Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV preexposure prophylaxis

Eric C. Tang, Eric Vittinghoff, Susan S. Philip, Susanne Doblecki-Lewis, Oliver Bacon, Wairimu Chege, Megan E. Coleman, Richard Elion, Susan Buchbinder, Michael A. Kolber, Albert Y. Liu, Stephanie E. Cohen

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: The optimal screening frequency of sexually transmitted infections (STIs) for MSM and transgender women (TGW) on HIV pre-exposure prophylaxis (PrEP) is unclear, with present guidelines recommending screening every 3-6 months. We aimed to determine the number of STIs for which treatment would have been delayed without quarterly screening. DESIGN: The US PrEP Demonstration Project was a prospective, open-label cohort study that evaluated PrEP delivery in STI clinics in San Francisco and Miami, and a community health center in Washington, DC. In all, 557 HIV-uninfected MSM and TGW were offered up to 48 weeks of PrEP and screened quarterly for STIs. METHODS: The proportion of gonorrhea, chlamydia, and syphilis infections for which treatment would have been delayed had screening been conducted every 6 versus every 3 months was determined by taking the number of asymptomatic STIs at weeks 12 and 36 divided by the total number of infections during the study follow-up period for each STI. RESULTS: Among the participants, 50.9% had an STI during follow-up. If screening had been conducted only semiannually or based on symptoms, identification of 34.3% of gonorrhea, 40.0% of chlamydia, and 20.4% of syphilis infections would have been delayed by up to 3 months. The vast majority of participants (89.2%) with asymptomatic STIs reported condomless anal sex and had a mean of 8.1 partners between quarterly visits. CONCLUSIONS: Quarterly STI screening among MSM on PrEP could prevent a substantial number of partners from being exposed to asymptomatic STIs, and decrease transmission.

Original languageEnglish (US)
Pages (from-to)1181-1186
Number of pages6
JournalAIDS (London, England)
Volume34
Issue number8
DOIs
StatePublished - Jul 1 2020

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Tang, E. C., Vittinghoff, E., Philip, S. S., Doblecki-Lewis, S., Bacon, O., Chege, W., Coleman, M. E., Elion, R., Buchbinder, S., Kolber, M. A., Liu, A. Y., & Cohen, S. E. (2020). Quarterly screening optimizes detection of sexually transmitted infections when prescribing HIV preexposure prophylaxis. AIDS (London, England), 34(8), 1181-1186. https://doi.org/10.1097/QAD.0000000000002522