PrEP initiation correlated with a significant increase in the development of STIs, according to results from a large study published in AIDS. Theodoros N. Sergentanis, MD, PhD, and colleagues examined the impact of PrEP initiation on the development of bacterial STIs across 23 studies with 11,776 participants. Overall, PrEP initiation was associated with a significant increase in the development of any STI (pooled effect size: 1.15; 95% CI, 1.04-1.26), any gonorrhea (pooled effect size: 1.17; 95% CI, 1.02-1.34), any chlamydia (pooled effect size: 1.31; 95% CI, 1.09-1.58), and rectal chlamydia (pooled effect size: 1.31; 95% CI, 1.05-1.64). A borderline increase was seen for urethral chlamydia (pooled effect size: 1.25; 95% CI, 0.99-1.60). Changes in the development of pharyngeal chlamydia and site-specific gonorrhea were not significant, and there was “virtually no change” for syphilis following the start of PrEP. “These results highlight the need for more comprehensive, accessible STI testing to tackle bacterial STI infections in PrEP users,” Dr. Sergentanis and colleagues wrote.
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