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

doi:10.1093/cid/ciac102

Meta-Analysis

. 2022 Aug 24;75(1):e991-e999.

doi: 10.1093/cid/ciac102.

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

Jennifer Toller Erausquin¹, Rayner K J Tan^{2

3

4}, Maximiliane Uhlich⁵, Joel M Francis⁶, Navin Kumar⁷, Linda Campbell^{8

9}, Wei Hong Zhang^{9

10}, Takhona G Hlatshwako¹¹, Priya Kosana¹¹, Sonam Shah¹¹, Erica M Brenner¹¹, Lore Remmerie⁹, Aamirah Mussa¹², Katerina Klapilova^{13

14}, Kristen Mark¹⁵, Gabriela Perotta¹⁶, Amanda Gabster^{17

18}, Edwin Wouters⁸, Sharyn Burns¹⁹, Jacqueline Hendriks¹⁹, Devon J Hensel^{20

21}, Simukai Shamu^{22

23}, Jenna Marie Strizzi²⁴, Tammary Esho²⁵, Chelsea Morroni^{12

26}, Stefano Eleuteri²⁷, Norhafiza Sahril²⁸, Wah Yun Low²⁹, Leona Plasilova^{13

14}, Gunta Lazdane³⁰, Michael Marks¹⁸, Adesola Olumide³¹, Amr Abdelhamed³², Alejandra López Gómez³³, Kristien Michielsen⁹, Caroline Moreau^{34

35}, Joseph D Tucker^{3

11

18}; International Sexual Health And REproductive Health during COVID-19 Research Consortium

Collaborators, Affiliations

Collaborators

International Sexual Health And REproductive Health during COVID-19 Research Consortium:
Adedamola Adebayo, Emmanuel Adebayo, Noor Ani Ahmad, Nicolás Brunet, Anna Kagesten, Elizabeth Kemigisha, Eneyi Kpokiri, Ismael Maatouk, Griffins Manguro, Filippo M Nimbi, Pedro Nobre, Caitlin O'Hara, Oloruntomiwa Oyetunde, Muhd Hafizuddin Taufik Ramli, Dace Rezeberga, Juan Carlos Rivillas, Kun Tang, Ines Tavares

Affiliations

¹ Department of Public Health Education, University of North Carolina-Greensboro, Greensboro, North Carolina, USA.
² Dermatology Hospital of Southern Medical University, Guangzhou, China.
³ University of North Carolina Project-China, Guangzhou, China.
⁴ Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
⁵ Department of Psychology, Western University, London, Ontario, Canada.
⁶ Department of Family Medicine, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.
⁷ Department of Sociology, Yale University, New Haven, Connecticut, USA.
⁸ Center for Population, Family, and Health, University of Antwerp, Antwerp, Belgium.
⁹ Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
¹⁰ School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
¹¹ Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
¹² Botswana Sexual and Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
¹³ Faculty of Humanities, Charles University, Prague, Czech Republic.
¹⁴ National Institute of Mental Health, Klecany, Czech Republic.
¹⁵ Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
¹⁶ Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina.
¹⁷ Gorgas Memorial Institute for Health Studies, Panama City, Panama.
¹⁸ Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
¹⁹ Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia.
²⁰ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
²¹ Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
²² Health Systems Strengthening, Foundation for Professional Development, Pretoria, South Africa.
²³ School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
²⁴ Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
²⁵ End FGM/C Centre of Excellence, Amref Health Africa, Nairobi, Kenya.
²⁶ MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom.
²⁷ Department of Psychology, Sapienzo University, Rome, Italy.
²⁸ Ministry of Health Malaysia, Putrajaya, Malaysia.
²⁹ Asia-Europe Institute, Universiti Malaya, Kuala Lumpur, Malaysia.
³⁰ Institute of Public Health, Riga Stradins University, Riga, Latvia.
³¹ College of Medicine, University of Ibadan, Ibadan, Nigeria.
³² Department of Dermatology, Venereology & Andrology, Sohag University, Sohag, Egypt.
³³ Department of Psychology, University of the Republic, Montevideo, Uruguay.
³⁴ Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAand.
³⁵ Primary Care and Prevention, Center for Research in Epidemiology and Public Health, National Institute of Health and Medical Research 1018, Villejuif, France.

PMID: 35136960
PMCID: PMC9383436
DOI: 10.1093/cid/ciac102

Meta-Analysis

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

Jennifer Toller Erausquin et al. Clin Infect Dis. 2022.

. 2022 Aug 24;75(1):e991-e999.

doi: 10.1093/cid/ciac102.

