Increased Depression and Anxiety among Men and Transgender Women Receiving Care at a Sexual Health Clinic in New York City During COVID-19

Background Clients seeking sexual health care often need concurrent mental healthcare services, which were disrupted during the COVID-19 pandemic. Using data from two studies conducted before and after the onset of COVID-19, we examined changes in self-reported depression and anxiety scores among clients in a sexual health clinic in New York City (NYC). Methods We enrolled 144 participants pre-COVID-19 and 319 post-COVID-19 pandemic onset. Participants completed questionnaires assessing demographics, sexual behaviors, and mental health status. Primary mental outcomes included depression (Patient Health Questionnaire [PHQ-9]) and anxiety (Generalized Anxiety Disorder Scale [GAD-7]). We conducted descriptive analyses and used generalized linear mixed models (GLMM) to estimate predictors of mental health changes. Results Cohorts were comparable by age, self-identified gender, race/ethnicity, income, HIV and sexually transmitted infection (STI) assessment scores. Post-COVID-19 participants reported significantly higher mean PHQ-9 and GAD-7 scores compared to pre-COVID-19 participants (3.6 ± 4.2 vs 5.7 ± 5.3, p<0.001; 3.9 ± 4.3 vs 5.1 ± 5.0; p=0.019). Post-COVID-19 participants were also more likely to be uninsured or on Medicaid (2.7% vs 20%, 18% vs 30%, p<0.001), and to report intimate partner violence (IPV) victimization (24% vs 45%, p=0.003). Adjusted GLMM showed post-COVID-19 was associated with a 1.55 (95%CI: 0.07, 3.03, p<0.04) mean increase in PHQ-9 scores, but not GAD-7. Conclusions Depression and anxiety scores increased after the onset of the COVID-19 pandemic in this NYC sexual health clinic sample. The sustained impact of the COVID-19 pandemic on depression calls for integrated, accessible mental health services within sexual health care settings.