Substantial Decline in Use of HIV Preexposure Prophylaxis Following Introduction of COVID-19 Physical Distancing Restrictions in Australia: Results From a Prospective Observational Study of Gay and Bisexual Men
BACKGROUND:In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (G...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2021-01, Vol.86 (1), p.22-30 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Hammoud, Mohamed A. Grulich, Andrew Holt, Martin Maher, Lisa Murphy, Dean Jin, Fengyi Bavinton, Benjamin Haire, Bridget Ellard, Jeanne Vaccher, Stefanie Saxton, Peter Bourne, Adam Degenhardt, Louisa Storer, Daniel Prestage, Garrett |
| description | BACKGROUND:In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM).
METHODS:Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors.
RESULTS:Among 847 men, mean age was 44.1 years (SD12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR0.17; 95% CI0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR0.28; 95% CI0.14 to 0.54; P < 0.001).
CONCLUSIONS:By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions. |
| doi_str_mv | 10.1097/QAI.0000000000002514 |
| format | Article |
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METHODS:Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors.
RESULTS:Among 847 men, mean age was 44.1 years (SD12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR0.17; 95% CI0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR0.28; 95% CI0.14 to 0.54; P < 0.001).
CONCLUSIONS:By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000002514</identifier><identifier>PMID: 33027151</identifier><language>eng</language><publisher>United States: JAIDS Journal of Acquired Immune Deficiency Syndromes</publisher><subject>Adolescent ; Adult ; Australia ; Bisexuality ; Confidence intervals ; Constrictions ; Coronaviruses ; COVID-19 ; COVID-19 - prevention & control ; Dosage ; Health risks ; HIV ; HIV Infections - prevention & control ; Homosexuality, Male ; Human immunodeficiency virus ; Humans ; Male ; Middle Aged ; Observational studies ; Pandemics ; Physical Distancing ; Pre-Exposure Prophylaxis - statistics & numerical data ; Prevention Research ; Prophylaxis ; Prospective Studies ; Public health ; Sexual and Gender Minorities ; Sexual Behavior ; Sexually transmitted diseases ; Social distancing ; Statistical analysis ; STD ; Viral diseases ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2021-01, Vol.86 (1), p.22-30</ispartof><rights>JAIDS Journal of Acquired Immune Deficiency Syndromes</rights><rights>Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5814-9b0c88444c74260754038535ac501dbb715fa1e3b5891bead0b716bc1ca2ed003</citedby><cites>FETCH-LOGICAL-c5814-9b0c88444c74260754038535ac501dbb715fa1e3b5891bead0b716bc1ca2ed003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-202101010-00005$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>230,314,778,782,883,4597,27911,27912,65218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33027151$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hammoud, Mohamed A.</creatorcontrib><creatorcontrib>Grulich, Andrew</creatorcontrib><creatorcontrib>Holt, Martin</creatorcontrib><creatorcontrib>Maher, Lisa</creatorcontrib><creatorcontrib>Murphy, Dean</creatorcontrib><creatorcontrib>Jin, Fengyi</creatorcontrib><creatorcontrib>Bavinton, Benjamin</creatorcontrib><creatorcontrib>Haire, Bridget</creatorcontrib><creatorcontrib>Ellard, Jeanne</creatorcontrib><creatorcontrib>Vaccher, Stefanie</creatorcontrib><creatorcontrib>Saxton, Peter</creatorcontrib><creatorcontrib>Bourne, Adam</creatorcontrib><creatorcontrib>Degenhardt, Louisa</creatorcontrib><creatorcontrib>Storer, Daniel</creatorcontrib><creatorcontrib>Prestage, Garrett</creatorcontrib><title>Substantial Decline in Use of HIV Preexposure Prophylaxis Following Introduction of COVID-19 Physical Distancing Restrictions in Australia: Results From a Prospective Observational Study of Gay and Bisexual Men</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>BACKGROUND:In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM).
METHODS:Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors.
RESULTS:Among 847 men, mean age was 44.1 years (SD12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR0.17; 95% CI0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR0.28; 95% CI0.14 to 0.54; P < 0.001).
