(P38) Impact of the COVID-19 pandemic on HIV and sexually transmitted infections testing and diagnosis in Lebanon

Background

Social distancing restrictions during the COVID-19 pandemic caused substantial disruptions to sexual health services (SHS) worldwide. During the first year of the pandemic, Lebanon implemented multiple lockdowns during which SHS were considered non-essential and endured repetitive closures. While social distancing may have reduced opportunities for sexual risk-taking, these disruptions meant restricted access to sexually transmitted infections (STIs) screening, prevention, and treatment. Our aim was to explore the impact of the pandemic on SHS delivery and the diagnosis rate of STIs among attendees of a sexual health clinic in Beirut, Lebanon.



Methods

This was a retrospective analysis of the clinical database of a sexual health clinic in Beirut that offers comprehensive SHS, including subsidized voluntary counseling and testing (VCT) for HIV, HBV, and syphilis. We compared the number and types of services provided, and the number and rate of positive STI diagnoses before (Mar 2019-Feb 2020) and during (Mar 2020-Feb 2021) COVID-19. Several lockdowns were imposed and eased in the latter period.



Results

Men who have sex with men (MSM) comprised 35% and 40% of the patients before and during COVID-19, respectively. During COVID-19, a total of 1,350 VCT services and 406 medical consultations were provided, an overall 45% decrease compared with the period before COVID-19. However, in June 2020, following easing of the first and strictest lockdown, there was a surge in the number of services provided (20% more than June 2019). During COVID-19, 1.7% of patients tested positive for any STI compared with 1.1% before COVID-19 (OR: 1.5, 95%CI: 0.8-2.7). The increase in positivity rate was highest for syphilis (OR: 2.4, 95% CI: 0.8-7.6). Close to 90% of all positive diagnoses were among MSM.



Conclusion

COVID-19 related closures led to substantial reduction in SHS accessibility among clinic attendees. STIs positivity rates increased during COVID-19, although this increase was not statistically significant. The persistence of new diagnoses during COVID-19 and the demand for SHS in the immediate post-lockdown period suggest that sexual risk behavior was taking place during the pandemic and highlights the need to minimize disruptions in the provision of SHS during similar crises, particularly to key populations.