Sexual health service needs by gender and sexual orientation among clients in British Columbia during the first few months of the COVID-19 pandemic response

Background:
Existing disparities in sexual health service access experienced by sexual and gender minorities may have been exacerbated by public health responses to the COVID-19 pandemic. We describe differences in service access among a diverse sample of sexual health service clients in British Columbia (BC).

Methods:
We used data from the Sex in the Time of COVID-19 survey administered from July 21-August 4, 2020. Clients >15 years old who had visited the BC Centre for Disease Control’s STI clinic or GetCheckedOnline, BC’s internet-based testing program, in the year prior to March 2020 were invited to complete the online anonymous survey. We describe sexual health needs and service access during the initial months of the pandemic, stratified by gender and sexual orientation: heterosexual men (het-men), sexual minority men (SMM), heterosexual women (het-women), sexual minority women (SMW), and non-binary/genderfluid people (NB).

Results:
Of n=1196 survey participants (median age: 32; 4% Indigenous; 24% racialized minority), 21% (n=247) were het-men, 28% (n=331) were SMM, 29% (n=342) were het-women, 18% (n=221) were SMW, and 5% (n=55) were NB. Almost two-thirds of SMW (65%) and het-men (62%) needing sexual health services, including STI testing, had unmet sexual health needs. Most SMW (73%) and NB participants (92%) reported any reason for delaying/avoiding sexual healthcare. Details of sexual health service needs and access barriers are presented in Table 1.

Conclusion:
Inequities in sexual health care access experienced by sexual and gender minorities must be addressed in service planning and delivery throughout and beyond the COVID-19 pandemic response.