Suspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex

doi:10.1590/0034-7167-2020-0913

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (suppl 2) • 2020 • https://doi.org/10.1590/0034-7167-2020-0913 copy

Suspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex

Síndrome gripal sospecha de COVID-19 en hombres que tienen sexo con hombres y se envolvieron en sexo ocasional

About the SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation.

Method:

National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling.

Results:

1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p < 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7).

Conclusion:

Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation.

Descriptors:
Men; Homosexuality, Male; Coronavirus; Pandemics; COVID-19

Variables	n	%
Social and demographic characterization
Gender identity
Cisgender man	1.333	99.7
Transgender man	4	0.3
Age
18-20 years	68	5.1
21-30 years	930	69.5
31-40 years	172	12.9
41-50 years	111	8.3
> 50 years	56	4.2
Resides in metropolitan area/large centers?
Yes	1005	75.2
No	332	24.8
Current relationship type
Single	965	72.2
In a polyamorous relationship	48	3.6
In a fixed relationship	324	24.2
Who do you usually have sex with?
Casual partner	971	72.6
Casual/fixed partners	215	16.1
Fixed partner	151	11.3
Are you living with your sexual partner?
Yes	156	42.7
No	209	57.3
Are you in social isolation?
Yes	850	63.6
Partially	438	32.7
No	49	3.7
Duration of the current social isolation
Less than 30 days	294	22
Between 30 and 45 days	765	57.2
More than 45 days	237	17.7
I am not in social distancing	41	3.1
How do you rate the impact of social isolation in your life?
High impact	593	44.3
Medium impact	561	42
Low impact	183	13.7
Partnerships and sexual activities during periods of social isolation
Number of partners
1	456	34.1
2 to 3	762	57
> 3	119	8.9
Paid for sexual relations
Yes	59	4.4
No	1.278	95.6
Orgy/Menage (Sexual intercourse, simultaneously, with two or more people)
Yes	385	28.8
No	952	71.2
Chemsex (Sexual intercourse under the effect of licit or illicit substances)
Yes	942	70.5
No	395	29.5
Sexual intercourse without condom use?
Yes	533	39.9
No	804	60.1
Signs and symptoms of flu-like syndrome presented in the period of social isolation
Fever
Yes	516	38.6
No	821	61.4
Cough
Yes	781	58.4
No	556	41.6
Sore throat
Yes	776	58
No	561	42
Tiredness or fatigue
Yes	378	28.3
No	959	71.7
Dyspnea/Respiratory discomfort
Yes	479	35.8
No	858	64.2
At least one sign/symptom
Yes	790	59.1
No	547	40.9
Fever associated with another sign/symptom of flu-like syndrome
Yes	514	38.4
No	823	61.6

Factors of interest	Presence of signs and symptoms of flu-like syndrome
	Yes		No		p value
	n	%	n	%	p value
Age (years)					< 0,001
18-20	17	25,0	51	75,0
21-30	392	42,2	538	57,8
31-40	63	36,6	109	63,46
41-50	30	27,0	81	73,03
More than 50 years	12	21,4	44	78,6
Gender Identity					0,305*
Cisgender man	514	38,6	819	61,4
Transgender man	-	-	4	100
Resident in metropolitan area/large centers					< 0,001
Yes	427	42,5	578	57,5
No	87	25,2	245	73,8
Is social distancing					0,515*
Yes	330	38,8	520	61,2
Partially	169	38,6	269	61,4
No	15	30,6	34	69,4
Duration of the current social isolation					< 0,001
Less than 30 days	104	35,4	190	64,6
Between 30 and 45 days	270	35,3	495	64,7
More than 45 days	126	53,2	111	46,8
I'm not distancing myself	14	34,1	27	65,9
Perceived impact of social isolation					< 0,001
Low impact	89	48,6	94	51,4
Medium impact	151	26,9	410	73,1
High impact	274	46,2	319	53,8
Sexual practices
Type of partner					< 0,001
Casual partner	427	44,0	544	56,0
Casual/fixed partners	69	32,1	146	67,9
Fixed partner	18	11,9	133	88,1
Current relationship type					< 0,001
Single	425	44,0	540	56,0
In a polyamorous relationship	15	31,3	33	68,8
In a fixed relationship	74	22,8	250	77,2
Living with your sexual partner					0,007
Yes	26	16,7	130	83,3
No	60	28,7	149	71,3
Sexual activity in the period of social isolation due to COVID-19
Paid for sexual relations	42	71,2	17	28,8	< 0,001
Had sex, simultaneously, with two or more people	182	47,3	203	52,7	< 0,001
Had sexual intercourse under the effect of licit or illicit substances	395	41,9	547	58,1	< 0,001
Had sex without a condom	297	55,7	236	44,3	<0,001
Amount of partners during the period of social withdrawal					< 0,001
1	67	14,7	389	85,3
2-3	343	45,0	419	55,0
> 3	104	87,4	15	12,6

Factors of interest	Presence of signs and symptoms of flu-like syndrome
	Yes	No	p value^* * Test t the Student.
	Average (SD)	Average (SD)	p value^* * Test t the Student.
Ages (years)	29.92 (6.3)	30.54 (8.7)	0.165
Amount of partners during the period of social isolation	3.5 (3.4)	1.7 (0.9)	<0.001

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[1] Corresponding author: Álvaro Francisco Lopes de Sousa. E-mail: alvarosousa@usp.br