OBJECTIVE: The SARS-CoV-2 pandemic had a variable impact on sexually transmitted infections (STIs) in different regions of the world. There are currently no data on the impact of the pandemic on STIs in Nigeria. This study estimated the impact of the SARS-CoV-2 pandemic on non-HIV STIs, sexual behaviors, and treatment outcomes at an STI clinic in Ile-Ife, Nigeria.

PATIENTS AND METHODS: A retrospective review of the records of symptomatic non-HIV STI patients, diagnosed between February 2017 and January 2023 was conducted. We compared the trends in STIs, sexual behaviors, and clinical outcomes before (February 2017-January 2020) and during (February 2020-January 2023) SARS-CoV-2 pandemic periods. The data between the two periods were compared using bivariate and multivariate statistical tests, and the level of statistical significance was set at p-value <0.05.

RESULTS: There was a remarkable decline (88.89%) in the number of consultations for new STIs during the early phase of the pandemic, followed by a gradual rise to pre-pandemic levels in the latter part of the pandemic. The observed decline was most significant for STIs with relatively short incubation periods, such as non-gonococcal urethritis (p=0.024) and genital scabies (p=0.030), which declined by -68.7% and -75.0%, respectively. STIs with relatively longer incubation periods, such as syphilis and genital warts, did not decline significantly from pre-pandemic levels (p>0.05). The intra-pandemic STI patients exhibited greater STI risk behaviors and were significantly more likely to default from care than the pre-pandemic counterparts (adj OR= 2.479, 95% CI: 1.256-4.890).

CONCLUSIONS: Public health measures instituted to curb the spread of SARS-CoV-2 at the onset of the pandemic resulted in a significant decline in STI transmission in the early phase of the pandemic. However, increased STI risk behaviors and higher rates of default from clinical care during the peak pandemic period may have negated such benefits, resulting in a rapid increase in the incidence of new STIs with potentially worse treatment outcomes in the latter parts of the pandemic.