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      Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

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          Abstract

          Objectives

          The COVID-19 pandemic has exposed and exacerbated existing socioeconomic and health disparities, including disparities in sexual health and well-being. While there have been several reviews published on COVID-19 and population health disparities generally—including some with attention to HIV—none has focused on sexual health (ie, STI care, female sexual health, sexual behaviour). We have conducted a scoping review focused on sexual health (excluding reproductive health (RH), intimate partner violence (IPV) and gender-based violence (GBV)) in the COVID-19 era, examining sexual behaviours and sexual health outcomes.

          Methods

          A scoping review, compiling both peer-reviewed and grey literature, focused on sexual health (excluding RH, IPV and GBV) and COVID-19 was conducted on 15 September 2020. Multiple bibliographical databases were searched. Study selection conformed to Joanna Briggs Institute (JBI) Reviewers’ Manual 2015 Methodology for JBI Scoping Reviews. We only included English-language original studies.

          Results

          We found that men who have sex with men may be moving back toward pre-pandemic levels of sexual activity, and that STI and HIV testing rates seem to have decreased. There was minimal focus on outcomes such as the economic impact on sexual health (excluding RH, IPV and GBV) and STI care, especially STI care of marginalised populations. In terms of population groups, there was limited focus on sex workers or on women, especially women’s sexual behaviour and mental health. We noticed limited use of qualitative techniques. Very few studies were in low/middle-income countries (LMICs).

          Conclusions

          Sexual health research is critical during a global infectious disease pandemic and our review of studies suggested notable research gaps. Researchers can focus efforts on LMICs and under-researched topics within sexual health and explore the use of qualitative techniques and interventions where appropriate.

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          Most cited references135

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

            Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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              Scoping studies: towards a methodological framework

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                Author and article information

                Journal
                Sex Transm Infect
                Sex Transm Infect
                sextrans
                sti
                Sexually Transmitted Infections
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1368-4973
                1472-3263
                September 2021
                29 March 2021
                29 March 2021
                : 97
                : 6
                : 402-410
                Affiliations
                [1 ]departmentDepartment of Sociology , Yale University , New Haven, Connecticut, USA
                [2 ]departmentHarvey Cushing/John Hay Whitney Medical Library , Yale University School of Medicine , New Haven, Connecticut, USA
                [3 ]Department of Environmental Health Sciences, Yale School of Public Health , New Haven, CT, USA
                [4 ]departmentDepartment of Biostatistics , Yale School of Public Health , New Haven, CT, USA
                [5 ]departmentSchool of Public Health , Free University of Brussels , Brussels, Belgium
                [6 ]departmentInternational Centre for Reproductive Health, Department of Public Health and Primary Care , Ghent University , Ghent, Belgium
                [7 ]departmentDepartment of Global Public Health , Karolinska Institutet , Stockholm, Sweden
                [8 ]departmentDepartment of Psychology , University of Friborg , Fribourg, Switzerland
                [9 ]departmentDepartment of Sociology, Centre for Population, Family and Health , University of Antwerp , Antwerp, Belgium
                [10 ]departmentDepartment of Family Medicine and Primary Care, School of Clinical Medicine, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg-Braamfontein, Gauteng, South Africa
                [11 ]departmentPublic Health Education , University of North Carolina at Greensboro , Greensboro, North Carolina, USA
                [12 ]departmentDepartment of Women's and Children's Health , Karolinska Institutet , Stockholm, Sweden
                [13 ]departmentDepartment of Epidemiology, Mailman School of Public Health , Columbia University , New York, NY, USA
                [14 ]departmentSchool of Social Justice , Queensland University of Technology , Brisbane, Queensland, Australia
                [15 ]departmentFaculty of Medicine and Health , University of New England , Armidale, New South Wales, Australia
                [16 ]University of North Carolina at Chapel Hill School of Medicine , Chapel Hill, North Carolina, USA
                [17 ]departmentSchool of Medicine , University of North Carolina at Chapel Hill , Chapel Hill, NC, USA
                [18 ]departmentFaculty of Infectious and Tropical Diseases , London School of Hygiene and Tropical Medicine , London, UK
                Author notes
                [Correspondence to ] Navin Kumar, Yale University, New Haven, CT 06511, USA; navin183@ 123456gmail.com
                Author information
                http://orcid.org/0000-0003-4502-069X
                http://orcid.org/0000-0003-4271-6077
                Article
                sextrans-2020-054896
                10.1136/sextrans-2020-054896
                8380886
                33782145
                a25b57d3-74e1-4674-aa7a-f812d75264ce
                © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

                This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

                History
                : 30 November 2020
                : 20 February 2021
                : 27 February 2021
                Funding
                Funded by: Fund for Lesbian and Gay Studies, Yale University;
                Categories
                Review
                2474
                Custom metadata
                free

                Sexual medicine
                covid-19,sexual health,hiv,sex work,sexual and gender minorities
                Sexual medicine
                covid-19, sexual health, hiv, sex work, sexual and gender minorities

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