Concerns that high-risk men on pre-exposure prophylaxis (PrEP) for HIV would stop using condoms and start getting other sexually transmitted infections have been somewhat validated in a Boston clinic.
When pharmaceutical pre-exposure prophylaxis (PrEP) first came on the scene, some AIDS advocates were concerned that high-risk men would stop using condoms and start getting other sexually transmitted infections.
A study due to be presented October 29 at IDWeek 2016 in New Orleans, Louisiana shows those concerns may be valid.
Researchers Kenneth Mayer, MD, and colleagues from the Beth Israel Deaconess Medical Center in Boston, Massachusetts, report that HIV infection and PrEP are independently associated with increasing diagnoses of bacterial sexually transmitted infections in men who get care at their Boston community health center.
Fenway Health, an urban community health center, provides primary and HIV and sexually transmitted infection care for 27,000 patients annually.
The study looked at trends in bacterial sexually transmitted infections (BSTI) in the clinic's male patients.
Of the 19,238 men who had at least one clinic visit from 2005 to 2015, nearly half were gay or bisexual.
HIV prevalence was 14.7%.
Of men seen in 2015, 14.2% were getting PrEP.
Between 2005 and 2015, 17.5% were diagnosed with at least one BSTI.
In 2015, 13.9% of HIV infected patients and 24.8% of PrEP patients had at least on BSTI.
The risk of getting at BSTI was 2.66 times greater in patients with HIV, an 3.43 times greater in men getting PrEP.
The team called on clinicians to be aware of this enhanced risk and to do more testing for BSTI in these patients.
“PrEP use and HIV infection were each associated with increasing BSTI rates,” and these infections were more common among men of color and/or those without stable health insurance," they noted.
“Increased BTSI screening and education is warranted for patients in these subgroups,” they said.