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Original article

Vol. 152 No. 2526 (2022)

Changes in mental and sexual health among MSM using HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: longitudinal analysis of the SwissPrEPared cohort study

  • Babette L. Winter
  • Frédérique Hovaguimian
  • Roger D. Kouyos
  • Axel Jeremias Schmidt
  • Enos Bernasconi
  • Dominique L. Braun
  • Alexandra Calmy
  • Julia Notter
  • Marcel Stoeckle
  • Bernard Surial
  • Vanessa Christinet
  • Matthias Cavassini
  • Carsten Depmeier
  • Severin Läuchli
  • Emmanuelle Boffi El Amari
  • Matthias Reinacher
  • Manuela Rasi
  • Philip Bruggmann
  • David Haerry
  • Raphaël Bize
  • Nicola Low
  • Andreas Lehner
  • Boris B. Quednow
  • Jan S. Fehr
  • Benjamin Hampel
Cite this as:
Swiss Med Wkly. 2022;152:w30192


BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SARS-CoV-2 pandemic remain unclear.

METHODS: Design: Longitudinal analysis of an ongoing, multicentre, pre-exposure prophylaxis (PrEP) cohort (NCT03893188) in Switzerland. Participants: HIV-negative MSM aged ≥18 who completed at least one questionnaire before and one after the start of the SARS-CoV-2 pandemic. Outcomes: Primary: mental health, defined as anxiety and depression scores assessed by the Patient Health Questionnaire-4. Secondary: sexual behaviour, well-being, PrEP use and disruption of care. Outcomes were assessed over seven periods corresponding to different SARS-CoV-2 prevention measures in Switzerland. We performed pairwise comparisons between periods (Wilcoxon signed rank test).

RESULTS: Data from 1,043 participants were included. Whilst anxiety scores remained stable over time, depression scores worsened in the second wave and the second lockdown period compared to pre-pandemic scores. This was confirmed by pairwise comparisons (pre-SARS-CoV-2/second wave and pre-SARS-CoV-2/second lockdown: p <0.001). Downward trends in sexual activity,sexualized substance use, and a switch from daily to "event-driven" PrEP were found. Disruption of care affected 42.6% (790/1856) of daily PrEP users’ follow-up visits.

CONCLUSION: In this longitudinal analysis of a PrEP cohort enrolling MSM, depression scores worsened in the second wave and the second lockdown compared to the pre-pandemic period.


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