Background: The COVID-19-pandemic impacts on sexual health services access have not been fully examined. We sought to describe characteristics associated with unmet sexual health needs and access barriers during the initial pandemic phases in BC, Canada.
Methods: An anonymous online survey about sexual health service needs and access was administered from July 21-August 4, 2020 to clients 16 years old who had visited the BC Centre for Disease Control’s sexually transmitted infections (STI) clinic and/or GetCheckedOnline testing service in the year prior to March 2020. Using logistic regression, we reported univariate odds ratios (OR) with 95% confidence intervals [95% CI] for characteristics associated with unmet sexual health needs (i.e., not accessing needed services) during March–July 2020.
Results: Of 1198 respondents, 59% (n=706; median age: 32 years, 71% White, 47% women, 27% men having sex with men only (MSM)) reported needing sexual health services since March 2020, of which 52% (365/706) did not access needed services. Women (OR=1.37 [1.01–1.86]) were more likely to have unmet sexual health needs, while MSM (OR=0.37 [0.23–0.61]) were less likely to. Participants needing routine STI testing were more likely to report not accessing services (OR=2.49 [1.64–3.79]), whereas those needing birth control (OR=0.48 [0.30–0.75]), HIV pre-exposure prophylaxis (OR=0.39 [0.22–0.66]), or treatment for a new STI (OR=0.40 [0.21–0.76]) were less likely to report not accessing services. Most common reasons for avoiding/delaying service access were: concern about getting COVID-19 while at or traveling to a clinic/lab (249/689, 36%), public messaging against seeking non-urgent healthcare (239/689, 35%), and closure of usual place of service (182/689, 26%).
Conclusion: BC sexual health service clients experienced numerous barriers in accessing needed sexual health services during the initial pandemic phases. Offering alternative service delivery methods and more nuanced public health messaging may help address the identified barriers to improve access.