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to Section One | to Arts & Entertainment
posted Friday, April 12, 2019 - Volume 47 Issue 15
'Surprising' new findings: PrEP users at risk for STIs but not because they don't use condoms
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'Surprising' new findings: PrEP users at risk for STIs but not because they don't use condoms

There was no link between condom use and STIs among PrEP users, study finds

by Mike Andrew - SGN Staff Writer

People on PrEP are at risk of acquiring sexually transmitted infections (STIs), but not because they're using condoms less than those not on PrEP, according to new research. The new study, published in the Journal of the American Medical Association, tracked 2,981 Gay and Bi men in the heavily populated Australian state of Victoria, in which Melbourne is located.

Researchers found a 20% increase in the rates of new STIs among people on a PrEP trial called 'PrEPX.' They also found there was an increased risk of acquiring an STI while on PrEP compared to before starting PrEP.

But they found there was no correlation between that increase and the rate of condom use among the test subjects. Researchers said they found it 'surprising' that 'condom use was not a significant predictor of acquiring an STI when using PrEP,' since it goes against common assumptions about the safety of sexual practices.

In trying to explain the greater incidence of STIs, the study posited that an increase in casual sex partners and group sex led to more STI diagnoses. But, the researchers said, more regular testing associated with PrEP use also explained the increase in STI diagnoses.

'It's important to understand that when people start taking PrEP, they also get tested more frequently, so STIs are more likely to be detected anyway,' said lead author and Burnet Institute PhD student Michael Traeger.

He argued the study results should help better guide STI prevention campaigns for people who take PrEP. Those campaigns should not just focus on condom use, he said, but also reduce the time to STI diagnosis through frequent testing.

'But as PrEP uptake increases, identifying individuals most at risk of STIs will become increasingly important for informing effective and focused STI prevention,' Traeger added.

The study showed that about 25% of participants accounted for a majority of the new STI diagnoses, and that group of subjects experienced very high rates of STIs.

Associate Professor Edwina Wright argued that the findings 'are a rebuttal to the backlash against PrEP users for reducing condom use.'

Wright is the principal researcher in the PrEPX Study. She is also the co-head of the HIV Elimination Program at the Burnet Institute.

'The findings are also important because they highlight the need to target our sexual health messaging about STI risks to a relatively small proportion of PrEP users to help reduce their STI rates,' she said.

'We need to address these findings by engaging in more research to prevent STIs, including STI vaccines and antibiotics that may prevent STIs.'

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