OBJECTIVE: To investigate the impact of Dutch COVID-19 restrictions on sexual behavior and HIV/STI acquisition among men who have sex with men (MSM) participating in the Amsterdam Cohort Studies (ACS) on HIV in Amsterdam. METHODS: ACS participants complete a questionnaire on sexual behaviour and are tested for HIV/STI biannually. They may also be tested at the sexually transmitted infections (STI) clinic in-between study visits. On May 29, 2020, ACS participants were invited to complete an online questionnaire on health, COVID-19 risk perceptions and sexual behavior. Determinants of reporting casual sex partners (CSP) during COVID-19 restrictions were examined using logistic regression. RESULTS: 353/683 MSM (52%; median age 47; IQR 38-53) completed the questionnaire. Since COVID-19, 73% reported a reduction in number of CSP. CSP during COVID-19 restrictions were reported by 133 (38%) MSM and, in multivariable analysis, was associated with not having a college/university degree, being single, lower perceived importance of avoiding COVID-19, number of CSP before COVID-19 and current PrEP use (p<0.05 for all). During COVID-19 restrictions, no HIV infections were diagnosed and the STI positivity rate was 8%. CONCLUSION: Since COVID-19, the number of CSP decreased among MSM and there may have been a temporary reduction in HIV/STI transmission. Some MSM were not fully compliant to social distancing regulations and reported CSP, which was related to prior sexual behavior and low perceived importance of avoiding COVID-19. For these men, it is important to maintain accessible HIV/STI-related testing and care during times of lockdown.
Sexual behavior and its determinants during COVID-19 restrictions among men who have sex with men in Amsterdam