Though some of those fears were tinged with moral judgement, there’s now data showing the concern about the health consequences is justified. A systematic review published in March in the journal Clinical Infectious Diseases found that some PrEP users are having more risky sex — and as a result, getting more sexually transmitted infections (STIs). The review, which brought together 17 studies on PrEP use and sexual behavior change, suggests that as people begin to trust PrEP, they’re having more condomless sex and worrying less about other STIs. The more recent studies in the review show the strongest trend. [...]
The HIV/AIDS epidemic has killed 37 million people since it was officially recognized in 1981, but thanks to effective antiretroviral drugs, HIV is now a treatable chronic illness. Although gay and bisexual men account for just 2 percent of the population of the United States, they accounted for 70 percent of new HIV diagnoses in 2014. Recent estimates place the number of gay and bisexual men currently living with HIV in the United States at more than 600,000. [...]
The authors found that in some studies, PrEP use was associated with a 9 percent increase in the amount of receptive anal sex without a condom with 10 or more partners, an 11 percent increase in the amount of sex without a condom with an HIV-positive person or with someone whose HIV status was unknown, and a 14 percent increase in people never using condoms during anal sex. These are all high-risk behaviors that increase the chances of getting HIV and other STIs. [...]
The rates of gonorrhea infection among men who have sex with men have been climbing from 3.9 percent in 1989 to 37.8 percent in 2016. In 2016 there were more than 2 million cases of syphilis, gonorrhea, and chlamydia in the United States — the highest cumulative number of cases the US has ever seen. In the same year, men who had sex with men accounted for 80 percent of all primary and secondary cases of syphilis.
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