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- Dema, Emily, et al.
(author)
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How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID)
- 2023
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In: Sexually Transmitted Infections. - : BMJ Publishing Group Ltd. - 1368-4973 .- 1472-3263. ; 99:4, s. 261-267
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Journal article (peer-reviewed)abstract
- Objectives: To investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic.Methods: British participants (18-59 years) completed a cross-sectional web survey 1 year (March-April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16-74 years) conducted in 2010-2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18-44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors.Results: In 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18-24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers.Conclusions: Our study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010-2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.
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| 2. |
- Dema, Emily, et al.
(author)
-
How did the COVID-19 pandemic affect unmet need for condoms at a population level? (Natsal-COVID)
- 2022
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In: Sexually Transmitted Infections. - : BMJ Publishing Group Ltd. - 1368-4973 .- 1472-3263. ; 98:Suppl. 1, s. A42-A42
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Journal article (other academic/artistic)abstract
- Introduction: Use of condoms to prevent STIs/HIV and unplanned pregnancy remains important during the COVID-19 pandemic. However, it is unknown whether the pandemic affected condom access and which population groups were most impacted.Methods: 6658 participants (18-59y) completed a cross-sectional web survey one-year after the initial British lockdown from 23 March 2020. Quota-based sampling and weighting resulted in a sample that was quasi-representative of the British population. We report the prevalence of unmet need for condoms because of the pandemic among sexually-experienced participants aged 18-44 years (n=2869). Adjusted odds ratios (AOR) quantify associations with demographic and behavioural factors.Results: Overall, 6.9% of women and 16.2% of men reported unmet need for condoms in the past year because of the pandemic. This was more likely to be reported by participants who: were aged 18-24 years vs. 35-44 (AOR: men 2.25 [95%CI:1.26-4.01], women 2.95[1.42-6.16]); were Black or Black British vs. White (men 2.86 [1.45-5.66], women 1.93 [1.03-8.30]); reported same-sex sex vs. not (past five years; men 2.85 [1.68-4.86], women 5.00 [2.48-10.08]); or ≥1 new relationships vs. not (past year, men 5.85 [3.55-9.66], women 6.38 [3.24-12.59]). Men, but not women, reporting STI-related service use (past year) were more likely to report unmet need for condoms compared to men that did not report service use (3.83 [2.18-6.71]).Discussion: Unmet need for condoms because of the pandemic was more likely to be reported by populations at higher risk of adverse sexual health outcomes, including STI/HIV transmission. Improved access to free/low-cost condoms is crucial for all.
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| 3. |
- Oeser, Clarissa, et al.
(author)
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Feasibility and acceptability of home-based self-collection of multiple vaginal swabs in a general population survey in Britain′s fourth National Survey of Sexual Attitudes and Lifestyles-4 (Natsal-4)
- 2024
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In: Sexually Transmitted Diseases. - : Lippincott Williams & Wilkins. - 0148-5717 .- 1537-4521. ; 51:1S, s. S318-S319
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Journal article (other academic/artistic)abstract
- Background: Despite greater sensitivity of vaginal swabs compared to urine for detection of STIs and high acceptability in clinical settings, acceptability and feasibility of home-based self-collected vaginal swabs for research are less certain. We undertook development work to test these attributes for self-collected vaginal swabs for Natsal-4, a probability sample, interviewer-administered, survey of the ritish population aged 16-59 years.Methods: We conducted two pilot studies in 2021-22. After completing an interview, all participants identifying as cisgender women were invited to provide three self-collected vaginal swabs, with procedures for providing samples during or afte rface-to-face interviews or after remote interviews. Samples were posted to the laboratory. Consent was provided with the understanding of non-return of results. Participants declining vaginal swabs were invited to provide urine. Interviewers were not clinically trained. Qualitative follow-up interviews were conducted with participants and interviewers provided feedback.Results: Of the 153 cisgender women interviewed, 77 (50%) agreed to provide a vaginal swab, and 22 preferred to provide urine, resulting in an overall biosample consent rate of 65%. Of these, 60 swabs and 18 urine samples were received (Figure), resulting in an overall response of 51% (39% for vaginal swabs). Of the 77 who consented to provide swabs, 43 (56%) were during face-to-face interviews, of which 95% were received, compared to 13 (17%) agreeing to collection after face-to-face with 54% received, and 21 (27%) choosing remote interviews with 57% received. Fourteen participants (10 provided swabs) gave follow-up interviews and seven interviewers provided feedback. Participants conveyed their motivation to support research by giving samples. Interviewers were surprised at participants’ willingness to provide swabs. Reasons for not providing a swab included the belief that it was uncomfortable, too intimate or not relevant for their circumstances, or that urine was easier to collect.Conclusion: Our findings show that self-collection of vaginal swabs at home facilitated by non-clinically trained interviewers for a population-based probability survey is feasible and acceptable. Mode of interview and timing of sample collection are important as they affect response rate. Vaginal swab collection was incorporated into the main Natsal-4study with similar response to date.
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