Study Examines Impact of Pre-Exposure Prophylaxis on Sexual Behavior

Overview of Pre-Exposure Prophylaxis

A recent study evaluated the effects of antiretroviral drugs used as pre-exposure prophylaxis (PrEP) on sexual behavior among individuals at substantial risk for HIV. PrEP is recognized by the World Health Organization as an effective means to prevent HIV infection through daily medication.

Research Methodology

Conducted in Australia, the study analyzed data from 16,827 gay and bisexual men regarding their PrEP usage. Researchers collected data before and after the implementation of state-funded PrEP programs in Victoria and New South Wales. The findings were published in the journal Lancet HIV.

Findings on Condom Use

The study revealed a significant increase in PrEP utilization among HIV-negative men, rising from 2% in 2013 to 24% in 2017. However, those who reported having casual sexual partners while on PrEP also exhibited a concerning trend: unprotected sex increased from 1% in 2013 to 5% in 2016, reaching 16% in 2017. Concurrently, consistent condom use among these men declined from 46% in 2013 to 42% in 2016 and further to 31% in 2017. This decrease in condom use, despite heightened PrEP adoption, raises concerns about the potential effectiveness of the drug.

Risky Behavior Among Non-PrEP Users

Among men who were not utilizing PrEP, there was also a 9% increase in unprotected sex with casual partners between 2013 and 2017. This suggests that risky sexual behavior is not limited to those on PrEP.

Long-Term Effectiveness of PrEP

Researchers cautioned that the long-term effectiveness of PrEP, which has been hailed as a transformative tool in HIV prevention, may diminish. They speculated that reduced condom usage might stem from a false sense of security among men not taking PrEP, influenced by the increasing number of individuals utilizing the preventive measure.

Consequences and Observations

The implications of this uptick in risky sexual behavior remain uncertain. Notably, a decline in new HIV diagnoses among men who have sex with men coincided with the increase in PrEP usage and the decrease in condom use. However, this decline may also correlate with improved awareness of HIV status through regular testing and advancements in antiretroviral treatments.

Recommendations for Future Campaigns

Despite the rise in sexually transmitted infections (STIs) among gay and bisexual men predating PrEP’s introduction in England, recent data indicates a persistently high risk for STIs in this population. Going forward, experts recommend enhancing safe sex campaigns that promote sexual health alongside PrEP programs.

Maximizing opportunities to discuss STIs and HIV prevention in the context of PrEP is crucial. This approach aims to ensure individuals are informed about safe sex practices and have access to necessary testing and treatment services.

Conclusion

The study underscores the importance of addressing sexual health education and resources in conjunction with the rollout of PrEP, ensuring that individuals are equipped with the knowledge and tools needed to engage in safer sexual practices.

Written by Lacey Hizartzidis, PhD
Reference: Pre-exposure prophylaxis may increase risky behaviour when introduced, study finds. The BMJ. https://www.bmj.com/content/361/bmj.k2514. Accessed June 25, 2018.