Pre-exposure prophylaxis, commonly known as PrEP, is a “game-changer” when it comes to preventing HIV infections, doctors say. But some new studies are suggesting that people who take it use condoms less often – increasing their risk of contracting other sexually-transmitted infections.
PrEP is a combination of two drugs, initially used to treat HIV. But it can also help stop someone from getting HIV in the first place and is increasingly being used for that purpose in the gay community in Canada and elsewhere.
“If you take them before you get exposed to HIV, it can actually dramatically reduce your risk of actually acquiring HIV if you’re exposed to it,” said Dr. David Moore, an associate professor of medicine at the University of British Columbia and a research scientist at the B.C. Centre for Excellence in HIV/AIDS.
It has been shown to be between 90-100 per cent effective in a number of studies, he said. Some research suggests that the number of HIV diagnoses in certain communities has actually decreased since it was introduced there.
Condom use
But as many men start using PrEP to reduce their risk of HIV transmission, they use condoms less, according to a recent analysis from Australia.
The researchers reviewed existing research on the subject and found evidence of more people reporting condomless anal sex with more than 10 partners, condomless sex with an HIV-positive or unknown HIV status partner and never using condoms during anal sex.
This seems to have consequences. “Study findings suggest that STIs increase after participants commence PrEP,” the authors wrote.
However, in an email, study co-author Michael Traeger noted that condom use had already been declining and STI rates increasing among gay and bisexual men before PrEP was introduced. “PrEP is perhaps just one of many contributors to changing STI epidemiology among gay and bisexual men,” he wrote.