Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV preexposure prophylaxis.

Tang, Eric C.; Vittinghoff, Eric; Philip, Susan S.; Doblecki-Lewis, Susanne; Bacon, Oliver; Chege, Wairimu; Coleman, Megan E.; Elion, Richard; Buchbinder, Susan; Kolber, Michael A.; Liu, Albert Y.; Cohen, Stephanie E.

doi:10.1097/qad.0000000000002522

Cited by 31HIV/AIDS Research and InterventionsReproductive tract infections researchHIV, Drug Use, Sexual Risk

Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV preexposure prophylaxis.

Tang, Eric C., Vittinghoff, Eric, Philip, Susan S., Doblecki-Lewis, Susanne, Bacon, Oliver, Chege, Wairimu, Coleman, Megan E., Elion, Richard +4 more·2020·AIDS

DOI 10.1097/qad.0000000000002522

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Abstract

OBJECTIVE: The optimal screening frequency of sexually transmitted infections (STIs) for MSM and transgender women (TGW) on HIV pre-exposure prophylaxis (PrEP) is unclear, with present guidelines recommending screening every 3-6 months. We aimed to determine the number of STIs for which treatment would have been delayed without quarterly screening. DESIGN: The US PrEP Demonstration Project was a prospective, open-label cohort study that evaluated PrEP delivery in STI clinics in San Francisco and Miami, and a community health center in Washington, DC. In all, 557 HIV-uninfected MSM and TGW were offered up to 48 weeks of PrEP and screened quarterly for STIs. METHODS: The proportion of gonorrhea, chlamydia, and syphilis infections for which treatment would have been delayed had screening been conducted every 6 versus every 3 months was determined by taking the number of asymptomatic STIs at weeks 12 and 36 divided by the total number of infections during the study follow-up period for each STI. RESULTS: Among the participants, 50.9% had an STI during follow-up. If screening had been conducted only semiannually or based on symptoms, identification of 34.3% of gonorrhea, 40.0% of chlamydia, and 20.4% of syphilis infections would have been delayed by up to 3 months. The vast majority of participants (89.2%) with asymptomatic STIs reported condomless anal sex and had a mean of 8.1 partners between quarterly visits. CONCLUSIONS: Quarterly STI screening among MSM on PrEP could prevent a substantial number of partners from being exposed to asymptomatic STIs, and decrease transmission.

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Studies have reported that MSM taking PrEP have high rates of STIs, and frequent screening is warranted.
“Studies have reported that MSM taking PrEP have high rates of STIs, and frequent screening is warranted (204–206).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [206]
Quarterly screening was reported to have prevented STI exposure in a median of three sex partners per STI infection.
“In addition, quarterly screening was reported to have prevented STI exposure in a median of three sex partners per STI infection (206).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [206]

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Authors: Tang, E. C., Vittinghoff, E., Philip, S. S., Doblecki-Lewis, S., Bacon, O., Chege, W., Coleman, M. E., Elion, R., Buchbinder, S., Kolber, M. A., Liu, A. Y., & Cohen, S. E.
Affiliations: California Department of Public Health (US)
University of California, San Francisco (US)
University of Miami, Miller School of Medicine, Miami, FL
National Institutes of Health (US)
Whitman-Walker Health (US)
Washington DC Department of Health, Center for Sexual Health, Washington, DC, USA.
University of Miami (US)
Corresponding author: Tang, Eric C.
Cohen, Stephanie E.
ORCID: Tang, Eric C.
Vittinghoff, Eric
Philip, Susan S.
Bacon, Oliver
Chege, Wairimu
Coleman, Megan E.
Buchbinder, Susan
Kolber, Michael A.
Liu, Albert Y.
Cohen, Stephanie E.
Venue: AIDS
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2020-03-19
Volume: 34
Issue: 8
Pages: 1181-1186
ISSN: 0269-9370 (ISSN-L)
1473-5571
DOI: 10.1097/qad.0000000000002522
OpenAlex: W3012908993
Cited by: 31
References: 29
Citations by year: 2026: 3 · 2025: 3 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 3
FWCI: 0.59
Type: journal article
Language: en
Open access: closed
Locations: AIDS (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (R01MH095628)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords: sexually transmitted infections, HIV pre-exposure prophylaxis, screening frequency, men who have sex with men, transgender women, gonorrhea, chlamydia, syphilis, condomless anal sex
MeSH terms: Adolescent, Adult, Aged, Chlamydia Infections, Female, Gonorrhea, Humans, Male, Mass Screening, Middle Aged, Prospective Studies, San Francisco, Sexually Transmitted Diseases, Cohort Studies, HIV Infections, Homosexuality, Male, Delivery of Health Care, Integrated, Young Adult, Transgender Persons, Pre-Exposure Prophylaxis

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Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV preexposure prophylaxis.

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