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Abstract

Introduction

Despite increased use of pre-exposure prophylaxis (PrEP) in Germany, HIV infection rates are not declining and little is known about how this prevention method affects the prevalence of sexually transmitted infections (STI) among men who have sex with men (MSM).

Aim

We studied, in a large multicentre cohort, STI point prevalence, co-infection rates, anatomical location and influence of PrEP.

Methods

The BRAHMS study was a prospective cohort study conducted at 10 sites in seven major German cities that enrolled MSM reporting increased sexual risk behaviour. At screening visits, MSM were tested for (MG), (NG), (CT) and Treponema pallidum , and given a behavioural questionnaire. With binomial regression, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) for the association of PrEP and STI.

Results

We screened 1,043 MSM in 2018 and 2019, with 53.0% currently using PrEP. At screening, 370 participants (35.5%) had an STI. The most common pathogen was MG in 198 (19.0%) participants, followed by CT (n = 133; 12.8%), NG (n = 105; 10.1%) and TP (n = 37; 3.5%). Among the 370 participants with at least one STI, 14.6% (n = 54) reported STI-related symptoms. Infection prevalence was highest at anorectal site (13.4% MG, 6.5% NG, 10.2% CT). PrEP use was not statistically significant in adjusted models for STI (PR: 1.10; 95% CI: 0.91–1.32), NG/CT, only NG or only CT.

Conclusions

Prevalence of asymptomatic STI was high, and PrEP use did not influence STI prevalence in MSM eligible for PrEP according to national guidelines.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2022-04-07
2024-12-21
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HIV pre-exposure prophylaxis was associated with no impact on sexually transmitted infection prevalence in a high-prevalence population of predominantly men who have sex with men, Germany, 2018 to 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Hendrik+Streeck&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Streeck Hendrik</a>, <a href="/search?value1=Klaus+Jansen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jansen Klaus</a>, <a href="/search?value1=Trevor+A+Crowell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Crowell Trevor A</a>, <a href="/search?value1=Allahna+Esber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Esber Allahna</a>, <a href="/search?value1=Heiko+K+Jessen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jessen Heiko K</a>, <a href="/search?value1=Christiane+Cordes&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cordes Christiane</a>, <a href="/search?value1=Stefan+Scholten&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scholten Stefan</a>, <a href="/search?value1=Stephan+Schneeweiss&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schneeweiss Stephan</a>, <a href="/search?value1=Norbert+Brockmeyer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brockmeyer Norbert</a>, <a href="/search?value1=Christoph+D+Spinner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Spinner Christoph D</a>, <a href="/search?value1=Markus+Bickel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bickel Markus</a>, <a href="/search?value1=Stefan+Esser&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Esser Stefan</a>, <a href="/search?value1=Jukka+Hartikainen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hartikainen Jukka</a>, <a href="/search?value1=Albrecht+Stoehr&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stoehr Albrecht</a>, <a href="/search?value1=Clara+Lehmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lehmann Clara</a>, <a href="/search?value1=Ulrich+Marcus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marcus Ulrich</a>, <a href="/search?value1=J%C3%B6rg+Janne+Vehreschild&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vehreschild Jörg Janne</a>, <a href="/search?value1=Alexandra+Knorr&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Knorr Alexandra</a>, <a href="/search?value1=Anna-Lena+Brillen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brillen Anna-Lena</a>, <a href="/search?value1=Carsten+Tiemann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tiemann Carsten</a>, <a href="/search?value1=Merlin+L+Robb&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Robb Merlin L</a>, <a href="/search?value1=Nelson+L+Michael&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Michael Nelson L</a></span>. HIV pre-exposure prophylaxis was associated with no impact on sexually transmitted infection prevalence in a high-prevalence population of predominantly men who have sex with men, Germany, 2018 to 2019. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(14):pii=2100591. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.14.2100591" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.14.2100591</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 15 Jun 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 05 Nov 2021 </span> </p>
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