Secondary analysis of PrEP (Pre-Exposure Prophylaxis) and STI incidence trends among MSM locally and nationwide
Abstract
Title:
Secondary analysis of PrEP (Pre-Exposure Prophylaxis) and STI incidence trends among MSM locally and nationwide
Background:
Many MSM clients of CDPH that test positive for an STI happen to also use PrEP and say they adhere to PrEP follow-up guidelines. Many clients that use PrEP, mention multiple partners and condomless sex. Historically, MSM PrEP users have reported risky sexual behavior. A review of STI and PrEP use data for Georgia as well as peer-reviewed articles help further demonstrate this epidemiology and a similar trend from 2018 to 2021.
Method:
A review of several peer-reviewed articles demonstrated the relationship between PrEP and STI incidence since 2007 in the United States from perspectives of different studies and US regions. STI incidence and PrEP use data from OASIS and AIDSVu reflected Cobb and Douglas County trends from 2018 to 2021.
Results:
In 2007, foundational trials for PrEP demonstrated high STI incidence among study participants using PrEP. A secondary analysis of MSM STI data in Seattle, Washington from 2011 to 2017 demonstrated that MSM with PrEP had a 2-3-fold higher STI incidence than MSM without PrEP. The ongoing RADAR cohort study in Chicago found that young MSM PrEP users reported an increase in condomless anal sex. Between 2017 and 2019, the ARTnet study found PrEP users in the Southeast were less likely to have consistent STI screenings during PrEP care compared to other US regions. OASIS and AIDSVu data demonstrate both a 2-fold PrEP user increase and an STI incidence increase for Cobb and Douglas County.
Conclusions:
STI testing has historically demonstrated the capability of reducing STI incidence rates and more frequent testing for MSM on PrEP may benefit. CDC guidelines encourage symptom-based full-STI panel tests every three months; however, incubation periods for STI’s ranges from 1-90 days. It is suggested that CDC guidelines for PrEP acknowledge the trend of increased risks, consider non-symptom-based testing, and reduce time between PrEP follow-ups.
Key words: PrEP, STI, secondary analysis
References:
AIDSVu. Mapping PrEP: First Ever Data on PrEP Users Across the U.S. Retrieved from https://aidsvu.org/prep/
CDC (2019).Gonorrhea, Immigrant and Refugee Health. Retrieved from https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/sexually-transmitted-diseases/gonorrhea.html#:~:text=Signs%20and%20symptoms%20of%20gonorrhea
CDC (2022). Chlamydia pneumoniae: Disease-Pathogenesis for Labs. Retrieved from https://www.cdc.gov/pneumonia/atypical/cpneumoniae/hcp/disease.html#:~:text=Disease%20Specifics
Chandra, C., Weiss, K. M., Kelley, C. F., Marcus, J. L., & Jenness, S. M. (2020). Gaps in Sexually Transmitted Infection Screening Among Men who Have Sex with Men in Pre-exposure Prophylaxis (PrEP) Care in the United States. Clinical Infectious Diseases, 73(7), e2261–e2269. https://doi.org/10.1093/cid/ciaa1033
MONTAÑO, M. A., DOMBROWSKI, J. C., DASGUPTA, S., GOLDEN, M. R., MANHART, L. E., BARBEE, L. A., DUERR, A., & KHOSROPOUR, C. M. (2019). Differences in STI Risk Comparing PrEP Users and Propensity Score-Matched Historical Controls in a Clinic Setting. AIDS (London, England), 33(11), 1773–1780. https://doi.org/10.1097/QAD.0000000000002281
Morgan, E., Dyar, C., Newcomb, M. E., D’Aquila, R. T., & Mustanski, B. (2019). PrEP Use and Sexually Transmitted Infections Are Not Associated Longitudinally in a Cohort Study of Young Men Who Have Sex with Men and Transgender Women in Chicago. AIDS and Behavior, 24(5), 1334–1341. https://doi.org/10.1007/s10461-019-02664-9
OASIS. Online Analytical Statistical Information System. Tools for Public Health and Public Policy Data Analysis. Retrieved from https://oasis.state.ga.us/
Ramchandani, M. S., & Golden, M. R. (2019). Confronting Rising STIs in the Era of PrEP and Treatment as Prevention. Current HIV/AIDS Reports, 16(3), 244–256. https://doi.org/10.1007/s11904-019-00446-5
Scott, H.M., Klausner, J.D. Sexually transmitted infections and pre-exposure prophylaxis: challenges and opportunities among men who have sex with men in the US. AIDS Res Ther 13, 5 (2016). https://doi.org/10.1186/s12981-016-0089-8
Keywords
PrEP, STI, secondary analysis
Secondary analysis of PrEP (Pre-Exposure Prophylaxis) and STI incidence trends among MSM locally and nationwide
Title:
Secondary analysis of PrEP (Pre-Exposure Prophylaxis) and STI incidence trends among MSM locally and nationwide
Background:
Many MSM clients of CDPH that test positive for an STI happen to also use PrEP and say they adhere to PrEP follow-up guidelines. Many clients that use PrEP, mention multiple partners and condomless sex. Historically, MSM PrEP users have reported risky sexual behavior. A review of STI and PrEP use data for Georgia as well as peer-reviewed articles help further demonstrate this epidemiology and a similar trend from 2018 to 2021.
