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Changes in Sexual Behavior and STI Diagnoses Among MSM Initiating PrEP in a Clinic Setting

Michalina A Montaño1, Julia C Dombrowski2,3, Sayan Dasgupta4

  • 1Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Box 357236, Seattle, WA, 98195, USA. micham@uw.edu.

AIDS and Behavior
|August 18, 2018
PubMed

Insights

Condom use decreased among men who have sex with men (MSM) starting pre-exposure prophylaxis (PrEP). Sexually transmitted infection (STI) prevalence was higher during PrEP use, potentially due to increased screening.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Sexual Health

Background:

  • Pre-exposure prophylaxis (PrEP) is a key HIV prevention strategy for men who have sex with men (MSM).
  • Understanding behavioral changes and infection rates during PrEP use is crucial for optimizing prevention efforts.
  • Previous studies suggest mixed impacts of PrEP on sexual behaviors and STI acquisition.

Purpose of the Study:

  • To evaluate changes in sexual behavior and sexually transmitted infection (STI) prevalence among MSM initiating PrEP.
  • To compare STI prevalence before and during PrEP use in a clinical setting.
  • To identify trends in condom use, partner status, and STI diagnosis rates.

Main Methods:

  • Retrospective analysis of 183 MSM initiating PrEP at an STD clinic.
  • Generalized estimating equations used to assess changes in sexual behavior.
  • Linking PrEP patient data with STI surveillance data for chlamydia, gonorrhea, and syphilis.

Main Results:

  • Reporting never using condoms increased by 46% at 12 months post-PrEP initiation.
  • STI prevalence was higher during PrEP use (49.2%) compared to the prior 12 months (35.0%).
  • No significant changes observed in the number of sexual partners or reporting HIV-positive/negative partners.

Conclusions:

  • PrEP initiation among MSM was associated with decreased condom use and increased STI prevalence.
  • Increased STI screening during PrEP use may contribute to higher observed prevalence.
  • Continued monitoring of sexual behavior and STI screening is essential for MSM on PrEP.
Keywords:
HIVMen who have sex with menPre-exposure prophylaxisSexual behaviorSexually transmitted infections

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