"Now it's more of an effort": COVID-19 impacts on HIV/STI testing among young queer men and non-binary adults.

The purpose of this study was to (1) explore how COVID-19 affected different experiences of HIV/STI testing, such as venue-based (in-person), telemedicine and at-home HIV/STI testing provided by the #MVMNT study, and (2) how HIV/STI testing utilization themes and experiences reflected different contextual factors of the Andersen behavioral model. We conducted semi-structured interviews with 48 queer men and non-binary individuals from the Northeast and Southeast regions. Themes were organized using the Andersen behavioral model: (1) environmental factors, (2) population characteristics, (3) health behavior and (4) health outcomes. Accessing HIV/STI testing through traditional healthcare systems was challenging for several participants owing to constantly changing COVID-19 protocols (e.g., outdated hours of operation, long wait times and scheduling precautions). Otherfactors such as opting out of HIV/STI testing due to the higher risk of contracting COVID-19 highlight the convenience and compromises of telemedicine HIV/STI testing (e.g., accessible, but not as holistic as in-person care). Given these findings, health systems, hospitals, departments of health and community clinics can be better situated to continue HIV/STI testing service deliveries in times of rapidly changing health emergencies without overextending their institutional capacities by ensuring that in-person and telemedicine HIV/STI testing options are accessible and affordable.