CONCLUSIONS:By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Australia</subject><subject>Bisexuality</subject><subject>Confidence intervals</subject><subject>Constrictions</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - prevention & control</subject><subject>Dosage</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - prevention & control</subject><subject>Homosexuality, Male</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observational studies</subject><subject>Pandemics</subject><subject>Physical Distancing</subject><subject>Pre-Exposure Prophylaxis - statistics & numerical data</subject><subject>Prevention Research</subject><subject>Prophylaxis</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Sexual and Gender Minorities</subject><subject>Sexual Behavior</subject><subject>Sexually transmitted diseases</subject><subject>Social distancing</subject><subject>Statistical analysis</subject><subject>STD</subject><subject>Viral diseases</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkstu1DAUhiMEoqXwBghZYsMmxddcWCBNp7QdqWgKpd1GjnOm4-KJBzuey2vyRNhMqUoXkCxi53z_f-KTP8teE3xIcF2-_zKaHOIHFxWEP8n2Sc15XlYVfxrXgoqcEyb2shfe32JMCs7r59keY5iWRJD97OdlaP0g-0FLg45BGd0D0j268oDsDJ1NrtGFA9gsrQ8O4tou51sjN9qjE2uMXev-Bk36wdkuqEHbPqnG0-vJcU5qdDHfeq2Ss05NVIK_gh-c_s361GkU4l4aLT-kUjBDdHZ2gWRq5pcQyRWgaevBrWRSRbvLIXTb1OlUbpHsO3SkPWxCrHyG_mX2bCaNh1d3z4Ps6uTTt_FZfj49nYxH57kSFeF53WIVx8S5KjktcCk4ZpVgQiqBSde2cT4zSYC1oqpJC7LD8VXRKqIkhQ5jdpB93PkuQ7uATkGfztEsnV5It22s1M3flV7Pmxu7asqSlowmg3d3Bs7-CHEszUJ7BcbIHmzwDY0_ixaUsoS-fYTe2uDiKCIlcMkLInARKb6jVJycdzC7_xiCmxSaJoameRyaKHvz8CD3oj8piUC1A9bWDOD8dxPW4Jo5SDPM_-fN_yGNiaQFYzynmBKc7jwpBfsFFBLhCg</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Hammoud, Mohamed A.</creator><creator>Grulich, Andrew</creator><creator>Holt, Martin</creator><creator>Maher, Lisa</creator><creator>Murphy, Dean</creator><creator>Jin, Fengyi</creator><creator>Bavinton, Benjamin</creator><creator>Haire, Bridget</creator><creator>Ellard, Jeanne</creator><creator>Vaccher, Stefanie</creator><creator>Saxton, Peter</creator><creator>Bourne, Adam</creator><creator>Degenhardt, Louisa</creator><creator>Storer, Daniel</creator><creator>Prestage, Garrett</creator><general>JAIDS Journal of Acquired Immune Deficiency Syndromes</general><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210101</creationdate><title>Substantial Decline in Use of HIV Preexposure Prophylaxis Following Introduction of COVID-19 Physical Distancing Restrictions in Australia: Results From a Prospective Observational Study of Gay and Bisexual Men</title><author>Hammoud, Mohamed A. ; Grulich, Andrew ; Holt, Martin ; Maher, Lisa ; Murphy, Dean ; Jin, Fengyi ; Bavinton, Benjamin ; Haire, Bridget ; Ellard, Jeanne ; Vaccher, Stefanie ; Saxton, Peter ; Bourne, Adam ; Degenhardt, Louisa ; Storer, Daniel ; Prestage, Garrett</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5814-9b0c88444c74260754038535ac501dbb715fa1e3b5891bead0b716bc1ca2ed003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Australia</topic><topic>Bisexuality</topic><topic>Confidence intervals</topic><topic>Constrictions</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - prevention & control</topic><topic>Dosage</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV Infections - prevention & control</topic><topic>Homosexuality, Male</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observational studies</topic><topic>Pandemics</topic><topic>Physical Distancing</topic><topic>Pre-Exposure Prophylaxis - statistics & numerical data</topic><topic>Prevention Research</topic><topic>Prophylaxis</topic><topic>Prospective Studies</topic><topic>Public health</topic><topic>Sexual and Gender Minorities</topic><topic>Sexual Behavior</topic><topic>Sexually transmitted diseases</topic><topic>Social distancing</topic><topic>Statistical analysis</topic><topic>STD</topic><topic>Viral diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hammoud, Mohamed A.</creatorcontrib><creatorcontrib>Grulich, Andrew</creatorcontrib><creatorcontrib>Holt, Martin</creatorcontrib><creatorcontrib>Maher, Lisa</creatorcontrib><creatorcontrib>Murphy, Dean</creatorcontrib><creatorcontrib>Jin, Fengyi</creatorcontrib><creatorcontrib>Bavinton, Benjamin</creatorcontrib><creatorcontrib>Haire, Bridget</creatorcontrib><creatorcontrib>Ellard, Jeanne</creatorcontrib><creatorcontrib>Vaccher, Stefanie</creatorcontrib><creatorcontrib>Saxton, Peter</creatorcontrib><creatorcontrib>Bourne, Adam</creatorcontrib><creatorcontrib>Degenhardt, Louisa</creatorcontrib><creatorcontrib>Storer, Daniel</creatorcontrib><creatorcontrib>Prestage, Garrett</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hammoud, Mohamed A.</au><au>Grulich, Andrew</au><au>Holt, Martin</au><au>Maher, Lisa</au><au>Murphy, Dean</au><au>Jin, Fengyi</au><au>Bavinton, Benjamin</au><au>Haire, Bridget</au><au>Ellard, Jeanne</au><au>Vaccher, Stefanie</au><au>Saxton, Peter</au><au>Bourne, Adam</au><au>Degenhardt, Louisa</au><au>Storer, Daniel</au><au>Prestage, Garrett</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Substantial Decline in Use of HIV Preexposure Prophylaxis Following Introduction of COVID-19 Physical Distancing Restrictions in Australia: Results From a Prospective Observational Study of Gay and Bisexual Men</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>86</volume><issue>1</issue><spage>22</spage><epage>30</epage><pages>22-30</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><abstract>BACKGROUND:In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM).
METHODS:Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors.
RESULTS:Among 847 men, mean age was 44.1 years (SD12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR0.17; 95% CI0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR0.28; 95% CI0.14 to 0.54; P < 0.001).
CONCLUSIONS:By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions.</abstract><cop>United States</cop><pub>JAIDS Journal of Acquired Immune Deficiency Syndromes</pub><pmid>33027151</pmid><doi>10.1097/QAI.0000000000002514</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Australia Bisexuality Confidence intervals Constrictions Coronaviruses COVID-19 COVID-19 - prevention & control Dosage Health risks HIV HIV Infections - prevention & control Homosexuality, Male Human immunodeficiency virus Humans Male Middle Aged Observational studies Pandemics Physical Distancing Pre-Exposure Prophylaxis - statistics & numerical data Prevention Research Prophylaxis Prospective Studies Public health Sexual and Gender Minorities Sexual Behavior Sexually transmitted diseases Social distancing Statistical analysis STD Viral diseases Young Adult |
| title | Substantial Decline in Use of HIV Preexposure Prophylaxis Following Introduction of COVID-19 Physical Distancing Restrictions in Australia: Results From a Prospective Observational Study of Gay and Bisexual Men |
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