Sexual behaviors and access to HIV services during the COVID-19 pandemic among cisgender men who have sex with men in Lima, Peru

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BACKGROUND: The COVID-19 pandemic significantly impacted sexual behaviors, access to health services, and other factors related to HIV vulnerability among sexual and gender minority populations globally. This study investigates such changes among men who have sex with men (MSM) in Lima, Peru. METHODS: We analyzed data from a cross-sectional survey that was conducted initially in 2018–2019 (‘pre-pandemic’ period, n = 382) and then repeated in 2020–2021 (‘mid-pandemic’ period, n = 387). The survey asked about participants’ sexual behaviors in the previous three months, including attendance of sex-on-premises venues (SOPVs) and the use of online platforms to meet partners, as well as their knowledge and behaviors related to HIV testing and prevention. We assessed for differences in sexual behaviors and HIV testing/prevention knowledge between the mid-pandemic period and the pre-pandemic period using robust Poisson regression, including in multivariable models adjusting for age and educational attainment. The mid-pandemic survey included additional questions asking about access to HIV services and changes in perceived health status during the pandemic, which we analyzed descriptively. RESULTS: Participants in the mid-pandemic period were significantly less likely to report they had attended an SOPV, met a sex partner online, engaged in group sex, or had three or more partners in the past three months. However, the prevalence of other HIV-related sexual risk behaviors, including condomless anal sex and substance use in a sexual context, was unchanged compared to pre-pandemic. Among mid-pandemic survey participants, SOPV attendance and meeting a partner online were both associated with a range of sexual risk behaviors, similar to the relationship observed between these behaviors during the pre-pandemic period. CONCLUSIONS: We observed relatively modest differences in the prevalence of sexual risk behaviors during, versus prior to, the COVID-19 pandemic. These findings underscore the importance of minimizing disruptions to HIV prevention and sexual health services for vulnerable populations such as MSM in Peru.

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