Trends in Pre-exposure Prophylaxis Use, Condom Use, and Sexually Transmitted Infections Among Men Who Have Sex with Men from 2014, 2017, and 2023.

OBJECTIVE

To explore the association of pre-exposure prophylaxis (PrEP) use with condomless sex and sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (MSM) in Washington, DC.

DESIGN

Multivariate analysis of cross-sectional weighted survey data from 2014, 2017, and 2023 among MSM.

METHODS

This analysis used venue-based, time-space sampling to survey MSM about HIV-related behavioral risk factors, HIV testing, and use of prevention services. Chi-square tests and logistic regression were conducted to calculate adjusted prevalence ratios (aPR) and ascertain the association between the use of PrEP with condomless sex and having a bacterial STI in the past 12 months

RESULTS

774 MSM were surveyed during the three cycles in 2014, 2017, and 2023. The proportion of MSM reporting PrEP use, having a STI in the past 12 months, and condomless sex in the past 12 months increased over time from 2014 to 2023. MSM that used PrEP were more likely to report condomless sex (aPR = 1.33, 95% CI: 1.11-1.55) and having a STI in the past 12 months (aPR = 2.97, 95% CI: 1.35-4.59).

CONCLUSIONS

There is a significant association of PrEP use with both condomless sex and having a STI in the past 12 months among MSM in Washington, DC. As a result, this population may benefit from doxycycline post-exposure prophylaxis (doxy PEP) and other STI prevention methods, but further research is needed to understand the relationship between PrEP, condomless sex, and STIs.