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

Swiss Med Wkly. 2022 Jun 27:152:w30192. doi: 10.4414/smw.2022.w30192. eCollection 2022 Jun 20.

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.

MeSH terms

  • COVID-19* / prevention & control
  • Cohort Studies
  • Communicable Disease Control
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Pandemics / prevention & control
  • Pre-Exposure Prophylaxis*
  • SARS-CoV-2
  • Sexual Behavior
  • Sexual Health*
  • Sexual and Gender Minorities*