HIV Pre-exposure Prophylaxis Does Not Increase Gonorrhea and Chlamydia Incidence in Young Black and Hispanic Men who Have Sex With Men: An Observational Cohort Study

Abstract

Background. HIV pre-exposure prophylaxis (PrEP) use has been linked with increases in sexually transmitted infection (STI) incidence. Despite efforts to expand PrEP uptake among young Black and Hispanic men who have sex with men (YBHMSM), little research has been done to understand the impact of PrEP on STI incidence within these communities. We examine the effect of PrEP use on gonorrhea and chlamydia (NG/CT) incidence, condom use, and external STI testing (ie, outside of study visits). Methods. In a longitudinal cohort of HIV-negative YBHMSM (ages 16–24 years), we modeled the effect of PrEP use on studyexternal STI testing and number of condomless sex partners during the following 6 months using mixed-effects generalized linear models. We modeled the effect of PrEP use on NG/CT incidence using time-updated proportional hazard regression. Results. While on PrEP compared with periods not on PrEP, participants reported on average 2.51 (adjusted beta; 95% CI, 1.51–3.51; P < .001) more condomless sex partners and were 2.28 (adjusted OR; 95% CI, 1.48–3.52; P