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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

Toller Erausquin J 1 , Tan RKJ 2 , Uhlich M 3 , Francis JM 4 , Kumar N 5 , Campbell L 6 Show all authors , Zhang WH 7 , Hlatshwako TG 8 , Kosana P 8 , Shah S 8 , Brenner EM 8 , Remmerie L 7 , Mussa A 9 , Klapilova K 10 , Mark K 11 , Perotta G 12 , Gabster A 13 , Wouters E 6 , Burns S 14 , Hendriks J 14 , Hensel DJ 15 , Shamu S 16 , Marie Strizzi J 17 , Esho T 18 , Morroni C 9 , Eleuteri S 19 , Sahril N 20 , Yun Low W 21 , Plasilova L 10 , Lazdane G 22 , Marks M 23 , Olumide A 24 , Abdelhamed A 25 , López Gómez A 26 , Michielsen K 7 , Moreau C 27 , Tucker JD 28 , International Sexual Health And REproductive Health during COVID-19 Research Consortium

Affiliations 

  • 1 Department of Public Health Education, University of North Carolina-Greensboro, Greensboro, North Carolina, USA
  • 2 Dermatology Hospital of Southern Medical University, Guangzhou, China
  • 3 Department of Psychology, Western University, London, Ontario, Canada
  • 4 Department of Family Medicine, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa
  • 5 Department of Sociology, Yale University, New Haven, Connecticut, USA
  • 6 Center for Population, Family, and Health, University of Antwerp, Antwerp, Belgium
  • 7 Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
  • 8 Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  • 9 Botswana Sexual and Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
  • 10 Faculty of Humanities, Charles University, Prague, Czech Republic
  • 11 Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
  • 12 Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina
  • 13 Gorgas Memorial Institute for Health Studies, Panama City, Panama
  • 14 Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
  • 15 Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
  • 16 Health Systems Strengthening, Foundation for Professional Development, Pretoria, South Africa
  • 17 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • 18 End FGM/C Centre of Excellence, Amref Health Africa, Nairobi, Kenya
  • 19 Department of Psychology, Sapienzo University, Rome, Italy
  • 20 Ministry of Health Malaysia, Putrajaya, Malaysia
  • 21 Asia-Europe Institute, Universiti Malaya, Kuala Lumpur, Malaysia
  • 22 Institute of Public Health, Riga Stradins University, Riga, Latvia
  • 23 Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • 24 College of Medicine, University of Ibadan, Ibadan, Nigeria
  • 25 Department of Dermatology, Venereology & Andrology, Sohag University, Sohag, Egypt
  • 26 Department of Psychology, University of the Republic, Montevideo, Uruguay
  • 27 Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAand
  • 28 University of North Carolina Project-China, Guangzhou, China
Clin Infect Dis, 2022 Aug 24;75(1):e991-e999.
PMID: 35136960 DOI: 10.1093/cid/ciac102

Abstract

BACKGROUND: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, 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 use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence.

RESULTS: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [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.

CONCLUSIONS: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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