No increased incidence of bacterial sexually transmitted infections with PrEP use among men who have sex with men in a clinic cohort

Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention to prevent human immunodeficiency virus (HIV) acquisition in at-risk populations, particularly in men who have sex with men (MSM).1 However, concerns about risk compensation, such as reduced condom use or increased partner numbers, have raised the possibility of rising bacterial sexually transmitted infection (STI) incidence among PrEP users.2,3 While some studies report higher STI rates among PrEP users,4,5 others suggest that structured PrEP programmes with routine screening may mitigate these risks.6 Singapore’s Department of STI Control (DSC) Clinic introduced PrEP services in 2018, offering regular reviews, testing and counselling. This study evaluated whether PrEP use was associated with different STI outcomes compared to non-PrEP users within this structured framework.