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

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; International Sexual Health And REproductive Health during COVID-19 Research Consortium

doi:10.1093/cid/ciac102

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

Clin Infect Dis. 2022 Aug 24;75(1):e991-e999. doi: 10.1093/cid/ciac102.

Authors

Jennifer Toller Erausquin¹, Rayner K J Tan^{2

3

4}, Maximiliane Uhlich⁵, Joel M Francis⁶, Navin Kumar⁷, Linda Campbell^{8

9}, Wei Hong Zhang^{9

10}, Takhona G Hlatshwako¹¹, Priya Kosana¹¹, Sonam Shah¹¹, Erica M Brenner¹¹, Lore Remmerie⁹, Aamirah Mussa¹², Katerina Klapilova^{13

14}, Kristen Mark¹⁵, Gabriela Perotta¹⁶, Amanda Gabster^{17

18}, Edwin Wouters⁸, Sharyn Burns¹⁹, Jacqueline Hendriks¹⁹, Devon J Hensel^{20

21}, Simukai Shamu^{22

23}, Jenna Marie Strizzi²⁴, Tammary Esho²⁵, Chelsea Morroni^{12

26}, Stefano Eleuteri²⁷, Norhafiza Sahril²⁸, Wah Yun Low²⁹, Leona Plasilova^{13

14}, Gunta Lazdane³⁰, Michael Marks¹⁸, Adesola Olumide³¹, Amr Abdelhamed³², Alejandra López Gómez³³, Kristien Michielsen⁹, Caroline Moreau^{34

35}, Joseph D Tucker^{3

11

18}; International Sexual Health And REproductive Health during COVID-19 Research Consortium

Collaborators

International Sexual Health And REproductive Health during COVID-19 Research Consortium:
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

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 University of North Carolina Project-China, Guangzhou, China.
⁴ Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
⁵ Department of Psychology, Western University, London, Ontario, Canada.
⁶ Department of Family Medicine, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.
⁷ Department of Sociology, Yale University, New Haven, Connecticut, USA.
⁸ Center for Population, Family, and Health, University of Antwerp, Antwerp, Belgium.
⁹ Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
¹⁰ School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
¹¹ Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
¹² Botswana Sexual and Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
¹³ Faculty of Humanities, Charles University, Prague, Czech Republic.
¹⁴ National Institute of Mental Health, Klecany, Czech Republic.
¹⁵ Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
¹⁶ Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina.
¹⁷ Gorgas Memorial Institute for Health Studies, Panama City, Panama.
¹⁸ Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
¹⁹ Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia.
²⁰ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
²¹ Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
²² Health Systems Strengthening, Foundation for Professional Development, Pretoria, South Africa.
²³ School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
²⁴ Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
²⁵ End FGM/C Centre of Excellence, Amref Health Africa, Nairobi, Kenya.
²⁶ MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom.
²⁷ Department of Psychology, Sapienzo University, Rome, Italy.
²⁸ Ministry of Health Malaysia, Putrajaya, Malaysia.
²⁹ Asia-Europe Institute, Universiti Malaya, Kuala Lumpur, Malaysia.
³⁰ Institute of Public Health, Riga Stradins University, Riga, Latvia.
³¹ College of Medicine, University of Ibadan, Ibadan, Nigeria.
³² Department of Dermatology, Venereology & Andrology, Sohag University, Sohag, Egypt.
³³ Department of Psychology, University of the Republic, Montevideo, Uruguay.
³⁴ Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAand.
³⁵ Primary Care and Prevention, Center for Research in Epidemiology and Public Health, National Institute of Health and Medical Research 1018, Villejuif, France.

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.

Keywords: HIV; condom use; sexual behavior; sexual violence; sexually transmitted infections.

Publication types

Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
Condoms
Cross-Sectional Studies
HIV Infections*
Humans
Reproductive Health
Sexual Behavior
Sexual Health*
Sexual Partners
Sexually Transmitted Diseases* / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding