Many guys on PrEP are not getting regularly tested for STIs

Two recent studies have highlighted how many men taking PrEP are not getting themselves regularly screened for sexually transmitted infections (STIs).

Less than half (43%) of the gay and bi men taking PrEP (Pre-Exposure Prophylaxis) in Baltimore, MD, were fully screened for the most common STIs (syphilis, gonorrhea, and chlamydia) when they started the medication.

The US study followed 290 men in the US city over a course of 30 months.

Of those surveyed, 7.8% tested positive for syphilis when they started PrEP. Participants also tested positive for rectal (11.1%), throat (7.5%) and urogenital (5%) gonorrhea, and rectal (11.7%), urogenital (5%) and throat (1.5%) chlamydia.

At biannual check-ups, researchers found that STI screening was lower and positivity for syphilis and rectal gonorrhea/chlamydia was higher. They said that whether the men reported having anal or oral sex impacted whether they had tests for certain STIs. This led them to call for greater clarification on STI screening guidelines for PrEP users.

PrEP, when used correctly, can minimize the likelihood of someone acquiring HIV.

However, many health organizations recommend those taking it to undergo regular check-ups. If PrEP users engage in condomless sex, they could be at an increased risk of picking up other sexually transmitted infections.

The US has seen a significant increase in the rates of syphilis, chlamydia and gonorrhea over the past five years.

A separate study from Germany discovered that one in nine PrEP users have not been tested for HIV or further STIs whilst being on PrEP. The results were discussed at the recent 17th European AIDS Conference and reported by AIDSmap.

Besides not being tested for other STIs, those one-in-nine users had also not had kidney function tests. Because the medication can have side effects in some people, it’s recommended to have a kidney function test regularly if you’re taking PrEP (the drugs are not recommended for people with certain kidney conditions).

Of those who did go back for tests, around 15% had an HIV test less frequently than every three months, and 8.5% went longer than the recommended six months before getting tested for STIs.

More concerning still, one in 25 of PrEP users had not had an HIV test before commencing their PrEP course. Anyone thinking of starting PrEP should always ensure they’re not already HIV positive – as the medication can cause the virus to develop resistance and become harder to treat.

Germany recommends PrEP users are tested for HIV and kidney function every three months and for other STIs at least every six months.

In the US, those on PrEP are advised to have an HIV test every three months. The CDC has previously recommended those on PrEP should have kidney function tests every six months.

Dr Will Nutland, of the UK-based organization PrEPster, told Queerty, “Regular STI tests – and HIV tests if someone doesn’t have HIV – are recommended for everyone who is sexually active, regardless of whether they are using PrEP or not.

“International guidelines make strong recommendations about having HIV and kidney function tests before or shortly after starting PrEP. If someone already has HIV when they start using PrEP, they are, in effect, taking sub-optimal HIV treatment and could be passing on HIV to their sexual partners.

“A very small number of people develop kidney problems when they use PrEP. A simple kidney function test will spot any problems and determine if it’s safe to use, or continue using PrEP.”