Even if sex has declined, researchers question how long it can remain suppressed. Dr. Lehmiller noted that online dating apps report record business. Whether that translates into sexual activity rather than virtual meet-ups is unclear, he said. If people are returning to normal levels of encounters, they may not want to admit it.
“There is shaming about traveling, social events and gatherings during the pandemic, so sex and dating is seen as part of that,” he said.
Confused by the terms about coronavirus testing? Let us help:
- Antibody: A protein produced by the immune system that can recognize and attach precisely to specific kinds of viruses, bacteria, or other invaders.
- Antibody test/serology test: A test that detects antibodies specific to the coronavirus. Antibodies begin to appear in the blood about a week after the coronavirus has infected the body. Because antibodies take so long to develop, an antibody test can’t reliably diagnose an ongoing infection. But it can identify people who have been exposed to the coronavirus in the past.
- Antigen test: This test detects bits of coronavirus proteins called antigens. Antigen tests are fast, taking as little as five minutes, but are less accurate than tests that detect genetic material from the virus.
- Coronavirus: Any virus that belongs to the Orthocoronavirinae family of viruses. The coronavirus that causes Covid-19 is known as SARS-CoV-2.
- Covid-19: The disease caused by the new coronavirus. The name is short for coronavirus disease 2019.
- Isolation and quarantine: Isolation is the separation of people who know they are sick with a contagious disease from those who are not sick. Quarantine refers to restricting the movement of people who have been exposed to a virus.
- Nasopharyngeal swab: A long, flexible stick, tipped with a soft swab, that is inserted deep into the nose to get samples from the space where the nasal cavity meets the throat. Samples for coronavirus tests can also be collected with swabs that do not go as deep into the nose — sometimes called nasal swabs — or oral or throat swabs.
- Polymerase Chain Reaction (PCR): Scientists use PCR to make millions of copies of genetic material in a sample. Tests that use PCR enable researchers to detect the coronavirus even when it is scarce.
- Viral load: The amount of virus in a person’s body. In people infected by the coronavirus, the viral load may peak before they start to show symptoms, if symptoms appear at all.
For now, triage at clinics is pervasive. Pre-pandemic, the San Francisco City Clinic would typically send more than a hundred specimens to be processed daily at the health department laboratory. Because those supplies have dwindled, the clinic is resorting to a smaller, more expensive backup system, that can only process several dozen gonorrhea and chlamydia tests a day, said Dr. Ina Park, an associate professor of community and family medicine at the University of California San Francisco School of Medicine.
Men who take PrEP to prevent H.I.V. transmission should be screened for S.T.D.s every three months, but many clinics have spaced out those screenings to every six months, she said.
A Michigan colleague who had run out of urine testing kits for chlamydia and gonorrhea, she said, was returning to techniques that had been replaced almost 20 years ago: “using older swabs that have to be placed a few centimeters inside the urethra of the penis and twirled around to obtain a specimen. It’s highly unpleasant for the patient and doesn’t encourage them to return for testing,” Dr. Park said.
“I’m concerned that this will worsen mistrust in the medical establishment, which is already an issue with some of the patients we serve,” added Dr. Park, the author of “Strange Bedfellows,” a book out in February on the history and science of sexually transmitted diseases.
David C. Harvey, executive director of the National Coalition of STD Directors, said clinics are trying to come up with creative solutions, such as telemedicine visits. In a few districts where the biggest challenge is reduced clinic access, administrators are trying out test kits that allow patients to collect specimens at home, which they then mail to labs. And some clinics are working with pharmacies that can draw blood and have standing orders for some medications. Public health officials see these innovations as a silver lining that may continue after the pandemic abates.
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