Authors

Collaborators

International Sexual Health And REproductive Health during COVID-19 Research Consortium:
Adedamola Adebayo, Emmanuel Adebayo, Noor Ani Ahmad, Nicolás Brunet, Anna Kagesten, Elizabeth Kemigisha, Eneyi Kpokiri, Ismael Maatouk, Griffins Manguro, Filippo M Nimbi, Pedro Nobre, Caitlin O'Hara, Oloruntomiwa Oyetunde, Muhd Hafizuddin Taufik Ramli, Dace Rezeberga, Juan Carlos Rivillas, Kun Tang, Ines Tavares

Affiliations

¹ Department of Public Health Education, University of North Carolina-Greensboro, Greensboro, North Carolina, USA.
² Dermatology Hospital of Southern Medical University, Guangzhou, China.
³ University of North Carolina Project-China, Guangzhou, China.
⁴ Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
⁵ Department of Psychology, Western University, London, Ontario, Canada.
⁶ Department of Family Medicine, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.
⁷ Department of Sociology, Yale University, New Haven, Connecticut, USA.
⁸ Center for Population, Family, and Health, University of Antwerp, Antwerp, Belgium.
⁹ Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
¹⁰ School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
¹¹ Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
¹² Botswana Sexual and Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
¹³ Faculty of Humanities, Charles University, Prague, Czech Republic.
¹⁴ National Institute of Mental Health, Klecany, Czech Republic.
¹⁵ Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
¹⁶ Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina.
¹⁷ Gorgas Memorial Institute for Health Studies, Panama City, Panama.
¹⁸ Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
¹⁹ Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia.
²⁰ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
²¹ Department of Sociology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
²² Health Systems Strengthening, Foundation for Professional Development, Pretoria, South Africa.
²³ School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
²⁴ Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
²⁵ End FGM/C Centre of Excellence, Amref Health Africa, Nairobi, Kenya.
²⁶ MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom.
²⁷ Department of Psychology, Sapienzo University, Rome, Italy.
²⁸ Ministry of Health Malaysia, Putrajaya, Malaysia.
²⁹ Asia-Europe Institute, Universiti Malaya, Kuala Lumpur, Malaysia.
³⁰ Institute of Public Health, Riga Stradins University, Riga, Latvia.
³¹ College of Medicine, University of Ibadan, Ibadan, Nigeria.
³² Department of Dermatology, Venereology & Andrology, Sohag University, Sohag, Egypt.
³³ Department of Psychology, University of the Republic, Montevideo, Uruguay.
³⁴ Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAand.
³⁵ Primary Care and Prevention, Center for Research in Epidemiology and Public Health, National Institute of Health and Medical Research 1018, Villejuif, France.

PMID: 35136960
PMCID: PMC9383436
DOI: 10.1093/cid/ciac102

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.

Keywords: HIV; condom use; sexual behavior; sexual violence; sexually transmitted infections.

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Figures

**Figure 1.**
World map with the 25 countries included in the I-SHARE shaded. Abbreviation: I-SHARE, International Sexual Health And REproductive Health during COVID-19 Study.

See this image and copyright information in PMC

Update of

The International Sexual Health And Reproductive Health Survey (I-SHARE-1): A Multi-Country Analysis of Adults from 30 Countries Prior to and During the Initial COVID-19 Wave.
Erausquin JT, Tan RKJ, Uhlich M, Francis JM, Kumar N, Campbell L, Zhang WH, Hlatshwako TG, Kosana P, Shah S, Brenner EM, Remmerie L, Mussa A, Klapilova K, Mark K, Perotta G, Gabster A, Wouters E, Burns S, Hendriks J, Hensel DJ, Shamu S, Strizzi JM, Esho T, Morroni C, Eleuteri S, Sahril N, Low WY, Plasilova L, Lazdane G, Marks M, Olumide A, Abdelhamed A, López Gómez A, Michielsen K, Moreau C, Tucker JD; I-SHARE research consortium. Erausquin JT, et al. medRxiv [Preprint]. 2021 Oct 19:2021.09.18.21263630. doi: 10.1101/2021.09.18.21263630. medRxiv. 2021. Update in: Clin Infect Dis. 2022 Aug 24;75(1):e991-e999. doi: 10.1093/cid/ciac102. PMID: 34704103 Free PMC article. Updated. Preprint.

