Impact of the COVID-19 pandemic on sexually transmitted infection testing and diagnosis in Lebanon: A retrospective chart review
Nadine Sunji,
Peter Boufadel,
Iman Fakih,
Jana Haidar Ahmad,
Mathieu Choufani,
Nabih Habib,
Jean-Paul Rizk,
Ryan Yammine,
Sara Abu Zaki,
Ayman Assi,
Laith J. Abu-Raddad,
Sasha Fahme,
Ghina R. Mumtaz
Affiliations
Nadine Sunji
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Peter Boufadel
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Iman Fakih
Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
Jana Haidar Ahmad
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Mathieu Choufani
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Nabih Habib
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Jean-Paul Rizk
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Ryan Yammine
Faculty of Medicine, American University of Beirut, Beirut, Lebanon
Sara Abu Zaki
Marsa Sexual Health Center, Beirut, Lebanon
Ayman Assi
Marsa Sexual Health Center, Beirut, Lebanon; Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
Laith J. Abu-Raddad
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation–Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
Sasha Fahme
Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
Ghina R. Mumtaz
Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Corresponding author. American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon.
Background: Social distancing restrictions during the COVID-19 pandemic caused disruptions to sexual health services (SHS) worldwide. During the first year of the pandemic, Lebanon implemented multiple lockdowns during which SHS endured repetitive closures. We explore the impact of the pandemic on SHS delivery and the diagnosis rate of sexually transmitted infections (STIs) among attendees of a large sexual health clinic in Beirut, Lebanon. Methods: This was a retrospective analysis of the clinic's database, including data on voluntary counseling and testing (VCT) for HIV, syphilis, hepatitis B virus (HBV), and hepatitis C virus (HCV). We compared the number and types of services provided, and the number and rate of positive VCT diagnoses pre- (Mar 2019–Feb 2020) and post- (Mar 2020–Feb 2021) COVID-19 onset. Results: Men who have sex with men (MSM) comprised 35 % and 40 % of attendees pre- and post- COVID-19 onset, respectively. Post-COVID-19 onset, a total of 1350 VCT services and 406 medical consultations were provided, an overall 45 % decrease compared with pre-COVID-19 onset. The prevalence pre-COVID-19 onset of HIV, syphilis, HBV, and HCV was 0.8 %, 0.3 %, 0.2 %, and 0.1 %, respectively, and post-COVID-19 onset 1.2 %, 0.7 %, 0.3 %, and 0.3 %, respectively. Post-COVID-19 onset, 1.7 % of patients tested positive for any STI compared with 1.1 % pre-COVID-19 onset (OR: 1.5, 95%CI: 0.8–2.7). Close to 90 % of all positive diagnoses were among MSM. The prevalence of HIV, syphilis, HBV, and HCV among MSM in the total sample was 2.1 %, 1.2 %, 0.4 %, and 0.3 %, respectively. Conclusion: COVID-19 related closures led to substantial reduction in SHS accessibility among clinic attendees. STI positivity rates increased post-COVID-19 onset, although this increase was not statistically significant. Findings suggest that sexual risk behavior was taking place during the pandemic despite the lockdowns and highlight the need to minimize disruptions in provision of SHS during similar crises, particularly to key populations.
