, Amy; de Wit, John; Wallinga, Jacco; van Benthem, Birgit

BACKGROUND During the COVID-19 pandemic, the disruption in care for sexually transmitted infections (STIs) and the social distancing measures have led to reductions in STI testing and sexual behavior. We assessed the impact of these COVID-19-related changes on transmission of C. trachomatis (CT) and N. gonorrhoeae (NG) among men who have sex with men (MSM) in the Netherlands. METHODS We developed a mathematical model for CT and NG transmission among MSM, accounting for COVID-19-related changes in sexual behavior and testing in 2020-2021. Changes in 2020 were estimated from data from the Dutch COVID-19, Sex, and Intimacy Survey among MSM and the National Database of STI Clinics. Due to lack of data for 2021, we examined several scenarios covering a range of changes. RESULTS A reduction of 10% and 40% in STI testing of symptomatic and asymptomatic (respectively) individuals with a 10-20% reduction in numbers of casual partners (according to partner status and activity level) during the second lockdown, resulted in a 2.4% increase in CT prevalence, but a 2.8% decline in NG prevalence in 2021. A 5% and 30% reduction in STI testing of symptomatic and asymptomatic (respectively) individuals with the same reduction in casual partners resulted in a 0.6% increase in CT prevalence and a 4.9% decrease in NG prevalence in 2021. CONCLUSIONS The disruption in STI care due to COVID-19 might have resulted in a small increase in CT prevalence, but a decrease in NG prevalence. Scaling up STI care is imperative to prevent increases in STI transmission.