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. 2023 Mar 1;50(3):144-149.
doi: 10.1097/OLQ.0000000000001731. Epub 2022 Nov 6.

Factors Associated With Willingness to Use Daily Antibiotics as Sexually Transmitted Infection Prophylaxis Among HIV Preexposure Prophylaxis-Experienced Gay and Bisexual Men in Australia

Tyson Arapali  1 , Andrew E Grulich  1 , Anita E Heywood  2 , Curtis Chan  1 , Doug Fraser  1 , Iryna B Zablotska, Martin Holt  3 , Stefanie J Vaccher  1 , Benjamin R Bavinton  1
Affiliations

Factors Associated With Willingness to Use Daily Antibiotics as Sexually Transmitted Infection Prophylaxis Among HIV Preexposure Prophylaxis-Experienced Gay and Bisexual Men in Australia

Tyson Arapali et al. Sex Transm Dis. .

Abstract

Background: Gay and bisexual men (GBM) who use HIV preexposure prophylaxis (HIV-PrEP) have high rates of bacterial sexually transmitted infections (STIs). The use of daily antibiotics as STI preexposure prophylaxis (STI-PrEP) may be appealing to GBM who are using or have previously used HIV-PrEP (HIV-PrEP-experienced) for the prevention of bacterial STIs.

Methods: We examined willingness to use daily STI-PrEP among a cross-sectional sample of HIV-PrEP-experienced GBM in Australia who participated in an observational online cohort study from August 2018 to March 2020. Factors associated with willingness to use daily STI-PrEP were determined using bivariate and multivariate logistic regression.

Results: Of the 1347 participants, half (54.3%) were willing to use daily STI-PrEP. Factors independently associated with greater willingness to use daily STI-PrEP included having >10 sexual partners in the last 6 months, using methamphetamine in the last 6 months, being more conscious about avoiding STIs, having a greater number of STIs since commencing HIV-PrEP, being willing to take HIV-PrEP for as long as they were at risk of acquiring HIV, and only using condoms when a sexual partner requested them. Conversely, factors associated with less willingness to use daily STI-PrEP included being university educated, using nondaily dosing regimens of HIV-PrEP, preferring event-driven HIV-PrEP, and being concerned about long-term HIV-PrEP adverse effects.

Conclusions: Sexually transmitted infection PrEP is likely to be appealing to many HIV-PrEP-experienced GBM, especially those who engage in activities associated with a higher risk of STI transmission. However, they are less likely to be willing to use STI-PrEP unless it aligns with their HIV-PrEP dosing regimen, suggesting that research into the safety and efficacy of alternative STI prophylaxis dosing options should be prioritized.

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Conflict of interest statement

Conflict of Interest and Sources of Funding: A.E.G. has received an honorarium from MSD (2021) and research support from Glaxo Smith Kline (2021–2023) and ViiV Healthcare (2022–2023). A.E.H. has received honoraria from MSD (2022) and Pfizer (2021). B.R.B. has received honoraria from Gilead Sciences (2020) and ViiV Healthcare (2022), and is currently receiving unrestricted research grants from Gilead Sciences (2021–2022) and ViiV Healthcare (2022–2023). For the remaining authors, none were declared.

Comment in

References

    1. McGregor S, King J, McManus H, et al. HIV, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2018. Sydney, Australia: The Kirby Institute, 2018. Available at: https://kirby.unsw.edu.au/report/asr2018/ . Accessed August 12, 2021.
    1. Kirby Institute. Sexually transmissible infections. Available at: https://data.kirby.unsw.edu.au/STIs/ . Accessed September 27, 2022.
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    1. Traeger MW, Cornelisse VJ, Asselin J, et al. Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection. JAMA 2019; 321:1380–1390.
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