Changes in sexual behavior and STI diagnoses among MSM initiating PrEP in a clinic setting.
Open accessAbstract
We examined changes in sexual behavior and sexually transmitted infection (STI) prevalence among 183 men who have sex with men (MSM) initiating pre-exposure prophylaxis (PrEP) at an STD Clinic in Seattle, WA. We used generalized estimating equations to measure changes in sexual behavior during PrEP use, and linked PrEP patient data with STI surveillance data to compare the prevalence of chlamydia, gonorrhea, and early syphilis in the periods prior to and during PrEP use. Reporting never using condoms in the prior 30 days increased (adjusted relative risk = 1.46; 95% confidence interval 1.13, 1.88) at 12 months after PrEP initiation compared to the initial PrEP visit. Reporting unknown status partners in the prior 30 days decreased at 12 months compared to the initial PrEP visit, but there was no change in number of sexual partners or reporting HIV-positive or HIV-negative partners. The percentage of patients diagnosed with any STI while using PrEP (49.2%) was higher than the percentage diagnosed in the 12 months prior to PrEP use (35.0%), likely driven in part by increased STI screening during PrEP use. Among MSM on PrEP, we observed decreases in condom use, and a higher prevalence of STIs during PrEP use compared to prior to PrEP initiation.
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MSM taking PrEP might compensate for decreased HIV acquisition risk by using condoms less frequently or modifying their behavior in other ways, although data regarding this behavior are inconsistent.
“MSM taking PrEP might compensate for decreased HIV acquisition risk by using condoms less frequently or modifying their behavior in other ways (202,203), although data regarding this behavior are inconsistent.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [203]
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Sexually Transmitted Infections Treatment Guidelines, 2021
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Self-citation
- Authors
- Montaño, M. A., Dombrowski, J. C., Dasgupta, S., Golden, M. R., Duerr, A., Manhart, L. E., Barbee, L. A., & Khosropour, C. M.
- Affiliations
- University of Washington (US)
- Public Health – Seattle & King County (US)
- Fred Hutch Cancer Center (US)
- Corresponding author
- Montaño, Michalina A.
- ORCID
- Venue
- AIDS and Behavior
- Published
- 2018-08-16
- Volume
- 23
- Issue
- 2
- Pages
- 548-555
- ISSN
- 1090-7165 (ISSN-L)
- 1573-3254
- PMC
- PMC6368873
- OpenAlex
- W2887005269
- Cited by
- 155
- References
- 18
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 24 · 2023: 9 · 2022: 27 · 2021: 23 · 2020: 17 · 2019: 24 · 2018: 1 · 2013: 1
- FWCI
- 12.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS and Behavior (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (F31 MH114892)
- National Institute of Allergy and Infectious Diseases (K23 AI113185)
- National Institutes of Health (P30 AI027757)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Keywords
- pre-exposure prophylaxis, men who have sex with men, sexual behavior, sexually transmitted infections, condom use, chlamydia, gonorrhea, early syphilis, STI screening, STD clinics, HIV prevention
- MeSH terms
- Sexual and Gender Minorities, Adult, Chlamydia Infections, Gonorrhea, HIV Seropositivity, Humans, Male, Mass Screening, Risk, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases, Syphilis, HIV Infections, Prevalence, Condoms, Homosexuality, Male, Safe Sex, Young Adult, Pre-Exposure Prophylaxis
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