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

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  • Erausquin, J.T.
    • Other Affiliation: University of North Carolina at Greensboro
  • Tan, R.K.J.
    • Affiliation: School of Medicine, UNC Project-China
  • Uhlich, M.
    • Other Affiliation: Western University
  • Francis, J.M.
    • Other Affiliation: University of Witwatersrand
  • Kumar, N.
    • Other Affiliation: Yale University
  • Campbell, L.
    • Other Affiliation: University of Antwerp
  • Zhang, W.H.
    • Other Affiliation: University of Ghent
  • Hlatshwako, T.G.
    • Affiliation: School of Medicine, Institute for Global Health and Infectious Diseases
  • Kosana, P.
    • Affiliation: School of Medicine, Institute for Global Health and Infectious Diseases
  • Shah, S.
    • Affiliation: School of Medicine, Institute for Global Health and Infectious Diseases
  • Brenner, E.M.
    • Affiliation: School of Medicine, Institute for Global Health and Infectious Diseases
  • Remmerie, L.
    • Other Affiliation: University of Ghent
  • Mussa, A.
    • Other Affiliation: Botswana Harvard AIDS Institute Partnership
  • Klapilova, K.
    • Other Affiliation: Charles University
  • Mark, K.
    • Other Affiliation: University of Minnesota Medical School
  • Perotta, G.
    • Other Affiliation: University of Buenos Aires
  • Gabster, A.
    • Other Affiliation: London School of Hygiene and Tropical Medicine
  • Wouters, E.
    • Other Affiliation: University of Antwerp
  • Burns, S.
    • Other Affiliation: Curtin University
  • Hendriks, J.
    • Other Affiliation: Curtin University
  • Hensel, D.J.
    • Other Affiliation: Indiana University-Purdue University Indianapolis
  • Shamu, S.
    • Other Affiliation: University of Witwatersrand
  • Marie Strizzi, J.
    • Other Affiliation: University of Copenhagen
  • Esho, T.
    • Other Affiliation: Amref Health Africa
  • Morroni, C.
    • Other Affiliation: University of Edinburgh
  • Eleuteri, S.
    • Other Affiliation: Sapienzo University
  • Sahril, N.
    • Other Affiliation: Ministry of Health Malaysia
  • Yun Low, W.
    • Other Affiliation: Universiti Malaya
  • Plasilova, L.
    • Other Affiliation: Charles University
  • Lazdane, G.
    • Other Affiliation: Riga Stradins University
  • Marks, M.
    • Other Affiliation: London School of Hygiene and Tropical Medicine
  • Olumide, A.
    • Other Affiliation: University of Ibadan
  • Abdelhamed, A.
    • Other Affiliation: Sohag University
  • López Gómez, A.
    • Other Affiliation: University of the Republic
  • Michielsen, K.
    • Other Affiliation: University of Ghent
  • Moreau, C.
    • Other Affiliation: Johns Hopkins Bloomberg School of Public Health
  • Tucker, J.D.
    • Other Affiliation: UNC Project-China
  • International Sexual Health And REproductive Health during COVID-19 Research Consortium
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, 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.
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DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Journal title
  • Clinical Infectious Diseases
Journal volume
  • 75
Journal issue
  • 1
Page start
  • E991
Page end
  • E999
Language
  • English
Funder
  • National Institute of Allergy and Infectious Diseases, NIAID: K24AI143471, VPP-COVID-2020/1-0011
  • National Institutes of Health, NIH: UG3HD096929
ISSN
  • 1058-4838
Publisher
  • Oxford University Press

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