A new study has found no link between less frequent use of condoms and a 20 per cent increase in STIs among Victorian PrEP users.

The findings published today in the Journal of the American Medical Association drew on Alfred Health and Burnet Institute data on the Victorian PrEP trial, PrEPX.

To researchers’ surprise, the study found that condom use was not a significant predictor of whether or not a participant would acquire an STI while using PrEP.

The findings instead showed that STI risk was influenced more by numbers of casual partners and group sex.

The study also found that STIs were prevalent mainly among a quarter of the study participants, who accounted for a majority of the diagnoses and experienced high rates of reinfection.

Lead author, Burnet PhD student Michael Traeger, said the study findings suggest that STI prevention campaigns should not focus solely on condom use, but also on promoting frequent testing to reduce the time to STI diagnosis and treatment.

“It’s important to understand that when people start taking PrEP, they also get tested more frequently, so STIs are more likely to be detected anyway,” Traeger said.

“But as PrEP uptake increases, identifying individuals most at risk of STIs will become increasingly important for informing effective and focused STI prevention.”

Principal Investigator of the PrEPX Study and co-senior author, Associate Professor Edwina Wright, said the research counters backlash against PrEP users for reducing condom use.

“The findings are also important because they highlight the need to target our sexual health messaging about STI risks to a relatively small proportion of PrEP users to help reduce their STI rates,” Wright said.

The research used data from almost 3000 participants in PrEPX, which was led by The Alfred hospital, with support from the Victorian Government, and Thorne Harbour Health.

Thorne Harbour Health CEO Simon Ruth said the study “highlights that PrEP is more than a pill for HIV prevention.”

“It’s a highly effective sexual health strategy that includes quarterly STI testing that interrupts the onward transmission of other STIs,” he said.

“We now have an opportunity to further assist gay men in looking after their sexual health by exploring more targeted strategies for those at higher risk of STIs.”

Health data released last year showed a 22 per cent drop in new HIV transmissions in Victoria, the result of higher testing, broader adherence to treatment as prevention (TasP), as well as PrEP’s availability on the Pharmaceutical Benefits Scheme.

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