Gay and bi men who use PrEP often do not use condoms and are at risk for sexually transmitted infections as well as HIV, suggesting that those men who seek PrEP are the ones who need it most, recent data show.
“Seeing a correlation between high rates of [sexually transmitted diseases] and PrEP use is what we expect – individuals with high rates of STDs are exactly the people we want to be considering and starting PrEP,” Dr. Susan Philip, director of disease prevention and control at the San Francisco Department of Public Health, told the Bay Area Reporter.
The latest SFDPH HIV epidemiology annual report, released September 1, showed that new cases of HIV continue to steadily decline. The 255 newly diagnosed HIV infections in 2015 represent the lowest number since the start of the epidemic.
But at the same time sexually transmitted infections have continued an upward trajectory, especially among gay and bi men, according to reporting by laboratories and health providers throughout the city.
In 2006 there were around 200 cases of rectal gonorrhea among HIV-positive gay men and about 230 cases among HIV-negative men. After dipping slightly or remaining stable for a few years, rates began to rise sharply in 2010. By 2015 the numbers had increased to around 350 cases among HIV-positive and 650 among HIV-negative gay men. Early syphilis cases in both groups have increased nearly every year since 2006.
The U.S. Food and Drug Administration approved Gilead Sciences’ Truvada (tenofovir/emtricitabine) for HIV prevention in July 2012 and its use has grown rapidly in recent years. A recent informal survey by the B.A.R. found that more than 6,000 people in San Francisco have been prescribed PrEP, most of them gay men.