审查男男性行为者中 PrEP 对性传播感染发病率的影响——平衡增加性传播感染筛查和潜在行为性风险补偿。
Reviewing PrEP's Effect on STI Incidence Among Men Who Have sex with Men-Balancing Increased STI Screening and Potential Behavioral Sexual Risk Compensation.
机构信息
Division of STD Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 1600 Clifton Rd., US12-2, Atlanta, GA, 30316, USA.
Oak Ridge Institute of Science and Education, Oak Ridge, TN, USA.
出版信息
AIDS Behav. 2021 Jun;25(6):1810-1818. doi: 10.1007/s10461-020-03110-x. Epub 2020 Nov 26.
Abstract
Though pre-exposure prophylaxis (PrEP) can prevent HIV acquisition, it provides no protection against bacterial sexually transmitted infections (STIs). PrEP use may increase STI acquisition due to sexual risk compensation, but that could be counterbalanced by increased STI screening at regular PrEP visits. We conducted a literature search of studies with quantitative data published prior to March 2020, assessing sexual risk compensation or STI screening among men who have sex with men (MSM) before and after PrEP initiation. We identified 16 relevant publications. Changes in condom use were inconsistent across studies. Partner acquisition following PrEP initiation decreased in most studies, likely due to behavioral counseling. In publications comparing a PrEP arm to a non-PrEP arm, serodiscordance increased in the PrEP arm and decreased in the non-PrEP arm. STI screening among MSM was low within a month of PrEP initiation. Monitoring trends in sexual risk compensation and STI screening will be critical to understand PrEP's effects on STI burden.
摘要
尽管暴露前预防 (PrEP) 可以预防 HIV 感染，但它不能预防细菌性性传播感染 (STI)。PrEP 的使用可能会由于性风险补偿而增加 STI 的获得，但这可能会被定期 PrEP 就诊时增加的 STI 筛查所抵消。我们对截至 2020 年 3 月之前发表的具有定量数据的研究进行了文献检索，评估了男男性行为者 (MSM) 在开始 PrEP 前后的性风险补偿或 STI 筛查。我们确定了 16 篇相关出版物。 condom 使用的变化在不同的研究中不一致。大多数研究表明，PrEP 启动后伴侣的获得减少，这可能是由于行为咨询。在将 PrEP 组与非 PrEP 组进行比较的出版物中，PrEP 组的血清不一致性增加，而非 PrEP 组的血清不一致性减少。PrEP 启动后一个月内，MSM 的 STI 筛查率较低。监测性风险补偿和 STI 筛查的趋势对于了解 PrEP 对 STI 负担的影响至关重要。
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