A recent review of studies found that some people on PrEP engage in more risky sex.

Even before PrEP hit the US market in 2012, there were fears that it would promote promiscuity, more risky sex, and unintended health consequences. The president of the AIDS Health Foundation called it a “party drug,” and “Truvada Whore” emerged as a slut-shaming label for people who took it in the gay community.

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 are 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.

It’s a timely finding for two reasons: PrEP is about to become more widely available, and cases of syphilis, gonorrhea, and chlamydia have lately been rising in the United States. Right now, PrEP is only available to people at the highest risk of getting HIV, including gay and bisexual men, people who engage in sex work, and people who use injection drugs. But the Food and Drug Administration just approved it for teenagers, and some experts think anybody who wants it should have access.

With the development of PrEP, people can take it and have sex with whomever they want, however they want, as much as they want, with essentially no risk of getting HIV. Let us be clear: PrEP is essential for fighting HIV. It works. It is safe. Researchers think it may already be helping to reduce the number of new HIV infections. But to date, the question of how PrEP is changing people’s sexual behaviors has been an open one.

The researchers found the risk of getting an STI increased during the period that PrEP has been on the market. Studies from before 2016, when PrEP was just starting to be used, didn’t show any increase in STIs. When the review authors looked more closely at the recent studies, the ones whose last follow-up with study participants was after 2016, they found an astonishing effect: Those on PrEP have 1.5 times the odds of acquiring an STI like chlamydia, gonorrhea, and syphilis, compared to before they started taking PrEP.

MASS now offers free STI clinic services. No appointment is necessary to come get services in education and treatment for HIV, HCV, syphilis, trichonmiasis, gonorrhea and chlamydia. Walk-ins are available Monday-Friday 9am until 4 pm and appointments are also available. Call us or just come on by!

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