During the coronavirus lockdown in the UK, the majority of gay and bisexual men have stopped having casual sex and two-thirds of PrEP users have interrupted PrEP, a survey has found. But a quarter have had some casual sex and there are indications that increasing numbers of men will hook up in the coming weeks.
The survey, on the sexual behaviours of hook-up app users during the lockdown, was conducted by the University of Westminster, the London School of Hygiene and Tropical Medicine and others.
Its interim results come from 1386 gay or bisexual men who completed the survey between 17 April and 8 May; data from other participants, including trans and non-binary respondents, will be reported later. The sample was recruited through the gay hook-up app Grindr, social media, the researchers’ networks, and community organisations.
The gay and bisexual respondents were predominantly white (85%) and had a mean age of 36. Around 12% were diagnosed with HIV.
Almost a third were living on their own during lockdown. One-fifth were living with parents or family members, a fifth with a romantic partner and almost a quarter with housemates.
While two-thirds were single, 8% reported being in a monogamous relationship, 16% in an open relationship and 8% said that their relationship status “is complicated”. Almost 60% of respondents with a main sexual partner said that they had been unable to be with that partner since social distancing started in March.
During the lockdown 24% had had casual sex. For half of these men, it had been with one partner only, although there were 5% of the sample who had had more than five casual partners. Loneliness and a need for intimate physical contact were important reasons for having sex.
Asked for how long they would be able to refrain from having casual sex because of the coronavirus, 57% thought this could be for up to six months. Around 10% said that they thought they would be able to refrain for up to four weeks and 30% for up to three months. As restrictions were first put in place around three months ago, this suggests that the number of men hooking up (and needing sexual health services) may soon increase.
Thirty per cent of respondents took PrEP before the coronavirus outbreak and, of these, two-thirds had interrupted their regular PrEP use. The most common reason for PrEP interruption was not having sex during this time – two-thirds of PrEP interrupters said this. Inability to access PrEP was uncommon: less than 5% of respondents were unable to access PrEP from their usual IMPACT trial clinic and less than 5% reported issues with accessing PrEP online.
Twelve per cent reported having accessed STI testing since social distancing measures were introduced. About a quarter tested in a clinic, whilst almost three-quarters used remote testing such as self-sampling or self-testing. Respondents used a range of methods to get test results and any necessary treatments (in person, by post, phone or video call, etc.).
Access to coronavirus testing was more problematic – while 14% of respondents thought they had been infected, less than 2% of respondents had been able to test for the virus.
Although current public health guidelines make it illegal to have sex at home with a casual partner, the survey findings suggest that the demand for sexual health services is likely to increase in the coming weeks.
“As social restrictions ease, it is highly likely that increasing numbers of men who have sex with men will re-initiate sexual activity with casual partners,” Dr Charlie Witzel of the London School of Hygiene and Tropical Medicine commented. “Our research shows we're nearing the time-point when many felt their ability to abstain would decrease. Criminalisation of sex, while being unenforceable practically, may also prevent people from accessing sexual health care during the pandemic.”
“The data indicates that, during the first six-weeks of lockdown, access to PrEP was an issue for only a minority of current PrEP users,” commented Dr Will Nutland of PrEPster. “It might be argued that this would increasingly be a concern as lockdown continues and as individuals’ supplies of PrEP were used up. However, the gradual re-opening of sexual health services and PrEP services into June, and the lifting of delays of online deliveries of PrEP from overseas, mean that PrEP access might not be the major problem that was originally voiced”.