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Nimbi FM, Cavagnis S, Eleuteri S. Nimbi FM, et al. Int J Environ Res Public Health. 2024 Jan 15;21(1):96. doi: 10.3390/ijerph21010096. Int J Environ Res Public Health. 2024. PMID: 38248559 Free PMC article.
COVID-19 and Female Genital Mutilation/Cutting and child marriage: An online multi-country cross sectional survey.
Pande S, Shamu S, Abdelhamed A, Munyao Kingoo J, Van de Velde S, Temmerman M, Esho T, Kimani S, Omwoha J, Kpokiri EE, Tucker JD. Pande S, et al. PLoS One. 2024 Oct 31;19(10):e0304671. doi: 10.1371/journal.pone.0304671. eCollection 2024. PLoS One. 2024. PMID: 39480788 Free PMC article.
Sexual and reproductive health during COVID-19 - the I-SHARE multi-country survey.
Tan RKJ, Michielsen K, Campbell L, Tucker JD. Tan RKJ, et al. Nat Rev Urol. 2022 Jun;19(6):325-326. doi: 10.1038/s41585-022-00603-3. Nat Rev Urol. 2022. PMID: 35538153 Free PMC article.
Assessing changes in adolescent girls' and young women's sexual and reproductive health service utilisation following a COVID-19 lockdown in eSwatini.
Brault MA, Linnander EL, Ginindza TM, Mabuza K, Christie S, Canavan ME, Jones A, Desai MM. Brault MA, et al. Glob Health Action. 2023 Dec 31;16(1):2243760. doi: 10.1080/16549716.2023.2243760. Glob Health Action. 2023. PMID: 37565704 Free PMC article.
Impact of the COVID-19 pandemic on sexually transmitted infection testing and diagnosis in Lebanon: A retrospective chart review.
Sunji N, Boufadel P, Fakih I, Ahmad JH, Choufani M, Habib N, Rizk JP, Yammine R, Abu Zaki S, Assi A, Abu-Raddad LJ, Fahme S, Mumtaz GR. Sunji N, et al. Heliyon. 2024 Oct 10;10(20):e39191. doi: 10.1016/j.heliyon.2024.e39191. eCollection 2024 Oct 30. Heliyon. 2024. PMID: 39640771 Free PMC article.

See all "Cited by" articles

References

1. Hall KS, Samari G, Garbers S, et al. Centring sexual and reproductive health and justice in the global COVID-19 response. The Lancet 2020; 395:1175–7. - PMC - PubMed
1. Hall B, Tucker JD.. Surviving in place: the coronavirus domestic violence syndemic. Asian Journal of Psychiatry 2020; 53:102179. - PMC - PubMed
1. World Health Organization. Disruption in HIV, hepatitis and STI services due to COVID-19. Geneva, Switzerland: WHO, 2020.
1. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD.. How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet 2020; 395:931–4. - PMC - PubMed
1. Hale T, Petherick A, Phillips T, Webster S.. Variation in government responses to COVID-19. Blavatnik school of government working paper. 2020; 31:2020–11.

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[1] Hall KS, Samari G, Garbers S, et al. Centring sexual and reproductive health and justice in the global COVID-19 response. The Lancet 2020; 395:1175–7. - PMC - PubMed

[2] Hall KS, Samari G, Garbers S, et al. Centring sexual and reproductive health and justice in the global COVID-19 response. The Lancet 2020; 395:1175–7. - PMC - PubMed

[3] Hall B, Tucker JD.. Surviving in place: the coronavirus domestic violence syndemic. Asian Journal of Psychiatry 2020; 53:102179. - PMC - PubMed

[4] Hall B, Tucker JD.. Surviving in place: the coronavirus domestic violence syndemic. Asian Journal of Psychiatry 2020; 53:102179. - PMC - PubMed

[5] World Health Organization. Disruption in HIV, hepatitis and STI services due to COVID-19. Geneva, Switzerland: WHO, 2020.

[6] World Health Organization. Disruption in HIV, hepatitis and STI services due to COVID-19. Geneva, Switzerland: WHO, 2020.

[7] Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD.. How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet 2020; 395:931–4. - PMC - PubMed

[8] Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD.. How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet 2020; 395:931–4. - PMC - PubMed

[9] Hale T, Petherick A, Phillips T, Webster S.. Variation in government responses to COVID-19. Blavatnik school of government working paper. 2020; 31:2020–11.

[10] Hale T, Petherick A, Phillips T, Webster S.. Variation in government responses to COVID-19. Blavatnik school of government working paper. 2020; 31:2020–11.

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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

Collaborators

Affiliations

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

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Collaborators

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Abstract

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Update of

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