了解 COVID-19 大流行如何影响性与生殖健康 (SRH) 就诊。一项生态研究比较了 COVID-19 大流行爆发前后不同国家的 SRH 服务量。来自国际初级保健联盟的七个国家遍布四大洲的大数据研究人员 (INTRePID)。澳大利亚、中国、加拿大、挪威、新加坡、瑞典和美国的初级保健医生接受了超过 380 万次 SRH 就诊。大流行之前和期间 SRH 平均每月就诊的差异，具有负二项式回归模型比较大流行期间 SRH 就诊的预测和观察次数。2018 年至 2021 年每月去看初级保健医生的次数。大流行期间，加拿大每月 SRH 就诊的平均量增加了（15.6%、99%） CI 8.1-23.0%），其中虚拟护理很明显。中国、新加坡、瑞典和美国出现下降（-56.5%，99% CI -74.5 至 -38.5%；-22.7%，99% CI -38.8 至 -6.5%；-19.4%，99% CI -28.3 至-10.6%；和 -22.7%，99% CI 分别为 -38.8 至 -6.5%）；而澳大利亚和挪威则变化不大（6.5%，99% CI -0.7 至 -13.8% 和 1.7%，99% CI -6.4 至 -9.8%）。保持（澳大利亚、挪威）或超过（加拿大）大流行前就诊率的国家最大程度地使用了虚拟护理。在大流行期间，亲自到初级保健机构就诊的性健康和生殖健康人数有所减少。虚拟护理似乎抵消了这种下降。尽管宫颈癌筛查似乎对虚拟护理不敏感，但将自行采集的样本纳入 HPV 检测等策略可能会在未来的大流行中提供解决方案。© 2023 作者。 BJOG：约翰·威利出版的国际妇产科杂志

To understand how the COVID-19 pandemic has impacted sexual and reproductive health (SRH) visits.An ecological study comparing SRH services volume in different countries before and after the onset of the COVID-19 pandemic.Seven countries from the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID) across four continents.Over 3.8 million SRH visits to primary care physicians in Australia, China, Canada, Norway, Singapore, Sweden and the USA.Difference in average SRH monthly visits before and during the pandemic, with negative binomial regression modelling to compare predicted and observed number of visits during the pandemic for SRH visits.Monthly number of visits to primary care physicians from 2018 to 2021.During the pandemic, the average volume of monthly SRH visits increased in Canada (15.6%, 99% CI 8.1-23.0%) where virtual care was pronounced. China, Singapore, Sweden and the USA experienced a decline (-56.5%, 99% CI -74.5 to -38.5%; -22.7%, 99% CI -38.8 to -6.5%; -19.4%, 99% CI -28.3 to -10.6%; and -22.7%, 99% CI -38.8 to -6.5%, respectively); while Australia and Norway showed insignificant changes (6.5%, 99% CI -0.7 to -13.8% and 1.7%, 99% CI -6.4 to -9.8%). The countries that maintained (Australia, Norway) or surpassed (Canada) pre-pandemic visit rates had the greatest use of virtual care.In-person SRH visits to primary care decreased during the pandemic. Virtual care seemed to counterbalance that decline. Although cervical cancer screening appeared insensitive to virtual care, strategies such as incorporating self-collected samples for HPV testing may provide a solution in a future pandemic.© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.