The COVID-19 pandemic is exacerbating the socioeconomic vulnerability of LGBT+ communities, which in turn may raise gay and bisexual men and transgender people’s susceptibility to HIV, according to a recent survey.
Erik Lamontagne, PhD, MSc, a senior economist at the Joint United Nations Programme on HIV/AIDS (UNAIDS), presented findings from an anonymous international online survey at the International AIDS Conference, which is being held virtually this week.
The survey was available in 10 languages between April 16 and May 18. It was broadcast through social media and various other networks thanks to efforts by civil society organizations and activists.
Lamontagne and his colleagues collected responses from a convenience sample of 20,238 LGBT+ survey respondents in 138 nations.
Seventy-two percent of the respondents reported that they were HIV negative, 16% did not know their HIV status and 12% said they were living with HIV.
Seventy-four percent said restrictions related to the COVID-19 pandemic had left them partially or totally confined inside their homes.
Of the people with HIV, 94% reported that they were on antiretrovirals (ARVs). Seventy-two percent had been receiving uninterrupted access to ARV treatment since the advent of the COVID-19 pandemic.
However, 21% of the people with HIV reported that lockdown measures and other limitations to their personal movement had complicated their access to ARVs. Seven percent reported that they were at risk of running out of their HIV medications because they have no access to ARVs or refills.
Forty-two percent of the HIV-positive respondents said they had no more than a month of ARVs on hand. Twenty-four percent had a two-month supply, and 35% had a three-month stock.
Thirteen percent of the respondents said they had lost their job due to the COVID-19 crisis. An additional 21% were facing a high risk of losing their employment. Twenty-three percent said they were unsure about how their employment would fare in the near future.
Thirteen percent of the survey participants reported engaging in sex work. Two percent said they had to continue engaging in sex work during the COVID-19 pandemic, risking exposure to the novel coronavirus. Eleven percent said they could not continue engaging in sex work, meaning they were losing income. One percent of respondents began sex work as a result of the COVID-19 crisis.
For 17% of those doing sex work, their job, they reported, had become riskier or paid less since the advent of the new pandemic. Seven percent said they are engaging in more sex work than before the crisis; 4% say they earn less per client; and 4% are engaging in sex that poses a higher risk of HIV or sexually transmitted infection transmission or engaging in acts with clients that are beyond their comfort zone. In particular, 1% said they are now engaging in more condomless sex.
Of the HIV-negative survey respondents, 56% reported that they felt that they had access to HIV prevention services, including pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), condoms, HIV self-tests and in-person testing. For all prevention services, members of racial or ethnic minorities reported lower access.
“The impact of the COVID-19 pandemic is far reaching, with devastating effects across the world,” the study authors concluded. “The physical distancing required to flatten the curve of new cases is having a negative impact on [the] economy, the effects of which intersect with socioeconomic status, jobs and incomes, nutrition, access to health and HIV services of the LGBT community, and even more of the marginalized racial and ethnic LGBT individuals."
“Given that HIV also has a disproportionate impact on the LGBT community, COVID-19 is affecting people living with HIV in unique ways and will continue to have its impact,” the study authors continued. “Social dialogue for solutions and targeted interventions are required from the global community and the governments to help the LGBT communities not only to survive but emerge from the crisis.”
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