# The Impact of the COVID-19 Pandemic on STI and HIV Services in the Netherlands According to Health Care Professionals

## TL;DR

The study explores how the COVID-19 pandemic affected STI and HIV care in the Netherlands, focusing on challenges faced by vulnerable populations and the shift to online services.

## Contribution

The study provides new insights into the pandemic's impact on STI/HIV care from healthcare professionals' perspectives, highlighting disparities and online care challenges.

## Key findings

- Vulnerable populations, such as migrants and those with low digital literacy, faced greater barriers to STI/HIV care during the pandemic.
- Professionals reported concerns about the quality and follow-up of online STI/HIV care, especially with private providers.
- The pandemic may have worsened existing disparities in access to STI/HIV services.

## Abstract

Surveillance data from the Netherlands show that STI/HIV testing decreased at the start of the COVID-19 pandemic, suggesting barriers to access to STI/HIV care. However, the impact of the pandemic on STI/HIV care may be more complex, and key populations could be differentially affected. The aim of this study was to gain more insight into the impact of COVID-19 on STI/HIV care in the Netherlands from the perspective of STI/HIV care providers. We investigated whether professionals in STI/HIV care experienced changes compared to pre-COVID in access to STI/HIV care for priority populations, demand and provision of STI/HIV care, shifts to online STI/HIV counseling and care, and the quality assurance of STI/HIV care. An online survey was completed by 192 STI/HIV care professionals. Additionally, semi-structured interviews were held with 23 STI/HIV care professionals. According to participants, people in vulnerable circumstances, such as recent migrants and people with low health or digital literacy, may have had difficulties accessing STI/HIV care during the pandemic, especially during lockdowns and at public sexual health services. Hence, these may not have received the care they needed. Participants thought that COVID-19 measures may have compounded existing disparities. Furthermore, participants found that online care provision was not up to standard and were concerned about follow-up care for patients using private online providers of remote tests. It is important to explore how STI/HIV care for people in vulnerable circumstances can be ensured in future public health crises.