Sexual behavior and STIs during PrEP: condom use increases
Results from the ANRS Ipergay trial presented today at the 10th IAS Conference on HIV Science (Mexico City, 21-24 July 2019) by Luis Sagaon-Teyssier (IRD, SESSTIM UMR1252, Marseille), show that condom use increased in association with PrEP (preexposure prophylaxis of HIV by TDF/FTC) in the event of sexually transmitted bacterial infections.
ANRS Ipergay was a study of on-demand PrEP used at the time of exposure to health risks by seronegative men who have sex with men (MSM). From 2012 to 2014, the first phase of ANRS Ipergay was performed double-blind (half the group took a tablet containing two antiretrovirals [TDF/FTC] at the time of sexual relations; the other half took a placebo) and showed that on-demand PrEP reduced the risk of HIV infection by 86%(1).
The second phase, during which all volunteers received PrEP, started after publication of the first results in late 2014 and was completed in June 2016. It showed a relative 97% reduction in the incidence of HIV infection(2). The trial included 361 volunteers in France and Canada during two successive phases.
The results presented today at the 10th Conference on HIV Science in Mexico City concern sexual behavior during the second phase of the study and show that the occurrence of a sexually transmitted bacterial infection (chlamydia, gonorrhea, syphilis) boosted the use of condoms and PrEP. This increase in condom use was also dependent on sexual behavior, as it was more probable when there were more partners and sexual relations. In contrast, those who practiced "chemsex," ie, who used drugs during sex, were not inclined to use condoms in addition to PrEP, which mandates particular vigilance regarding sexually transmitted infections identified in this population through frequent screening.
In most (almost 60%) cases, resumption of condom use was not accompanied by interruption of PrEP. The authors conclude that, in addition to sexual behavior, the occurrence of a sexually transmitted infection during PrEP boosts condom use, and that this increased use does not necessarily result in the interruption of PrEP.
The volunteers seemed to adapt their preventive strategy to the situation. The authors conclude that users of PrEP combine it with condom use when engaging in risky sexual relations.
For more information
http://programme.ias2019.org/Abstract/Abstract/3442
NB. TIME DIFFERENCE:
Paris time minus 7 hours = Mexico City time
(When it's 14.00 in Paris, it's 7.00 in Mexico City)
Scientific contact
Luis Sagaon-Teyssier
Labor and health economist
luis.sagaon-teyssier@inserm.fr
ANRS press contacts:
Séverine Ciancia
01 53 94 60 30 - information@anrs.fr
Marc Fournet
01 53 94 80 63 - information@anrs.fr