The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave
Authors: Toller Erausquin Jennifer , Tan Rayner K J , Uhlich Maximiliane , Francis Joel M , Kumar Navin , Campbell Linda , Zhang Wei Hong , Hlatshwako Takhona G , Kosana Priya , Shah Sonam , Brenner Erica M , Remmerie Lore , Mussa Aamirah , Klapilova Katerina , Mark Kristen , Perotta Gabriela , Gabster Amanda , Wouters Edwin , Burns Sharyn , Hendriks Jacqueline , Hensel Devon J , Shamu Simukai , Marie Strizzi Jenna , Esho Tammary , Morroni Chelsea , Eleuteri Stefano , Sahril Norhafiza , Yun Low Wah , Plasilova Leona , Lazdane Gunta , Marks Michael , Olumide Adesola , Abdelhamed Amr , López Gómez Alejandra , Michielsen Kristien , Moreau Caroline , Tucker Joseph D ,   International Sexual Health And REproductive Health during COVID-19 Research Consortium, Adebayo Adedamola , Adebayo Emmanuel , Ani Ahmad Noor , Brunet Nicolás , Kagesten Anna , Kemigisha Elizabeth , Kpokiri Eneyi , Maatouk Ismael , Manguro Griffins , Nimbi Filippo M , Nobre Pedro , O’Hara Caitlin , Oyetunde Oloruntomiwa , Taufik Ramli Muhd Hafizuddin , Rezeberga Dace , Carlos Rivillas Juan , Tang Kun , Tavares Ines 
Published: February 2022

Abstract

Background
There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium.

Methods
Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence.

Results
Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%–42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%–5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%–8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy.

Conclusions
Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.