Abstract
BACKGROUND: Relaxing Coronavirus Disease 2019 (COVID-19) control measures and "resume normal" might have direct impacts on sexual behaviors and utilization of HIV prevention and sexual health services among gay, bisexual and other men who have sex with men (GBMSM). To address the knowledge gaps, this study aimed to compare self-reported changes in sexual risk behaviors and HIV service utilization among GBMSM in the post-pandemic era between Beijing and Hong Kong. In addition, the determinants of self-reported increase in condomless anal sex (CAS) were investigated among GBMSM in Beijing or Hong Kong. METHODS: This cross-sectional study was conducted between November 2023 and March 2024. Participants were Chinese males aged ≥ 18 years who had anal sex with at least one man in the past six months recruited through multiple sources. Eligible GBMSM completed a telephone interview. A multiple logistic regression model was then fitted. RESULTS: A total of 524 GBMSM in Beijing and 613 in Hong Kong completed the telephone interview. After adjusting for background characteristics with between-city differences, more GBMSM in Beijing self-reported an increase in the frequency of CAS with men (23.7% versus 7.8%, p < 0.001), anal sex with regular male sex partners (30.5% versus 15.5%, p < 0.001) and non-regular male sex partners (27.5% versus 16.0%, p < 0.001), seeking male partners online (28.8% versus 18.9%, p < 0.001), sexualized drug use (SDU) (9.4% versus 2.3%, p < 0.001), and using HIV testing (31.5% versus 11.7%, p < 0.001), pre-exposure prophylaxis (PrEP) (18.9% versus 3.6%, p < 0.001) and other HIV prevention services (20.2% versus 10.1%, p < 0.001). GBMSM in both cities who self-reported increases in the frequency of anal sex with regular and non-regular male sex partners, having sex with men coming from other cities, seeking male partners online, utilization of SDU, HIV testing, PrEP and other HIV prevention services were more likely to report an increase in CAS. CONCLUSIONS: More GBMSM in Beijing than their counterparts in Hong Kong reported increases in the frequency of sexual risk behaviors and HIV prevention services utilization when comparing their current situation with the time during COVID-19. Our findings highlighted the importance of strengthening HIV prevention in GBMSM in the post-pandemic era.