Impacts of COVID-19 on sexual behaviors, HIV prevention and care among men who have sex with men: A comparison of New York City and Metropolitan Atlanta

• Published in: PloS one Vol. 18; no. 3; p. e0282503
• Main Authors: Goodreau, Steven M, Delaney, Kevin P, Zhu, Weiming, Smith, Dawn K, Mann, Laura M, Sanchez, Travis H, Hamilton, Deven T, Hoover, Karen W
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21-03-2023; Public Library of Science (PLoS)
• Subjects: Acquired Immunodeficiency Syndrome - epidemiology; Age; Analysis; Antiretroviral agents; Antiretroviral therapy; Antiviral agents; Biology and Life Sciences; Cities; Comparative analysis; COVID-19; COVID-19 - epidemiology; Datasets; Disease prevention; Disease transmission; Epidemics; Gays & lesbians; Geography; Health aspects; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV infection; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV testing; Homosexuality, Male; Human immunodeficiency virus; Humans; Laboratories; Male; Males; Medical diagnosis; Medical tests; Medicine and Health Sciences; Mens health; Metropolitan areas; MSM (Men who have sex with men); New York City - epidemiology; Pandemics; Pandemics - prevention & control; People and Places; Pre-Exposure Prophylaxis - methods; Prescriptions; Prevention; Prophylaxis; Public health; Risk factors; Sex; Sexual and Gender Minorities; Sexual Behavior; Sexually transmitted diseases; Shelter in place; Social aspects; STD; Trends; United States; New York City; United States; Atlanta Georgia; Georgia; United States > US; New York City New York
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0282503

The COVID-19 pandemic has disrupted HIV prevention, care, and transmission opportunities. This likely varies by geography, given differences in COVID-19 burden and mandates over time, and by age, given different likelihoods of severe COVID-19 consequences. We consider changes in sexual behavior, HIV testing, pre-exposure prophylaxis (PrEP) use and antiretroviral therapy (ART) use among men who have sex with men (MSM) over the first year of the COVID-19 epidemic, comparing the Atlanta metropolitan area and New York City (NYC). We use two continuous time-series datasets and one panel dataset, assessing changes over time within city and comparing across cities, and disaggregate major findings by age. For clinical results, ART use showed by far the smallest reductions, and testing the largest. Disruptions occurred concurrently between cities, despite the major wave of COVID-19, and government mandates, occurring later in Atlanta. Test positivity increased in NYC only. In both cities, younger MSM saw the greatest reductions in testing and PrEP use, but the smallest in sexual behavior. Reduced clinical service usage would be unconcerning if stemming solely from reductions in exposure; however, the patterns for young MSM suggest that the COVID-19 epidemic likely generated new conditions for increased HIV transmission, especially in this cohort.