Sexually Transmitted Infections in Pre-Exposure Prophylaxis Patients

Background: Pre-exposure Prophylaxis (PrEP) has revolutionized HIV prevention, but concerns exist about its potential impact on other Sexually Transmitted Infections (STIs). This study aimed to assess the prevalence and patterns of STIs among PrEP users at a single urban clinic. Methods: We conducted a retrospective analysis of 100 patients on PrEP, evaluating STI diagnoses over a 12-month period. Comprehensive STI screening was performed quarterly, including nucleic acid amplification tests for chlamydia and gonorrhea at multiple anatomical sites, and serological testing for syphilis. Results: Of the 100 participants (mean age 32.5 years, 82% men who have sex with men), 42% were diagnosed with at least one STI during the study period. The most common infections were chlamydia (28%), gonorrhea (18%), and syphilis (8%). Among chlamydia and gonorrhea cases, 60.9% were rectal infections. Fifteen percent of patients experienced multiple STI diagnoses. Factors independently associated with STI diagnosis included age <30 years (OR 2.1, 95% CI: 1.3-3.4), ≥5 sexual partners in the past 6 months (OR 2.8, 95% CI: 1.7-4.6), and inconsistent condom use (OR 1.9, 95% CI: 1.2-3.0). Conclusion: This study demonstrates a high prevalence of STIs among PrEP users, emphasizing the need for comprehensive STI prevention, frequent screening, and prompt treatment in this population. While PrEP effectively prevents HIV transmission, it must be implemented as part of a holistic approach to sexual health to address the risk of other STIs.