Loneliness and sexual risk-taking among gay, bisexual and other men who have sex with men in the context of HIV and COVID-19, two ongoing pandemics


BACKGROUND: During the COVID-19 pandemic, social distancing and isolation measures have been imposed'however, both areassociated with increases in loneliness and decreases in social support. In the context of COVID-19, younger age has also been linked with increased loneliness and lower social support (Lisitsa et al., 2020; Groake et al., 2020). According to the loneliness and sexual risk model, higher levels of loneliness should be associated with increased sexual risk-taking; however, it's unknown whether this held true during COVID-19, when most Canadians were ordered to isolate, nor how age might impact this association. We examined these associations using data on gay, bisexual, and other men who have sex with men (GBM), living in Canada's three largest urban centers.
METHODS: Participants (n=1134) were recruited (09/2020-04/2021) from an ongoing cohort study of GBM aged 16+ in Montreal, Toronto, and Vancouver. We examined the associations of baseline perceived social support (SS) with emotional support (ES) during the early phase of the COVID-19 pandemic (March-May 2020). We used linear regressions to examine the association of age with loneliness and ES during COVID-19. We also examined whether age moderated associations between loneliness and sexual risk-taking (at least one episode of group sex, transactional sex, chemsex, or sex with anonymous or new casual partners). Analyses controlled for education, income, recruitment city, living alone, and HIV status.
RESULTS: Partial correlation analysis indicated a significant positive correlation between SS at baseline and ES during COVID-19 (r(1134)=.21, p<.001). Linear regressions revealed a significant association between age and loneliness (beta=-.144, p<.001) and age and ES (beta=-.170, p<.001). Further, age moderated the association between loneliness and the likelihood of reporting sexual risk-taking (B=-.02, p=.003, 95%CI: -0.04, -0.01), such that younger participants experiencing more loneliness were more likely to report engaging in sexual risk-taking.
CONCLUSIONS: GBM who began with higher levels of perceived social support pre-COVID-19 tended to be better able to access emotional support from family and friends during the early months of COVID-19. Further, younger GBM were particularly impacted by loneliness and may benefit from additional support to reduce their risk of transmission for both HIV and COVID-19.

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