Casual sex among MSM during the period of social isolation in the COVID-19 pandemic: Nationwide study in Brazil and Portugal.

ABSTRACT

BackgroundSheltering in place to reduce the spread of COVID-19 may have adverse effects on mental and sexual health, particularly for LGBT populations whose social support may be fragile. In this study, we investigated the extent to which Brazilian and Portuguese MSM had casual sex partners outside their homes during the period of sheltering in place for the COVID-19 pandemic. MethodsAn online survey was implemented nationally in Brazil and Portugal in April 2020, during the period of social isolation for COVID-19, with a sample of 2,361 MSM (1,651 in Brazil, 710 in Portugal). Recruitment was done through meeting apps and Facebook groups catering to MSM. Data collection was online via CASI. ResultsOver 95% of MSM were sheltering at least partially at the time of the survey. Nearly 50% said sheltering had a high impact on their lives. A majority (53.0%) had casual sex partners during sheltering. Factors that increased the odds of engaging in casual sex in Brazil were having group sex (adjusted odds ratio [aOR] 2.1, 95% CI 1.3-3.4), living in a urban area (aOR 1.6, 95% CI 1.1-2.2), feeling that sheltering had high impact on daily life (aOR 3.0, 95% CI 1.1-8.3), having casual vs steady partners (aOR 2.5, 95% CI 1.8-3.5), and not decreasing the number of partners during the COVID-19 epidemic (aOR 6.5, 95% CI 4.2-10.0). In Portugal, the odds of engaging in casual sex increased with using Facebook to find partners (aOR 4.6, 95% CI 3.0-7.2), not decreasing the number of partners during the COVID-19 epidemic (aOR 3.8, 95% CI 2.9-5.9), usually (pre-COVID-19) finding partners in physical venues (aOR 5.4, 95% CI 3.2-8.9), feeling that the isolation had high impact on daily life (aOR 3.0, 95% CI 1.3-6.7), and HIV-positive serostatus (aOR 11.7, 95% CI 4.7-29.2). Surprisingly, taking PrEP/Truvada to prevent COVID-19 was reported by 12.7% of MSM. ConclusionsThe COVID-19 epidemic has not stopped the majority of Brazilian and Portuguese MSM from finding sexual partners outside their home, with high risk sexual behaviors continuing. Public health messages for the prevention of COVID-19 need to be crafted to explicitly link sexual behavior to reduce pandemics in the current moment.