8 votes

Fears that PrEP could lead to an STI epidemic

Posted by Algernon_Asimov
Tags: health.public, hiv, prep, epidemics, diseases.sexually transmitted

Here's an article in Australian Fairfax Media: "Fears new wonder drug could lead to STI epidemic"

It refers to this article in The Lancet: "Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013–17"

Here's the key take-away from the Fairfax article:

An international 2016 study of men who have sex with men found the chances of contracting chlamydia, gonorrhoea and syphilis were increased 11, 24, and 44-fold respectively in PrEP users. Fears have now been raised that these staggering numbers might be replicated in Australia.

5 comments

  1. [4]
    Tuna
    Link
    The main point is that gay men using PrEP, leads to a decrease in use of condoms. Many probably think when taking PrEP, that their reason for using condoms (to prevent HIV) is gone and don't think...

    The main point is that gay men using PrEP, leads to a decrease in use of condoms.
    Many probably think when taking PrEP, that their reason for using condoms (to prevent HIV) is gone and don't think about other STIs which they aren't protected against without a condom.

    To sum it up: not the pill, but the reckless behaviour aka unprotected sex is the reason for higher STI ratios

    6 votes
    1. [2]
      Algernon_Asimov
      Link Parent
      Yes, that's exactly the point that the writers of the Fairfax article make:

      To sum it up: not the pill, but the reckless behaviour aka unprotected sex is the reason for higher STI ratios

      Yes, that's exactly the point that the writers of the Fairfax article make:

      the growing popularity of non-condom based risk reduction strategies in the gay community (such as choosing partners on the basis of HIV status) has already seen a gradual decline in condom use. Yet this trend looks to be rapidly escalating in the wake of PrEP roll-outs – and the potential fall-out could be severe.

      3 votes
      1. Tuna
        Link Parent
        Just wanted to clarify. Your original quote was a bit clumsy, by not stating the real cause for the increase even though you certainly seem to have understood the content.

        Just wanted to clarify.
        Your original quote was a bit clumsy, by not stating the real cause for the increase even though you certainly seem to have understood the content.

    2. musicotic
      Link Parent
      It's one of those paradoxes that are often talked about in all parts and aspects of sexual health research. Birth control, circumcision, etc

      It's one of those paradoxes that are often talked about in all parts and aspects of sexual health research. Birth control, circumcision, etc

  2. parenthesis
    Link
    I work in HIV/STI prevention, and there's definitely a lot of fear out there about PrEP raising STI rates. Interestingly though, it could actually lead to decreased rates of certain STIs because...

    I work in HIV/STI prevention, and there's definitely a lot of fear out there about PrEP raising STI rates. Interestingly though, it could actually lead to decreased rates of certain STIs because PrEP users (in theory) need to get regular STI testing. This modelling study found a decrease in bacterial STIs even with decreased condom use among PrEP users: https://www.cdc.gov/nchhstp/newsroom/2017/croi-prep-study.html

    5 votes