Changes in mental and sexual health among MSM using HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: longitudinal analysis of the SwissPrEPared cohort study

Author:

Winter Babette L.,Hovaguimian Frédérique,Kouyos Roger D.,Schmidt Axel Jeremias,Bernasconi Enos,Braun Dominique L.,Calmy Alexandra,Notter Julia,Stoeckle Marcel,Surial Bernard,Christinet Vanessa,Cavassini Matthias,Depmeier Carsten,Läuchli Severin,Boffi El Amari Emmanuelle,Reinacher Matthias,Rasi Manuela,Bruggmann Philip,Haerry David,Bize Raphaël,Low Nicola,Lehner Andreas,Quednow Boris B.,Fehr Jan S.,Hampel Benjamin

Abstract

BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SARS-CoV-2 pandemic remain unclear. METHODS: Design: Longitudinal analysis of an ongoing, multicentre, pre-exposure prophylaxis (PrEP) cohort (NCT03893188) in Switzerland. Participants: HIV-negative MSM aged ≥18 who completed at least one questionnaire before and one after the start of the SARS-CoV-2 pandemic. Outcomes: Primary: mental health, defined as anxiety and depression scores assessed by the Patient Health Questionnaire-4. Secondary: sexual behaviour, well-being, PrEP use and disruption of care. Outcomes were assessed over seven periods corresponding to different SARS-CoV-2 prevention measures in Switzerland. We performed pairwise comparisons between periods (Wilcoxon signed rank test). RESULTS: Data from 1,043 participants were included. Whilst anxiety scores remained stable over time, depression scores worsened in the second wave and the second lockdown period compared to pre-pandemic scores. This was confirmed by pairwise comparisons (pre-SARS-CoV-2/second wave and pre-SARS-CoV-2/second lockdown: p <0.001). Downward trends in sexual activity,sexualized substance use, and a switch from daily to "event-driven" PrEP were found. Disruption of care affected 42.6% (790/1856) of daily PrEP users’ follow-up visits. CONCLUSION: In this longitudinal analysis of a PrEP cohort enrolling MSM, depression scores worsened in the second wave and the second lockdown compared to the pre-pandemic period.

Publisher

SMW Supporting Association

Subject

General Medicine

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