Professor All India Institute of Medical Sciences NEW DELHI, Delhi, India
Background: COVID-19 pandemic greatly impacted sexual healthcare services throughout the world due to reasons like resource diversions, travel restrictions, lockdowns, poor accessibility of healthcare facilities, etc. The impact was greater in developing nations with limited resources. We evaluated the pattern and impact of COVID-19 on sexually transmitted diseases (STIs) at a tertiary center in India.
Methods: STI data of patients attending our STI/HIV clinic from January 2018 to December 2022 was retrospectively reviewed and the patterns of various STIs and other genital diseases were analysed. In the years 2020 and 2021, our clinic services were significantly impaired due to the pandemic which resumed in early 2022 following control of COVID-19 and lifting of restrictions, and returned to near pre-pandemic years 2019. The data of pre pandemic years 2018 and 2019 was compared with pandemic years 2020 and 2021 data, using paired t-test. Also the data of 2019 was compared with 2022, to assess post pandemic recovery. The yearly data was adjusted for reduced number of cases of individual STIs and analysed with univariate linear regression.
Results: The new patients with STIs/genital diseases seen in the years 2018, 2019, 2020, 2021, and 2022 were 798, 881, 260, 485, and 908 respectively. Genital warts, vaginal discharge, and syphilis were the most common STIs (Table 1). There was a significant reduction in the number of patients (nearly one-third and half in the years 2020 and 2021 respectively), during the pandemic period (p< 0.0001). However, after adjusting for reduced total new cases, there was no significant change in proportion of cases except for latent syphilis which increased from 4.6% in 2018 to 16.5% in 2022 (p=0.027) and symptomatic syphilis which showed a trend towards decrease from 9.3% in 2018 to 6.4% in 2022 (p=0.07). The incidence returned to the pre-pandemic levels in 2022 (p=0.3).
Conclusions: The number of STIs patients significantly decreased during the pandemic due to various pandemic-related reasons, however, the proportion of patients with various STIs did not change significantly. There was a significant increase in patients with latent syphilis even during the pandemic period which is worrisome.
