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New Study Ties PrEP to Significant Drop in Condom Use

Monday Jun 18, 2018

A new study of gay and bisexual men taking PrEP or pre-exposure prophylaxis to prevent HIV acquisition published in the Lancet HIV Journal last week confirms long-held concerns of public health advocates affiliated with AHF: While the use of PrEP may result in a decrease in transmission of HIV, it also contributes to a decrease in the use of condoms at a time when rates of other STDs in the US and elsewhere among young people and men-who-have-sex-with-men are exploding -- infections for which PrEP offers no preventive effect.

This latest PrEP study, undertaken in Melbourne and Sydney, Australia between January 1, 2013 and March 31, 2017, found that the percentage of men on PrEP who had sex with a casual partner without a condom rose from one percent to sixteen percent. There was even a nine percent jump in unprotected sex with a casual partner by men who were not on PrEP and who were HIV negative or untested. In interpreting the study in the Lancet HIV Journal, the researchers concluded:

"A rapid increase in PrEP use by gay and bisexual men in Melbourne and Sydney was accompanied by an equally rapid decrease in consistent condom use."

Even before the FDA first approved use of Gilead's HIV/AIDS treatment medication Truvada as pre-exposure prophylaxis (PrEP) as a tool for HIV prevention in July 2012, AHF expressed concern about the impact PrEP would have on public health prevention efforts, including concerns over patient adherence to a daily pill regimen for PrEP as well as the possible abandonment of the culture of condom use-something that appears borne out in this Australian study.

AHF's concerns about PrEP remained so strong that in November 2014 it published "An Open Letter to the CDC: "What if You're Wrong About PrEP?" in The Hill, a daily newspaper serving and reporting on elected officials and government staffers in Washington DC. AHF's "CDC: What if You're Wrong About PrEP?" ad also ran over the following ten days in newspapers and magazines in seven markets or cities nationwide: New York, Los Angeles, San Francisco, Oakland, Dallas, Washington, DC and South Florida.

"This latest study confirms the real damage being done to the culture of condom use attributed to PrEP," said Michael Weinstein, President of AHF. "AHF saw this coming years ago and challenged the CDC in its November 2014 open letter asking the CDC to monitor, rethink and retool its messaging and policies on PrEP and prevention as, if or when studies like this came to light and were published. That challenge fell on deaf ears. Today, we renew and restate our unanswered call, again asking, 'CDC: What if You're Wrong About PrEP?'"

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