The COVID-19 pandemic has caused disruptions to health care access for sexual and gender minorities in the U.S. We sought to explore the impact of COVID-19 on HIV pre-exposure prophylaxis (PrEP) use and sexual health services by assessing PrEP eligibility and use, changes in sexual behaviors, and HIV/STI testing during the COVID-19 pandemic. We surveyed 239 young sexual minority men (YSMM) 17–24 years old between April and September 2020 in the U.S. One-in-seven YSMM PrEP users discontinued use during the pandemic, and all those who discontinued PrEP reported a decrease in sexual activity. Twenty percent reported difficulty getting prescriptions and medications from their doctors or pharmacies, and more than 10% reported challenges accessing HIV/STI testing. Among those who met Centers for Disease Control and Prevention criteria for PrEP (n = 104), 86.5% were not currently using PrEP. Among those surveyed 3 months or later after the start of major COVID-19 stay-at-home measures (n = 165), 35.8% reported CAS with a causal partner within the past 3 months during the COVID-19 pandemic. Seeking HIV testing was associated with reporting condomless anal sex in the previous 3 months, indicating the necessity for ensuring continuity of basic sexual health services for YSMM. Failure to adequately adjust HIV prevention services and intervention in the face of pandemic-related adversity undermines efforts to end the HIV epidemic in the U.S.

COVID-19 大流行已对美国的性少数群体和性别少数群体的医疗保健获取造成干扰。我们试图通过评估 PrEP 资格和使用情况来探讨 COVID-19 对 HIV 暴露前预防 (PrEP) 使用和性健康服务的影响COVID-19 大流行期间性行为的变化以及 HIV/STI 检测。我们于 2020 年 4 月至 9 月期间对美国 239 名 17-24 岁的年轻性少数男性 (YSMM) 进行了调查。七分之一的 YSMM PrEP 用户在大流行期间停止使用，所有停止使用 PrEP 的人都报告性活动减少。 20% 的人表示很难从医生或药房获得处方和药物，超过 10% 的人表示在获得 HIV/STI 检测方面遇到困难。在符合疾病控制和预防中心 PrEP 标准的人群中（ n = 104），86.5% 目前未使用 PrEP。在主要 COVID-19 居家措施开始后 3 个月或更晚接受调查的受访者中（ n = 165），35.8% 的人报告在过去 3 个月内在 COVID-19 大流行期间与因果伴侣发生过 CAS。寻求艾滋病毒检测与报告过去 3 个月内的无套肛交行为有关，这表明有必要确保 YSMM 基本性健康服务的连续性。面对与大流行相关的逆境，未能充分调整艾滋病毒预防服务和干预措施会破坏美国结束艾滋病毒流行的努力