Gay And Bi Men On PrEP More Likely To Test Positive For STIs

According to data taken from an Australian men’s health study, more gay and bisexual men who are on PrEP are testing positive for STIs. But according to researchers, that might only be because more men are getting tested. 

For the first time seen in Victoria, Australia, there was an increase in STIs among gay and bisexual PrEP users. The biggest jump was seen in men of color.

The study, “Changes, Patterns, and Predictors of Sexually Transmitted Infections in Gay and Bisexual Men Using PrEP,” used interim analysis from a PrEPX study, a Melbourne-based study observing sexually active gay and bisexual men before and after they started practicing PrEP, a one-a-pill strategy that when taken as directed can prevent an HIV-negative person from contracting the virus. It doesn't protect against other STIs, however. 

The study's initial objective was to determine if PrEP is effective in reducing HIV diagnoses, as well as highlight the general incidence of STIs.

The findings were recently presented on at the 22nd International AIDS Conference  in Amsterdam (#AIDS2018) by Michael Traeger, one of the authors. Traeger received the Lange/van Tongeren award for young investigators at the conference for his contributions.

Most of the reason for increased STI levels, researchers said, should be placed on me who had a higher number of sexual partners. “STI incidence increased among [gay men] in PrEPX following PrEP initiation,” wrote researchers, “driven largely by [gay men]  experiencing repeat infections. High partner turnover and group sex elevated STI risk. Our findings support ongoing and frequent STI screening alongside education on early identification of STI symptoms for PrEP users, especially among those exhibiting multiple STIs and high-risk behaviors.”

Data was taken from PrEPX participants at five clinics specializing in gay or bisexual men’s health prior to the study that took place between July 2016 to December 2017 through the Australian Collaboration for Co-ordinated Enhanced Sentinel Surveillance (ACCESS).

Researchers observed the incidence of gonorrhea, chlamydia, and syphilis during the year before enrollment and during a follow-up visit. 4,275 participants were enrolled at a clinic that contributes data as part of its role with ACCESS, and data from 2981 of the participants was analyzed.

Of the participants, 98 percent were gay and bisexual men. The average age was 34 years, and 48 percent engaged in condomless receptive anal sex during the three months prior to enrollment and 28 percent had used PrEP before.

When the men were screened for STIs about a year later, 52 percent had no STIs. Among those men of color, 25 percent of participants had two or more diagnoses — or 76 percent of diagnoses. Thirteen percent of participants had three or more diagnoses, or 53 percent of diagnoses.

For the follow-up, 1,378 participants were observed who had been attending the same clinic before they enrolled in PrEPX.

Incidence greatly increased among men who took PrEP for the first time — from 55.1 per 100 person-years to 94.2 per 100 person-years. PrEP users are required to screen for STIs, so undoubtedly that led to a higher rate of STI diagnoses that were detected.

All eyes are on PrEP users, as scientists are eager to determine exactly how effective the drug is on certain populations of gay and bisexual men.

Watch a video of the PrEPX study data presentation below!

EDITOR'S NOTE: A previous version of this article stated that GBM stood for "Gay Black Men." It actually stands for "Gay and Bisexual Men."