The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave
Year: 2022
Type: review
Study design: Observational Study
Abstract: BACKGROUND: The COVID-19 pandemic forced billions of people to shelter in place, altering social and sexual relationships worldwide. In many settings, COVID-19 threatened already precarious health services. However, there is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of COVID-19 disease. To address this gap, our team organized a multi-country, cross-sectional online survey as part of a global consortium. METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service utilization, and we compared three months prior to and three months after policy measures to mitigate COVID-19. We used established indicators and analyses pre-specified in our protocol. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence using Cochrane methods. Descriptive analyses included 22,724 individuals in 25 countries. Five additional countries with sample sizes <200 were included in descriptive meta-analyses. RESULTS: Respondents were mean age 34 years; most identified as women (15160; 66.7%), cis-gender (19432; 86.6%) and heterosexual (16592; 77.9%). Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%) people and 640 (14.1%) people reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063/15144, 7.0%) compared to the period before COVID-19 measures (1469/15887, 9.3%). COVID-19 measures impeded access to condoms (933/10790, 8.7%), contraceptives (610/8175, 7.5%), and HIV/STI testing (750/1965, 30.7%). Pooled estimates from meta-analysis indicate during COVID-19 measures, 32.3% (95% CI 23.9-42.1) of people needing HIV/STI testing had hindered access, 4.4% (95% CI 3.4-5.4) experienced partner violence, and 5.8% (95% CI 5.4-8.2) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. CONCLUSION: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciac102
Authors: Jennifer Toller Erausquin, Rayner K J Tan, Maximiliane Uhlich, Joel M Francis, Navin Kumar, Linda Campbell, Wei Hong Zhang, Takhona G Hlatshwako, Priya Kosana, Sonam Shah, Erica M Brenner, Lore Remmerie, Aamirah Mussa, Katerina Klapilova, Kristen Mark, Gabriela Perotta, Amanda Gabster, Edwin Wouters, Sharyn Burns, Jacqueline Hendriks, Devon J Hensel, Simukai Shamu, Jenna Marie Strizzi, Tammary Esho, Chelsea Morroni, Stefano Eleuteri, Norhafiza Sahril, Wah Yun Low, Leona Plasilova, Gunta Lazdane, Michael Marks, Adesola Olumide, Amr Abdelhamed, Alejandra López Gómez, Kristien Michielsen, Caroline Moreau, Joseph D Tucker, Adedamola Adebayo, Emmanuel Adebayo, Noor Ani Ahmad, Nicolás Brunet, Anna Kagesten, Elizabeth Kemigisha, Eneyi Kpokiri, Ismael Maatouk, Griffins Manguro, Filippo M Nimbi, Pedro Nobre, Caitlin O’Hara, Oloruntomiwa Oyetunde, Muhd Hafizuddin Taufik Ramli, Dace Rezeberga, Juan Carlos Rivillas, Kun Tang, Ines Tavares
Institutions: University of North Carolina at Greensboro, National University of Singapore, Southern Medical University, Western University, University of the Witwatersrand, Yale University, University of Antwerp, Ghent University, Université Libre de Bruxelles, University of North Carolina at Chapel Hill, Botswana Harvard AIDS Institute Partnership, Charles University, National Institute of Mental Health, University of Minnesota, Universidad de Buenos Aires, Instituto Conmemorativo Gorgas de Estudios de la Salud, London School of Hygiene & Tropical Medicine, Curtin University, Indiana University Indianapolis, Indiana University School of Medicine, Indiana University – Purdue University Indianapolis, Foundation for Professional Development, University of Copenhagen, Amref Health Africa, Amref Health Africa, MRC Centre for Reproductive Health, University of Edinburgh, Sapienza University of Rome, Ministry of Health, University of Malaya, Riga Stradiņš University, University of Ibadan, Sohag University, Universidad de la República de Uruguay, Johns Hopkins University, Inserm, Centre de recherche en Epidémiologie et Santé des Populations
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,320
OpenAlex ID: W4210716530