Changes in sexual behavior among MSM during the spread of COVID-19 in China: results of an online survey

Background Sexual behavior drives the transmission of sexually transmitted infections, especially among men who have sex with men (MSM). This study aims to evaluate the sexual behavior changed among MSM during the COVID-19. Methods An online survey was conducted to collect socio-demographic, sexual behavioral, and HIV testing information before and during the COVID-19. Chi-square was used to determine the behavior differences before and during the COVID-19. We identified the factors associated with sexual behavior among MSM using logistic regression. Results Totally 506 MSM participated in the survey. Compared with participants who didn't reduce the number of sexual partners (193, 38.1%), participants who reduced sexual partners (313, 61.9%) had higher values of multiple sexual partners, causal sexual partners, used condoms with causal sexual partners, and sought sexual partners using apps. Participants who reduced the number of sexual partners than before COVID-19, reported having a higher proportion of causal sexual behavior (χ ²  = 21.047, p < 0.001), which means engaged in casual sex in the last three months. Conclusions The lockdown measures significantly impacted the sexual behavior of MSM. After the epidemic is over, however, we need to increase health education for MSM to reduce their high-risk sexual behaviors and protect them from STDs.