Prevention of HIV infection in MSM and gay communities under COVID-19 epidemic

the impact and effective countermeasures

Abstract

Since the COVID-19 has spread across the country, commercial establishments were temporarily closed or closed in succession and club events were cancelled in the gay community. The mood of self-restraint in behavior, such as avoiding the three Cs (closed, crowded, contact) increased, and there were periods when the city was deserted. The period during which testing opportunities were suspended due to the tight workload at public health centers was relatively short, and the situation has now nearly returned to that before the pandemic, although some centers have shifted to an appointment system for testing. However, the current slow growth in the number of tests is partly due to a sense of self-restraint and a decrease in activities for promoting testing.

For those in the gay community who wanted to be tested but were unable to do so, the six community centers that have been established nationwide and the 10 NGOs that continue to conduct preventive awareness-raising activities targeting MSM have provided testing opportunities through face-to-face and internet publicity, utilizing commercially available postal testing kits. In one province and four prefectures, they have continued to provide testing opportunities in collaboration with private medical institutions. The actual number of users of the provided testing opportunities has been small compared to the total number of MSM, they are reaching the population with high testing needs. Although the postal testing service was the first initiative of its kind in the country, the postal testing company and the NGOs that were involved in each region worked together to provide better follow-up after the test results.

Even amidst the COVID-19 epidemic, PrEP use has increased according to the results of the MSM and gay community survey, and the potential needs for a safe environment and regular testing are growing. In addition, condom-use behaviour has declined since before the COVID-19, and there is a concern that the attitudes of norm bearers regarding safer sex are changing. Therefore, it is necessary to develop preventive awareness-raising in a complex way. To make this a sustainable activity, a system to train and support party health workers working in community centers and communities is needed.