Delays in sexual health care among patients attending New York City Sexual Health Clinics during the COVID-19 pandemic, March 2020 to February 2021.

ABSTRACT

BACKGROUND: Public health emergencies can lead to reduced or suspended services in sexual health clinics (SHCs), raising questions about optimal ways to maintain access to care. We examined changes in sexual behaviors, HIV pre-exposure prophylaxis (PrEP) use, telehealth preference, and correlates of delayed sexual health care among patients attending New York City (NYC) publicly funded SHCs during the COVID-19 pandemic. METHODS: 470 patients from four SHCs (July-September 2021) completed a self-administered survey that collected data on access to sexual health care, overall and over three distinct time periods [Spring 2020 (COVID-19 wave 1), Summer 2020, Fall 2020/Winter 2021 (COVID-19 wave 2)]. We used log-binomial models to examine factors associated with delayed sexual health care. RESULTS: Participants reporting multiple in-person sexual contacts increased from 28% to 57% (P < 0.0001) between the first and second wave. Almost half of participants (35/72) taking HIV PrEP cited decreased use. Over 90% (423/460) of participants preferred in-person clinic visits over telehealth. Overall, delays in routine and urgent sexual health care were reported by 34% (129/375) and 12% (46/373) of participants, respectively. More men who have sex with men (MSM) and transgender/gender non-conforming/nonbinary (TGNCNB) individuals experienced delayed care compared with women [MSM aPR 1.43 (95% CI, 1.00-2.03); TGNCNB 1.67 (1.04-2.69)]. Compared with participants who primarily sought sexual health care from private providers, those who primarily used SHCs experienced significantly more delayed care [1.72 (1.14-2.59)]. CONCLUSIONS: Delays in sexual health care access can have serious implications for certain patient populations. Additional resources are needed to maintain access to sexual health clinic services.