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.

Asia Europe Institute Universiti Malaya Kuala Lumpur Malaysia

Botswana Sexual and Reproductive Health Initiative Botswana Harvard AIDS Institute Partnership Gaborone Botswana

Center for Population Family and Health University of Antwerp Antwerp Belgium

Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine London United Kingdom

Collaboration for Evidence Research and Impact in Public Health School of Population Health Curtin University Perth Australia

College of Medicine University of Ibadan Ibadan Nigeria

Department of Dermatology Venereology and Andrology Sohag University Sohag Egypt

Department of Family Medicine and Community Health University of Minnesota Medical School Minneapolis Minnesota USA

Department of Family Medicine School of Clinical Medicine University of Witwatersrand Johannesburg South Africa

Department of Pediatrics Indiana University School of Medicine Indianapolis Indiana USA

Department of Population Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USAand

Department of Psychology Sapienzo University Rome Italy

Department of Psychology University of the Republic Montevideo Uruguay

Department of Psychology Western University London Ontario Canada

Department of Public Health and Primary Care Faculty of Medicine and Health Sciences University of Ghent Ghent Belgium

Department of Public Health Education University of North Carolina Greensboro Greensboro North Carolina USA

Department of Public Health University of Copenhagen Copenhagen Denmark

Department of Sociology Indiana University Purdue University Indianapolis Indianapolis Indiana USA

Department of Sociology Yale University New Haven Connecticut USA

Dermatology Hospital of Southern Medical University Guangzhou China

End FGM C Centre of Excellence Amref Health Africa Nairobi Kenya

Faculty of Humanities Charles University Prague Czech Republic

Faculty of Psychology University of Buenos Aires Buenos Aires Argentina

Gorgas Memorial Institute for Health Studies Panama City Panama

Health Systems Strengthening Foundation for Professional Development Pretoria South Africa

Institute of Global Health and Infectious Diseases University of North Carolina at Chapel Hill Chapel Hill North Carolina USA

Institute of Public Health Riga Stradins University Riga Latvia

Ministry of Health Malaysia Putrajaya Malaysia

MRC Centre for Reproductive Health University of Edinburgh Edinburgh United Kingdom

National Institute of Mental Health Klecany Czech Republic

Primary Care and Prevention Center for Research in Epidemiology and Public Health National Institute of Health and Medical Research 1018 Villejuif France

Saw Swee Hock School of Public Health National University of Singapore Singapore

School of Public Health Université Libre de Bruxelles Brussels Belgium

School of Public Health University of Witwatersrand Johannesburg South Africa

University of North Carolina Project China Guangzhou China

medRxiv. 2021 Oct 19:2021.09.18.21263630. doi: 10.1101/2021.09.18.21263630. PubMed

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