Impact of COVID-19 on Sexual Health Services

The COVID-19 pandemic has had profound effects on the delivery, uptake and equity of sexual health services worldwide. Measures introduced to control viral transmission, including lockdowns, social distancing and the redeployment of healthcare resources, led to widespread reductions in face-to-face clinics, laboratory capacity and outreach programmes. As a result, testing for common sexually transmitted infections (STIs), routine vaccinations, contraception provision and preventive interventions such as pre-exposure prophylaxis (PrEP) all experienced significant disruption. Remote service delivery models, including telemedicine, postal self-sampling kits and digital counselling platforms, were rapidly scaled up to mitigate gaps in care. However, these adaptations have not been distributed evenly, with younger people, marginalised groups and those in low-resource settings often facing the greatest barriers to access. Concurrent changes in sexual behaviour, such as reductions in partner numbers during early lockdowns and shifts towards online partner-seeking, have further influenced service demand and epidemiology. Emerging evidence indicates that while some negative impacts may be transient, there is a risk of longer-term consequences for STI control, reproductive health outcomes and health inequalities unless innovative service models are sustained and equity is prioritised.

Research from Nature Portfolio

A longitudinal national cohort study among men living with HIV in Croatia documented a near doubling in syphilis incidence between 2019 and 2020, rising from 3.3 to 6.0 cases per 100 person-years. The first year of the pandemic saw a 91% increase in annual syphilis rates despite a 3.5% decline in testing coverage. Men who have sex with men and those with prior syphilis diagnoses were at highest risk, whereas individuals with advanced HIV disease were less likely to be tested. A notable shift towards asymptomatic and recurrent infections emphasises the need for novel prevention and screening strategies in periods of restricted healthcare access.

Impact of COVID-19 on Sexual Health Services publication trend

The graph below shows the total number of articles in impact of covid-19 on sexual health services across all publications each year (not limited to Nature Index journals).

Technical terms

Sexually transmitted infection (STI): An infection transmitted through sexual contact, including bacterial, viral or parasitic pathogens.

Pre-exposure prophylaxis (PrEP): A preventive medication taken by HIV-negative individuals to reduce the risk of acquiring HIV.

Voluntary counselling and testing (VCT): A service model providing one-on-one risk assessment, advice and diagnostic testing for HIV and other infections.

Telemedicine: The remote delivery of healthcare services via telephone, video or digital communication platforms.

References

1. Recruitment for Voluntary Video and Mobile HIV Testing on Social Media Platforms During the COVID-19 Pandemic: Cross-Sectional Study. Journal of Medical Internet Research (2024).
2. Statutory health insurance-covered pre-exposure prophylaxis in Germany: changing trends in nationwide tenofovir disoproxil/emtricitabine prescriptions during the COVID-19 pandemic. Frontiers in Pharmacology (2023).
3. Incidence, risk factors, and clinical findings of syphilis among men living with HIV in Croatia during the COVID-19 pandemic. Scientific Reports (2023).
4. Initial impacts of the COVID-19 pandemic on sexual and reproductive health service use and unmet need in Britain: findings from a quasi-representative survey (Natsal-COVID). The Lancet Public Health (2022).