The emerging impact of the COVID-19 outbreak on sexual health in Lebanon

Maatouk, I.; Assil, M.; Jaspal, R.

Background The coronavirus-2019 (COVID-19) has had compounding effects on the political and economic crisis with severe economic and health consequences. Throughout the lockdown, one of the largest sexually transmitted infections (STIs) and HIV clinics in Beirut with linkages to major civil organizations in direct contact with sexual health beneficiaries has remained open for emergencies. The main objective of this study was to measure COVID19 impact on sexual health services in this clinic in Beirut. Methods A review of electronically based STIs screenings and diagnoses for the period February-December 2020 was conducted. Results The clinic has noted a major reduction in STI testing rates. Only 116 screenings were recorded in the mentioned period which contrasts with the 334 screenings conducted during the same period of 2019 (65% drop in 2020). All the screenings were among men who have sex with men (MSM). On the other hand, PEP was prescribed 86 times in the period February-December 2020 compared to 67 times during the same period of time in 2019 (28% increase). All cases of PEP prescriptions were for MSM. A range of risky behaviors and a 12% prevalence of HIV have been documented in MSM in Lebanon. Conclusion The increase in PEP prescription for MSM indicates that sexual risk-taking has persisted despite potential fear of contracting COVID-19. Two factors could explain our Results (1) social psychological stressors (political and economic instability, huge explosion, COVID19) may threaten identity and wellbeing, leading MSM to resort to sexual risk behaviours;(2) data on epidemiology of STIs in COVID19 time are inconsistent due to the lack of stratification by incubation period, acute versus chronic type, duration of symptoms and sexual orientation. Future studies should ascertain the impact of COVID19 on both mental and sexual health especially in stigmatized communities such as MSM.