Adolescent health behaviors in the time of COVID-19

摘要 2019冠状病毒病大流行及相关公共卫生政策（例如，物理距离，学校关闭，疫苗 分布）可能会影响美国青少年的短期和长期性健康行为 美国。虽然对于减轻COVID-19对人口健康的影响至关重要，但这些必要的 公共卫生措施可能严重干扰性健康服务的提供和获取 (i.e.,避孕、HIV/STI检测、暴露前预防[PrEP]）。此外，新出现的证据 强调了身体距离措施对性行为以及心理健康的巨大影响 和物质使用。这一领域的初步研究是在成年人中进行的。很可能这些影响 考虑到青少年的发育阶段，这种情况可能更加明显。 在美国，13-17岁的青少年受到性传播感染（STI）的严重影响， 意外怀孕初步数据显示，COVID-19大流行和相关政策可能 具有两种有害影响，包括减少STI测试的机会，同时也具有潜在的 积极影响，如减少无安全套性行为对青少年性健康的机会。的 COVID-19和相关政策对青少年性健康行为的影响尚未得到系统的研究 然而，调查。此外，COVID-19可能会放大现有的性健康差异， 性和性别少数群体（SGM）和种族/少数民族青年。鉴于COVID-19不成比例地 在影响边缘化社区的同时，了解这一流行病如何影响 面对健康差距的青年的性健康。 调查COVID-19大流行和相关公共卫生政策如何影响性健康 青少年的短期和长期行为，我们建议通过社交媒体和调查招募 在线纵向队列的2000 13-17岁的青少年来自美国各地。SGM和种族/少数民族青年 会被过度招募。我们将在三年半的时间里对青年进行12次调查，以：（1）确定 COVID-19对她们性健康行为的影响（艾滋病毒/性传播感染;意外怀孕; 阴茎-阴道和阴茎-肛门性行为;使用安全套和避孕措施的性行为次数 行为;艾滋病毒/性传播感染检测;和PrEP吸收）;（2）确定性健康行为的纵向趋势， COVID-19大流行和相关公共卫生政策的变化;以及（3）研究趋势如何因重要性而变化 青年的亚群体（即，按出生时的性别、性别、性身份和种族/民族身份）。 COVID-19大流行在很短的时间内彻底改变了美国青少年的生活， 时间量。了解这种变化与他们的性健康行为的关系将至关重要， 继续缩小青少年之间的健康差距。

ABSTRACT The COVID-19 pandemic and related public health policies (e.g., physical distancing, school closures, vaccine distribution) are likely impacting the short- and long-term sexual health behaviors of adolescents in the United States (US). Although essential to mitigate the effects of COVID-19 on population health, these necessary public health measures may be substantially disrupting the provision of and access to sexual health services (i.e., contraception, HIV/STI testing, pre-exposure prophylaxis [PrEP]). Further, emerging evidence underscores the drastic impact of physical distancing measures on sexual behaviors, as well as mental health and substance use. The nascent research in this area has been among adults. It is likely that these effects may be even more pronounced among adolescents given their developmental stage. Youth 13–17 years of age in the US are substantially burdened by sexually transmitted infections (STIs) and unintended pregnancies. Preliminary data suggest that the COVID-19 pandemic and related policies may be having both deleterious effects, including decreased access to STI testing, while also having potentially positive impacts, such as reduced opportunities for condomless sex acts on adolescent sexual health. The effects of COVID-19 and related policies on adolescent sexual health behaviors have yet to be systematically investigated, however. Further, COVID-19 may be amplifying existing sexual health disparities experienced by sexual and gender minority (SGM) and racial/ethnic minority youth. Given that COVID-19 is disproportionately impacting marginalized communities, it is particularly critical to understand how the pandemic is influencing the sexual health of youth facing health disparities. To investigate how the COVID-19 pandemic and related public health policies are impacting the sexual health behaviors of adolescents both in the short- and long-term, we propose to recruit via social media and survey online a longitudinal cohort of 2000 13–17-year-olds from across the US. SGM and racial/ethnic minority youth will be over-recruited. We will survey youth 12 times over the course of 3.5 years to: (1) Identify the immediate impact of COVID-19 on their sexual health behaviors (HIV/STI acquisition; unintended pregnancy; number of penile-vaginal and penile-anal sex acts, respectively; number of condom- and contraceptive-protected sex acts; HIV/STI testing; and PrEP uptake); (2) Identify longitudinal trends in sexual health behaviors as the COVID-19 pandemic and related public health policies change; and (3) Examine how trends vary by important subgroups of youth (i.e., by sex assigned at birth, gender, sexual identity, and racial/ethnic identity). The COVID-19 pandemic has drastically changed the lives of adolescents across the US in a very short amount of time. Understanding how this change relates to their sexual health behaviors will be critical to continuing to reduce health disparities among adolescents.