For the last two and a half years, San Francisco has been running a pre-exposure prophylaxis (PrEP) program with Truvada. Of the 600 men who are taking part, none have contracted HIV.

 

Of course, one of the draws of PrEP for some men is the chance to lose the condom, and many of the individuals in the program admit to just that. But as they seem to be protected from HIV, the group is possibly contracting more STIs (sexually transmitted infections.) 

 

Kaiser Permanente published its findings in Clinical Infectious Diseases. The paper indicates that there may be some very positive protections afforded people on the PrEP program.

 

“Our study is the first to extend the understanding of the use of PrEP in a real-world setting and suggests that the treatment may prevent new HIV infections even in a high-risk setting,” explained Jonathan Volk, MD, MPH, a physician and epidemiologist at Kaiser Permanente San Francisco Medical Center. “Until now, evidence supporting the efficacy of PrEP to prevent HIV infection had come from clinical trials and a demonstration project.” 

 

Those who went on PrEP were more likely to admit to multiple sex partners than a comparison sample of subjects who opted not to use Truvada. 

 

It is also clear that these same men were at increased risk of acquiring HIV; their reliance on Truvada seemed to protect them from it, but it did not protect them from other STIs. Within the first six months, 30 percent had been diagnosed with at least one STI. After a year, half of them had contracted one or more STIs, with 33 percent diagnosed with a rectal STI, 33 percent with chlamydia, 28 percent with gonorrhea, and 5.5 percent with syphilis. Two of them contracted hep C.

 

“Without a control group, we don’t know if these STI rates were higher than what we would have seen without PrEP,” Julia Marcus, PhD, MPH, postdoctoral fellow at the Kaiser Permanente Division of Research, acknowledged. “Ongoing screening and treatments for STIs, including hepatitis C, are an essential component of a PrEP treatment program.”

 

You can get more details here.