How did the first wave of COVID-19 impact gay, bi, and queer men? Insights from the Engage COVID-19 Study

As time goes on, countless studies will explore how COVID-19 has impacted people in Canada’s biggest cities, but few will describe the unique experiences of gay, bisexual, and queer men (GBQM) during this time.

As part of the Engage study, we asked GBQM about their experiences of the COVID-19 pandemic using survey questionnaires and more in-depth qualitative interviews. Here we provide some initial findings (from the first wave of COVID-19) using our survey data. 

One key finding was that many participants experienced challenges with their mental wellbeing.

36.8% reported regular or near-constant stress due to the pandemic in the month before taking the survey, and the primary reasons for their stress were work-related (21.3%) or because of feelings of being trapped or a loss of freedom (18.3%). Most participants (52.2%) reported worsening mental health after the start of the COVID-19 pandemic, but a majority (60.7%) also reported receiving emotional support from friends or loved ones once a week or more. 

We also explored how the COVID-19 pandemic affected access to healthcare. Around half of Engage participants reported that their use of dental (52.8%) and family doctor (49.7%) services were impacted by COVID-19. Some people also avoided seeking care due to concerns about COVID safety: In our study, just under 1/3 of participants (32.1%) reported avoiding seeking healthcare due to COVID concerns.

Harm reduction services and HIV care were the least impacted. Respectively, 9.5% and 12.5% of respondents reported that access to these services was impacted by COVID-19. 

As for COVID-specific medical services, just under half (47.8%) of respondents had been tested for COVID as of May 2020, with 39.0% reporting experiencing any COVID symptoms. 9.6% reported a positive COVID-19 diagnosis.

When it came to participants’ sexual behaviour, the COVID-19 pandemic brought significant changes in this area as well. Nearly three quarters (72.3%) reported meeting guys from outside their households less or much less often compared to before the pandemic started; similarly, over three-quarters (77.3%) reported having less or much less anonymous sex. Phone sex saw the largest increase in reported frequency: 28.4% of respondents reported having more or much more phone sex since the start of the pandemic. 

29.7% of participants also reported experiencing impacts of COVID-19 on their access to and use of STI testing or treatment, and 21.2% of HIV- participants reported that they stopped taking pre-exposure prophylaxis (PrEP). 

These findings—including mental health challenges and disruptions in healthcare—are particularly relevant given the disproportionate mental health burden and barriers to healthcare access experienced by GBQM.  Continuing to address these inequities, for example, expanding mental health programming for GBQM, will be important in reacting to harms caused by the COVID-19 pandemic. 

However, in many ways GBQM also share the same sets of concerns and risks as other Canadians: 15.6% of the Engage sample were healthcare or other essential workers, and 22.2% were in contact with the public all the time or almost all the time at work; further, 11.2% indicated they could not stay home from work if sick. 

While COVID-19 brought greater attention to certain concerns—for example, access to healthcare and medication, workplace safety, isolation and emotional support, and financial security—these have also been long-standing concerns for GBQM prior to the pandemic. As we continue to analyze and share results from the Engage COVID-19 study, we’ll be able to better inform not just COVID-19 response, but other aspects of health and wellbeing for GBQM. 

Of course, the pandemic has also progressed since the completion of the first Engage COVID questionnaire module, and people’s experiences, behaviours, and attitudes have likewise changed and adjusted. We are eager to share the results of the second wave of data collection with you, and to explore how GBQM’s responses to the pandemic have changed as it’s progressed.

The Engage Cohort Study includes 1,248 GBQM living in Montreal, Toronto, and Vancouver. It covers a wide range of topics, including substance use, health and healthcare access, sexual behaviours, mental health, and community connections. The first round of COVID-19 questionnaires, described above, were gathered from the end of 2020 through the beginning of 2021.

Douglas Hanes and Daniel Grace 

University of Toronto, Dalla Lana School of Public Health

August 09th, 2022