OBJECTIVE: Since the recent introduction of preexposure prophylaxis (PrEP), several studies have reported a decrease in the use of condoms and a rise in STIs among users. This rise in risk behavior associated with the advent of PrEP is known as "risk compensation." The aim of this study is to measure clinical and behavioral changes associated with the introduction of PrEP by analyzing condom use for anal intercourse, number of sexual partners, sexualized drug use and STI incidence. METHODS: We performed a retrospective descriptive study of PrEP users followed every 3months over a 2-year period spanning 2017-2019 in a referral clinic specializing in STI/HIV in Madrid, Spain. One hundred ten men who have sex with men and transgender women underwent regular screening for STIs and hepatitis C virus (HCV) infection. Sociodemographic, clinical, and behavioral data were gathered for all subjects studied. RESULTS: The risk compensation observed in this study consisted primarily of a lower rate of condom use, while the number of sexual partners and recreational drug consumption remained stable. We observed a very high incidence of STIs in this sample, particularly rectal gonorrhea and chlamydia. The factors shown to be independently associated with the presence of an STI on multivariate analysis were age below 30 years and over 10 sexual partners/month. CONCLUSION: The incidence of STI acquisition was higher than expected, indicating a need for strategies to minimize this impact, particularly among younger individuals with a higher number of sexual partners.
OBJECTIVE: Since the recent introduction of preexposure prophylaxis (PrEP), several studies have reported a decrease in the use of condoms and a rise in STIs among users. This rise in risk behavior associated with the advent of PrEP is known as "risk compensation." The aim of this study is to measure clinical and behavioral changes associated with the introduction of PrEP by analyzing condom use for anal intercourse, number of sexual partners, sexualized drug use and STI incidence. METHODS: We performed a retrospective descriptive study of PrEP users followed every 3months over a 2-year period spanning 2017-2019 in a referral clinic specializing in STI/HIV in Madrid, Spain. One hundred ten men who have sex with men and transgender women underwent regular screening for STIs and hepatitis C virus (HCV) infection. Sociodemographic, clinical, and behavioral data were gathered for all subjects studied. RESULTS: The risk compensation observed in this study consisted primarily of a lower rate of condom use, while the number of sexual partners and recreational drug consumption remained stable. We observed a very high incidence of STIs in this sample, particularly rectal gonorrhea and chlamydia. The factors shown to be independently associated with the presence of an STI on multivariate analysis were age below 30 years and over 10 sexual partners/month. CONCLUSION: The incidence of STI acquisition was higher than expected, indicating a need for strategies to minimize this impact, particularly among younger individuals with a higher number of sexual partners.
Authors: Robert M Grant; Javier R Lama; Peter L Anderson; Vanessa McMahan; Albert Y Liu; Lorena Vargas; Pedro Goicochea; Martín Casapía; Juan Vicente Guanira-Carranza; Maria E Ramirez-Cardich; Orlando Montoya-Herrera; Telmo Fernández; Valdilea G Veloso; Susan P Buchbinder; Suwat Chariyalertsak; Mauro Schechter; Linda-Gail Bekker; Kenneth H Mayer; Esper Georges Kallás; K Rivet Amico; Kathleen Mulligan; Lane R Bushman; Robert J Hance; Carmela Ganoza; Patricia Defechereux; Brian Postle; Furong Wang; J Jeff McConnell; Jia-Hua Zheng; Jeanny Lee; James F Rooney; Howard S Jaffe; Ana I Martinez; David N Burns; David V Glidden Journal: N Engl J Med Date: 2010-11-23 Impact factor: 91.245
Authors: Jean-Michel Molina; Catherine Capitant; Bruno Spire; Gilles Pialoux; Laurent Cotte; Isabelle Charreau; Cecile Tremblay; Jean-Marie Le Gall; Eric Cua; Armelle Pasquet; François Raffi; Claire Pintado; Christian Chidiac; Julie Chas; Pierre Charbonneau; Constance Delaugerre; Marie Suzan-Monti; Benedicte Loze; Julien Fonsart; Gilles Peytavin; Antoine Cheret; Julie Timsit; Gabriel Girard; Nicolas Lorente; Marie Préau; James F Rooney; Mark A Wainberg; David Thompson; Willy Rozenbaum; Veronique Doré; Lucie Marchand; Marie-Christine Simon; Nicolas Etien; Jean-Pierre Aboulker; Laurence Meyer; Jean-François Delfraissy Journal: N Engl J Med Date: 2015-12-01 Impact factor: 91.245
Authors: Michael W Traeger; Sophia E Schroeder; Edwina J Wright; Margaret E Hellard; Vincent J Cornelisse; Joseph S Doyle; Mark A Stoové Journal: Clin Infect Dis Date: 2018-08-16 Impact factor: 9.079
Authors: Michael C Thigpen; Poloko M Kebaabetswe; Lynn A Paxton; Dawn K Smith; Charles E Rose; Tebogo M Segolodi; Faith L Henderson; Sonal R Pathak; Fatma A Soud; Kata L Chillag; Rodreck Mutanhaurwa; Lovemore Ian Chirwa; Michael Kasonde; Daniel Abebe; Evans Buliva; Roman J Gvetadze; Sandra Johnson; Thom Sukalac; Vasavi T Thomas; Clyde Hart; Jeffrey A Johnson; C Kevin Malotte; Craig W Hendrix; John T Brooks Journal: N Engl J Med Date: 2012-07-11 Impact factor: 91.245
Authors: Jonathan E Volk; Julia L Marcus; Tony Phengrasamy; Derek Blechinger; Dong Phuong Nguyen; Stephen Follansbee; C Bradley Hare Journal: Clin Infect Dis Date: 2015-09-01 Impact factor: 9.079
Authors: Lisa A Grohskopf; Kata L Chillag; Roman Gvetadze; Albert Y Liu; Melanie Thompson; Kenneth H Mayer; Brandi M Collins; Sonal R Pathak; Brandon Oʼhara; Marta L Ackers; Charles E Rose; Robert M Grant; Lynn A Paxton; Susan P Buchbinder Journal: J Acquir Immune Defic Syndr Date: 2013-09-01 Impact factor: 3.731
Authors: Charlotte O'Halloran; Brian Rice; Ellen White; Monica Desai; David T Dunn; Sheena McCormack; Ann K Sullivan; David White; Alan McOwan; Mitzy Gafos Journal: Int J Drug Policy Date: 2019-11-15