Jennifer Toller Erausquin1, Rayner K J Tan2,3,4, Maximiliane Uhlich5, Joel M Francis6, Navin Kumar7, Linda Campbell8,9, Wei Hong Zhang9,10, Takhona G Hlatshwako11, Priya Kosana11, Sonam Shah11, Erica M Brenner11, Lore Remmerie9, Aamirah Mussa12, Katerina Klapilova13,14, Kristen Mark15, Gabriela Perotta16, Amanda Gabster17,18, Edwin Wouters8, Sharyn Burns19, Jacqueline Hendriks19, Devon J Hensel20,21, Simukai Shamu22,23, Jenna Marie Strizzi24, Tammary Esho25, Chelsea Morroni12,26, Stefano Eleuteri27, Norhafiza Sahril28, Wah Yun Low29, Leona Plasilova13,14, Gunta Lazdane30, Michael Marks18, Adesola Olumide31, Amr Abdelhamed32, Alejandra López Gómez33, Kristien Michielsen9, Caroline Moreau34,35, Joseph D Tucker3,11,18. 1. Department of Public Health Education, University of North Carolina-Greensboro, Greensboro, North Carolina, USA. 2. Dermatology Hospital of Southern Medical University, Guangzhou, China. 3. University of North Carolina Project-China, Guangzhou, China. 4. Saw Swee Hock School of Public Health, National University of Singapore, Singapore. 5. Department of Psychology, Western University, London, Ontario, Canada. 6. Department of Family Medicine, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa. 7. Department of Sociology, Yale University, New Haven, Connecticut, USA. 8. Center for Population, Family, and Health, University of Antwerp, Antwerp, Belgium. 9. Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium. 10. School of Public Health, Université Libre de Bruxelles, Brussels, Belgium. 11. Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 12. Botswana Sexual and Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana. 13. Faculty of Humanities, Charles University, Prague, Czech Republic. 14. National Institute of Mental Health, Klecany, Czech Republic. 15. Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA. 16. Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina. 17. Gorgas Memorial Institute for Health Studies, Panama City, Panama. 18. Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. 19. Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia. 20. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA. 21. Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA. 22. Health Systems Strengthening, Foundation for Professional Development, Pretoria, South Africa. 23. School of Public Health, University of Witwatersrand, Johannesburg, South Africa. 24. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 25. End FGM/C Centre of Excellence, Amref Health Africa, Nairobi, Kenya. 26. MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom. 27. Department of Psychology, Sapienzo University, Rome, Italy. 28. Ministry of Health Malaysia, Putrajaya, Malaysia. 29. Asia-Europe Institute, Universiti Malaya, Kuala Lumpur, Malaysia. 30. Institute of Public Health, Riga Stradins University, Riga, Latvia. 31. College of Medicine, University of Ibadan, Ibadan, Nigeria. 32. Department of Dermatology, Venereology & Andrology, Sohag University, Sohag, Egypt. 33. Department of Psychology, University of the Republic, Montevideo, Uruguay. 34. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAand. 35. Primary Care and Prevention, Center for Research in Epidemiology and Public Health, National Institute of Health and Medical Research 1018, Villejuif, France.
Abstract
BACKGROUND: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium. METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence. RESULTS: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. CONCLUSIONS: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.
BACKGROUND: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium. METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence. RESULTS: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. CONCLUSIONS: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.
Authors: Vinicius Jobim Fischer; Raquel Gómez Bravo; Alice Einloft Brunnet; Kristien Michielsen; Joseph D Tucker; Linda Campbell; Claus Vögele Journal: BMC Public Health Date: 2022-06-03 Impact factor: 4.135