Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV.

Nguyen, Vinh-Kim; Greenwald, Zoë R; Trottier, Helen; Cadieux, Martha; Goyette, Alexandre; Beauchemin, Mariève; Charest, Louise; Longpré, Danièle; Lavoie, Stéphane; Tossa, Hermione Gbego; Thomas, Réjean

Nguyen, Vinh-Kim; Greenwald, Zoë R; Trottier, Helen; Cadieux, Martha; Goyette, Alexandre; Beauchemin, Mariève; Charest, Louise; Longpré, Danièle; Lavoie, Stéphane; Tossa, Hermione Gbego; Thomas, Réjean.

Afiliación

Nguyen VK; Department of social and preventive medicine, School of Public Health, University of Montréal, Montréal, Canada.
Greenwald ZR; Global Health Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland.
Trottier H; Clinique médicale l'Actuel.
Cadieux M; Department of social and preventive medicine, School of Public Health, University of Montréal, Montréal, Canada.
Goyette A; Sainte-Justine University Hospital Center, Montréal, Canada.
Beauchemin M; Clinique médicale l'Actuel.
Charest L; Clinique médicale l'Actuel.
Longpré D; Clinique médicale l'Actuel.
Lavoie S; Clinique médicale l'Actuel.
Tossa HG; Clinique médicale l'Actuel.
Thomas R; Clinique médicale l'Actuel.

AIDS ; 32(4): 523-530, 2018 02 20.

Article en En | MEDLINE | ID: mdl-29239887

RESUMEN

OBJECTIVE: Use of preexposure prophylaxis (PrEP) for HIV raises concerns about sexually transmitted infection (STI) incidence because of decreased condom use among MSM. This study examines whether PrEP is associated with STIs in the 12 months following PrEP prescription relative to the 12 months prior to PrEP and if STI rates are higher among PrEP users relative to individuals receiving postexposure prophylaxis (PEP). DESIGN: Retrospective cohort study including PrEP users with more than 12 months of follow-up before PrEP prescription and individuals receiving PEP from 2010 to 2015 at Clinique l'Actuel (Montréal, Canada). METHODS: Incidence of chlamydia, gonorrhoea, syphilis and hepatitis C virus over 12 months was compared before and after PrEP; and for PrEP versus PEP users using Poisson models to generate incidence rate ratios (IRRs) with 95% confidence intervals (CIs) and adjusted IRRs (aIRRs) controlling for frequency of STI-screening visits. Models comparing PrEP and PEP users were further adjusted for age and education. RESULTS: One hundred and nine PrEP and 86 PEP users were included. Increased rates of STIs were observed in the 12 months after PrEP relative to the 12 months prior (IRR: 1.72, CI: 1.22-2.41; aIRR: 1.39, CI 0.98-1.96). PrEP users were also at higher STI risk relative to PEP users (IRR: 2.18, CI: 1.46-3.24; aIRR: 1.76, CI: 1.14-2.71). CONCLUSION: Increased rates of STIs among individuals after initiation of PrEP may suggest greater risk behaviours during the first year on PrEP. Further studies are needed to measure long-term trends in STI acquisition following PrEP initiation.

Asunto(s)

Infecciones por VIH/prevención & control; Hepatitis C/epidemiología; Profilaxis Pre-Exposición/métodos; Enfermedades Bacterianas de Transmisión Sexual/epidemiología; Adulto; Canadá/epidemiología; Humanos; Incidencia; Masculino; Estudios Retrospectivos; Asunción de Riesgos; Encuestas y Cuestionarios

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Bacterianas de Transmisión Sexual / Infecciones por VIH / Hepatitis C / Profilaxis Pre-Exposición Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: AIDS Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido

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