In MSM, PrEP Stops HIV, Not Other STIs. Does It Matter?

Martha Kempner
Original Article:

Not so long ago, preventing HIV and other sexually transmitted infections (STIs) came down to the same basic safer sex choice: avoid risky sexual behavior or use condoms. But in recent years, much has changed. Improved antiretroviral therapy has turned treatment into prevention, because many people living with HIV have undetectable viral loads and cannot spread the virus. Meanwhile, increased testing rates have led some people to make decisions about partners and practices based on real (or assumed) test results.

Perhaps most notable, however, is the growing use of pre-exposure prophylaxis (PrEP) by those who are HIV negative but at risk of contracting the virus. In 2012, the U.S. Food and Drug Administration (FDA) approved Truvada (tenofovir/FTC), a once-daily pill, for use as PrEP. Studies show that when taken consistently it can reduce the risk of contracting HIV by over 90%. Both the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) now recommend PrEP for those at high risk of infection, which includes men who have sex with men (MSM) who have had sex without a condom in last six months.

While the introduction of a new prevention method is great news, not everyone in the public health world is excited about Truvada — in part because it only addresses HIV and does not provide protection against other STIs that are common among MSM, like gonorrhea and syphilis. AIDS Healthcare Foundation went so far as to launch a public campaign against Truvada because it feared that those using Truvada would give up condoms altogether.

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