Sexually transmitted diseases · 2025
Preexposure Prophylaxis Use Among Men Who Have Sex With Men With a History of Rectal Gonorrhea, Rectal Chlamydia, and/or Syphilis, STI Surveillance Network, 2021 to 2022.
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Tang Jennifer, Klingler Ellen J, Schumacher Christina M, Borrasca Wilbur, Danforth Brandi, Clark Madison, Meador Melissa, Cohen Stephanie E, Kerani Roxanne P, Pathela Preeti
Аннотация
BACKGROUND: We examined HIV preexposure prophylaxis (PrEP) use among men who have sex with men (MSM) with repeat bacterial sexually transmitted infections (STIs) at 14 publicly funded clinics across 10 US jurisdictions participating in the STI Surveillance Network.
METHODS: We identified MSM without HIV who had a diagnosis of rectal gonorrhea, rectal chlamydia, and/or syphilis in 2021 to 2022 and ≥1 diagnosis of these infections within the prior 12 months. We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) to evaluate differences in PrEP use at time of most recent infection by demographics and sexual behaviors.
RESULTS: We identified 542 MSM with repeat bacterial STI infections. Preexposure prophylaxis use at the time of repeat diagnosis was reported by 78% (421 of 542) overall; 76% (329 of 435) among patients with 1 prior STI infection and 86% (92 of 107) among those with ≥2 prior infections. Compared with non-Hispanic (NH) Black patients, those in other race/ethnicity groups had higher PrEP use prevalence (Hispanic: aPR, 1.37 [95% CI = 1.09-1.73]; NH-White: aPR, 1.31 [95% CI, 1.05-1.65]; NH-other race(s): aPR, 1.36 [95% CI, 1.07-1.72]). Preexposure prophylaxis use among those 25 to 34 years old (aPR, 1.73; 95% CI, 1.31-2.28) and >35 years old (aPR, 1.65; 95% CI, 1.08-1.59) was higher compared with those <25 years old. Among 97 MSM not on PrEP at the time of repeat diagnosis, 18% (n = 17) received PrEP on day of or in the following 30 days.
CONCLUSIONS: Although 8 in 10 MSM with a history of repeat bacterial STI were on PrEP, there were disparities among racial and age groups. Promoting awareness and equitable access are needed to address persistent barriers to PrEP use and encourage PrEP uptake and continuation.
METHODS: We identified MSM without HIV who had a diagnosis of rectal gonorrhea, rectal chlamydia, and/or syphilis in 2021 to 2022 and ≥1 diagnosis of these infections within the prior 12 months. We calculated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) to evaluate differences in PrEP use at time of most recent infection by demographics and sexual behaviors.
RESULTS: We identified 542 MSM with repeat bacterial STI infections. Preexposure prophylaxis use at the time of repeat diagnosis was reported by 78% (421 of 542) overall; 76% (329 of 435) among patients with 1 prior STI infection and 86% (92 of 107) among those with ≥2 prior infections. Compared with non-Hispanic (NH) Black patients, those in other race/ethnicity groups had higher PrEP use prevalence (Hispanic: aPR, 1.37 [95% CI = 1.09-1.73]; NH-White: aPR, 1.31 [95% CI, 1.05-1.65]; NH-other race(s): aPR, 1.36 [95% CI, 1.07-1.72]). Preexposure prophylaxis use among those 25 to 34 years old (aPR, 1.73; 95% CI, 1.31-2.28) and >35 years old (aPR, 1.65; 95% CI, 1.08-1.59) was higher compared with those <25 years old. Among 97 MSM not on PrEP at the time of repeat diagnosis, 18% (n = 17) received PrEP on day of or in the following 30 days.
CONCLUSIONS: Although 8 in 10 MSM with a history of repeat bacterial STI were on PrEP, there were disparities among racial and age groups. Promoting awareness and equitable access are needed to address persistent barriers to PrEP use and encourage PrEP uptake and continuation.