Adolescent Medicine Fellow SUNY Downstate Health Sciences University SUNY Downstate Health Sciences University Brooklyn, New York, United States
Background: Transgender (TG), young men who have sex with men (YMSM) and HIV+ youth, especially from communities of color, are marginalized populations whose multiple life challenges have persisted during the COVID-19 pandemic. Much has been speculated about how the pandemic has further potentiated pre-existing healthcare disparities impacting these populations, in particular STIs. Quantifying STI incidence among SGM youth is important for planning interventions and advocating for resources.
Objective: The HEAT Program at SUNY Downstate Medical Center remained open for priority sexual healthcare throughout the COVID-19 pandemic and sought to analyze the changes that occurred in the incidence of gonorrhea (GC), chlamydia (CT), and syphilis in SGM and HIV+ youth and young adults ages 16-29 engaged in HIV, PrEP, and transgender care as local incidence of these STIs from health department sources are currently unavailable. The authors aim to highlight what may be a significant public health issue in the larger community.
Design/Methods: Retrospective review of all deidentified GC/CT and syphilis testing results, both pre-pandemic and during-pandemic for 2019 and 2020 using Excel. Frequencies of new diagnoses of pharyngeal, rectal, and urogenital GC/CT NAAT tests were tabulated quarterly. Frequencies of new syphilis infection/reinfection were tabulated using RPR testing and FTA confirmation. Comparisons were made between pre-pandemic and during-pandemic frequencies for GC/CT/syphilis. Chi-square analyses were performed to determine statistical significance.
Results: Total GC/CT testing increased in the 3rd quarter 2020 and markedly increased for syphilis in the 4th quarter 2020 over pre-pandemic baseline. Positive results above pre-pandemic levels were statistically significant by chi-square analysis for urogenital and pharyngeal gonorrhea from the 2nd through 4th quarters 2020. Total number and percentage of syphilis reinfections significantly increased above pre-pandemic levels during the 3rd and 4th quarters 2020. All cases of positive STI test results were treated. Conclusion(s): GC/CT/syphilis incidence increased during COVID-19 compared to pre-pandemic levels reflecting that lockdown precautions did not reduce high risk sexual behavior. Comparisons to local health department data on STI incidence among SGM/HIV+ youth are still pending. Programs that serve SGM/HIV+ youth should plan to continue to provide essential sexual health services throughout the pandemic.
Authors/Institutions: Peter C. Pastolero, SUNY Downstate Health Sciences University, Brooklyn, New York, United States; JEFFREY M. BIRNBAUM, SUNY Downstate Health Sciences University, Brooklyn, New York, United States