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  AIDS 2022
July 29 - Aug 2
24th Intl AIDS Conference
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MSM Used HIV Sex-Negotiating Skills to Protect Themselves From COVID
  AIDS 2022, July 29-August 2, Montreal
Mark Mascolini
Canadian men who have sex with men (MSM) used what they learned about sexual negotiation to avoid HIV and other sexually transmitted infections (STIs) to lessen COVID-related sex risks during the pandemic, according to results of 93 in-depth interviews with MSM in Montreal, Toronto, and Vancouver [1]. "Negotiating COVID-19 safety," the investigators found, "was similar to asking about HIV/STI status."
Researchers at the University of Toronto and colleagues from other centers noted that social measures to hem in the COVID pandemic inevitably affected intimacy and sexual relations between MSM. Although many studies addressed the pandemic's impact on frequency and type of sex (often with disparate results), little research has explored strategies MSM crafted to help them avoid COVID during sex.
Engage-COVID-19 is a cohort study embedded in the Engage mixed=methods cohort study of Canadian MSM. The substudy aimed to explore the impact of the coronavirus on physical, sexual, and mental health of cohort members. This analysis had three parts: (1) quantitative COVID-19 modules completed by all study participants at two points, (2) COVID-19 antibody testing at two points for all participants who opted in, and (3) in-depth qualitative interviews of selected participants at two points.
Most study participants were young or middle-aged (22% in their 20s, 40% in their 30s, and 13% in their 40s), and the cohort was ethnically diverse (36% white, 24% mixed race, 16% East/Southeast Asian, 8% black, 6% Latin American, 3% Middle Eastern, and 3% South Asian). Most people reported being cisgender male (82%) and gay (70%). One in 5 men had HIV infection.
The 93 MSM who had in-depth interviews modified the frequency of their sexual encounters as the COVID pandemic evolved. About one quarter of these men practiced abstinence to avoid sex when COVID struck, while one third adopted "temporary monogamy." Fewer than half of the interviewed men maintained sexual relations with both casual and regular partners as COVID spread. But sexual activity rebounded as COVID incidence began to wane, and many men resumed uninhibited sexual activities when vaccination became available and COVID-containing restrictions began evaporating.
Four principal strategies emerged to avoid COVID-19 during sex:
1. Asking about SARS-CoV-2 infection status (asking how often potential partners go out, wear a mask, or got tested for COVID, and asking how they feel and whether they have COVID)
2. Reducing physical contact (suggesting wearing masks during sex, limiting sex to mutual masturbation)
3. Limiting sex to regular partners (limiting sex to partners with known COVID testing status)
4. Vaccine sorting (asking potential partners their COVID vaccine status; compared to HIV sorting by establishing partner's HIV status, viral load, or PrEP status) The Engage team suggested that MSM understand COVID avoidance "through the lens of HIV." They proposed that "applying experiential knowledge with HIV/STI prevention to COVID-19 provides evidence that gay or bisexual men are reflexive and knowledgeable consumers of public health information."
1. Daroya E, Skakoon-Sparling S, Cornel Grey C, et al. 'Just like you would with an STI or HIV': sexual risk mitigation during COVID-19 among gay, bisexual, and other men who have sex with men (GBM) in Canada. AIDS 2022, July 29-August 2, Montreal. Abstract OAD0302.