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?:abstract
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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 pre-exposure 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 behaviours RESULTS: Among 847 men, mean age was 44 1 years (SD: 12 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 (aOR: 0 17;95%CI: 0 09-0 34;p<0 001), and less likely to report sex with casual partners (aOR: 0 28;95%CI: 0 14-0 54;p<0 001) CONCLUSION: 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 behaviours among GBM need to be monitored as 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
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