Individuals who take PrEP are at higher risk for gonorrhea and should be regularly tested and treated to manage this risk effectively.
This is according to a study — “Study Finds PrEP Use Among Gay and Bisexual Men in Ontario Linked to Higher STI Rates” by Nguyen K. Tran, Seth L. Welles, Jason A. Roy, et al — that was published in The Annals of Family Medicine.
For this study, the researchers used data from the iCruise Study, an online longitudinal study of men who are gay or bisexual or have sex with men, in Ontario, Canada from July 2017 to April 2018. Particularly, the study examined how PrEP use related to the number of self-reported bacterial STIs. The researchers analyzed results from 535 participants who completed a weekly diary survey for up to a three-month study period. The study measured the number of chlamydia, gonorrhea, and syphilis infections per 100 months of participant observation time.
Main results of the study included:
- 535 participants in the iCruise Study were included in the analysis. Researchers followed participants for a total of 1,623.5 person-months (total time all participants were in the study). About 13.1% (70 participants) reported using PrEP during the study period.
- PrEP use was linked to a higher rate of gonorrhea:
- The initial analysis suggested that the rate of gonorrhea among PrEP users was four times higher than among non-users, with an incidence rate ratio of 4.00. After conducting a bias analysis to account for potential inaccuracies in self-reported data, the association was less pronounced, with a median incidence rate ratio of 2.36 among PrEP users.
- There was no significant increase in the rates of chlamydia or syphilis among PrEP users.
“The magnitude of risk for gonorrhea among those taking PrEP suggests a need to focus on ancillary services (e.g. STI testing) that can support the sexual health needs of GBM taking PrEP and potentially novel interventions for preventing transmission such as doxycycline post-exposure prophylaxis (doxy-PEP),” the researchers stressed.
In the end, this study “underscore the importance of investing in STI testing, risk reduction, secondary prevention measures such as doxy-PEP, surveillance, and partner management — alongside PrEP — to reduce bacterial STI transmission effectively.”
