Study Shows Higher Rates of STIs Among Users of PrEP by

Study Shows Higher Rates of STIs Among Users of PrEP

Posted on Tuesday, September 20th, 2016


A research letter detailing a study by Noah Kojimaa, Dvora Joseph Daveya and Jeffrey D. Klausner reports an increase of STIs among users of PrEP versus non-users of PrEP after analyzing 18 different studies. Using PubMed, the researchers identify over 140,000 studies utilizing the search terms ‘SYPHILIS’ OR ‘GONORRHEA’ OR
‘CHLAMYDIA’ OR ‘HOMOSEXUALITY’ OR ‘MALE’ OR ‘TRANSGENDER PERSONS’ AND ‘COHORT STUDIES’, and including the five studies about PrEP (http://links.lww.com/QAD/A944). They finally discover 18 studies that fit their criteria: “English language, cohort of MSM, and STI incidence rates reported with nucleic acid amplification testing.”

The results:

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  • Users of PrEP were 25.3 times more likely to catch gonorrhea, 11.2 times more likely to catch chlamydia and 44.6 times more likely to catch syphilis.
  • They repeated the analysis on studies after 1999 and arrived at similar results.

This study did identify limitations of their analysis.

  • Utilization of studies with heterogeneous populations.
  • Different frequencies of STI screenings.
  • Differences in diagnostic tests used.
  • PrEP studies recruited MSM with high-risk sexual behavior, whereas MSM in studies not using PrEP may have had different baseline risk behavior.

The researchers of this analysis recommend updated health screening guidelines. Currently the CDC (Center for Disease Control) advises users of PrEP to get biannual and quarterly testing but this report wants the CDC to recommend quarterly screenings, treatment of an infected person and their partner, plus re-screening services if positive for any disease.

This contradicts a study in 2014 of PrEP users. That research found that users of Truvada didn’t acquire other STIs but it was conducted with a smaller sample size.

It does show the need for more research to determine if there’s a correlation between PrEP and risky sexual behavior, and if PrEP is the statistically significant cause.


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