The International Sexual Health and REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and during the Initial Coronavirus Disease 2019 Wave

International Sexual Health And REproductive Health during COVID-19 Research Consortium

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17 Scopus citations

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, 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.

Original languageEnglish (US)
Pages (from-to)E991-E999
JournalClinical Infectious Diseases
Volume75
Issue number1
DOIs
StatePublished - Jul 1 2022

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (NIH; UG3HD096929 and NIAID K24AI143471). In Latvia, this research was supported by the National Research Programme to Lessen the Effects of COVID-19 (VPP-COVID-2020/1-0011).

Publisher Copyright:
© 2022 The Author(s).

Keywords

  • HIV
  • condom use
  • sexual behavior
  • sexual violence
  • sexually transmitted infections
  • HIV Infections
  • Sexual Behavior
  • Cross-Sectional Studies
  • Reproductive Health
  • Humans
  • Sexual Health
  • Sexually Transmitted Diseases/epidemiology
  • COVID-19
  • Adult
  • Condoms
  • Sexual Partners

PubMed: MeSH publication types

  • Journal Article
  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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