Method:
A review of several peer-reviewed articles demonstrated the relationship between PrEP and STI incidence since 2007 in the United States from perspectives of different studies and US regions. STI incidence and PrEP use data from OASIS and AIDSVu reflected Cobb and Douglas County trends from 2018 to 2021.
Results:
In 2007, foundational trials for PrEP demonstrated high STI incidence among study participants using PrEP. A secondary analysis of MSM STI data in Seattle, Washington from 2011 to 2017 demonstrated that MSM with PrEP had a 2-3-fold higher STI incidence than MSM without PrEP. The ongoing RADAR cohort study in Chicago found that young MSM PrEP users reported an increase in condomless anal sex. Between 2017 and 2019, the ARTnet study found PrEP users in the Southeast were less likely to have consistent STI screenings during PrEP care compared to other US regions. OASIS and AIDSVu data demonstrate both a 2-fold PrEP user increase and an STI incidence increase for Cobb and Douglas County.
Conclusions:
STI testing has historically demonstrated the capability of reducing STI incidence rates and more frequent testing for MSM on PrEP may benefit. CDC guidelines encourage symptom-based full-STI panel tests every three months; however, incubation periods for STI’s ranges from 1-90 days. It is suggested that CDC guidelines for PrEP acknowledge the trend of increased risks, consider non-symptom-based testing, and reduce time between PrEP follow-ups.
Key words: PrEP, STI, secondary analysis
References:
AIDSVu. Mapping PrEP: First Ever Data on PrEP Users Across the U.S. Retrieved from https://aidsvu.org/prep/
CDC (2019).Gonorrhea, Immigrant and Refugee Health. Retrieved from https://www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/sexually-transmitted-diseases/gonorrhea.html#:~:text=Signs%20and%20symptoms%20of%20gonorrhea
CDC (2022). Chlamydia pneumoniae: Disease-Pathogenesis for Labs. Retrieved from https://www.cdc.gov/pneumonia/atypical/cpneumoniae/hcp/disease.html#:~:text=Disease%20Specifics
Chandra, C., Weiss, K. M., Kelley, C. F., Marcus, J. L., & Jenness, S. M. (2020). Gaps in Sexually Transmitted Infection Screening Among Men who Have Sex with Men in Pre-exposure Prophylaxis (PrEP) Care in the United States. Clinical Infectious Diseases, 73(7), e2261–e2269. https://doi.org/10.1093/cid/ciaa1033
MONTAÑO, M. A., DOMBROWSKI, J. C., DASGUPTA, S., GOLDEN, M. R., MANHART, L. E., BARBEE, L. A., DUERR, A., & KHOSROPOUR, C. M. (2019). Differences in STI Risk Comparing PrEP Users and Propensity Score-Matched Historical Controls in a Clinic Setting. AIDS (London, England), 33(11), 1773–1780. https://doi.org/10.1097/QAD.0000000000002281
Morgan, E., Dyar, C., Newcomb, M. E., D’Aquila, R. T., & Mustanski, B. (2019). PrEP Use and Sexually Transmitted Infections Are Not Associated Longitudinally in a Cohort Study of Young Men Who Have Sex with Men and Transgender Women in Chicago. AIDS and Behavior, 24(5), 1334–1341. https://doi.org/10.1007/s10461-019-02664-9
OASIS. Online Analytical Statistical Information System. Tools for Public Health and Public Policy Data Analysis. Retrieved from https://oasis.state.ga.us/
Ramchandani, M. S., & Golden, M. R. (2019). Confronting Rising STIs in the Era of PrEP and Treatment as Prevention. Current HIV/AIDS Reports, 16(3), 244–256. https://doi.org/10.1007/s11904-019-00446-5
Scott, H.M., Klausner, J.D. Sexually transmitted infections and pre-exposure prophylaxis: challenges and opportunities among men who have sex with men in the US. AIDS Res Ther 13, 5 (2016). https://doi.org/10.1186/s12981-016-0089-8
