Assessing the Risk of Sexually Transmitted Infections among Men who have Sex with Men in San Francisco during COVID-19: A Socio-ecological Analysis

BackgroundMen who have sex with men (MSM) are disproportionately affected by sexually transmitted infections, a disparity that has only worsened in recent years. During the COVID-19 pandemic, an overall increasing trend remained.MethodsWe utilized data from the MSM cycle of the National HIV Behavioral Surveillance (NHBS) study in San Francisco, California, conducted from June 2021 through December 2021, to identify socio-ecological disruptions during the COVID-19 pandemic that were associated with sexually transmitted infections.ResultsIn total, 505 participants were surveyed, and approximately 24% of the participants reported having been diagnosed with an STI infection within the past 12 months. In the adjusted Poisson regression models, socio-ecologic factors that were independently associated with STI infection included barriers to STI testing due to COVID-19 (aRR 1.62, 95% CI 1.18-2.23), sex with partners part of small social circles/pods (aRR 2.41, 95% CI 1.41-4.12), sex with partners whose risk for COVID-19 was not known (aRR 3.53, 95% CI 2.05-6.06), and an increase or relapse in recreational substance use (aRR 2.01, 95% CI 1.49-2.72).ConclusionsThese findings indicate the importance of enacting comprehensive policies that not only address an ongoing global pandemic but also consider its potential effects on other public health epidemics, such as sexually transmitted infections among men who have sex with men.