ArticlePLoS medicine2024
Sexual behaviour and incidence of sexually transmitted infections among men who have sex with men (MSM) using daily and event-driven pre-exposure prophylaxis (PrEP): Four-year follow-up of the Amsterdam PrEP (AMPrEP) demonstration project cohort.
Article in PLoS medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Trial
- Migration Status and HIV Pre-exposure Prophylaxis (PrEP) Uptake Among Gay and Bisexual Men and Non-binary People in Australia: Results of a National Cross-Sectional Survey.AIDS and behavior · 2026Article
- Increasing Uptake of Pre-Exposure Prophylaxis and Associated Behavioral Changes Among Men Who Have Sex with Men - Qingdao City, Shandong Province, China, 2024-2025.China CDC weekly · 2026Article
- Observational
- Trends Analysis of Sexually Transmitted Infections Before and After Human Immunodeficiency Virus Pre-exposure Prophylaxis in the United States 2001-2022.Open forum infectious diseases · 2025Article
- High syphilis incidence among PrEP-adherent men who have sex with men and transgender women in Peru.Journal of the International AIDS Society · 2025Article
- Subpopulations with frequent healthcare barriers have increased risk of sexually transmitted infections and dropping out from HIV preexposure prophylaxis care.AIDS (London, England) · 2025Article
- Real-time digital intervention on oral pre-exposure prophylaxis adherence among MSM: randomized controlled trial.NPJ digital medicine · 2025Article
- Association Between Incorrect Use of Pre- and Post-Exposure Prophylaxis and HIV infection Among Men Who Have Sex with Men - Shenzhen City, Guangdong Province, China, 2021-2023.China CDC weekly · 2025Article
- Treponema pallidum infection in asymptomatic persons: A puzzling scenario in the Canary Islands (Spain) (2001-2020).PloS one · 2025Article
- Incidence of HIV infection and associated factors among men who have sex with men in Zhejiang, China: a cohort study.Frontiers in public health · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn increasing number of countries are currently implementing or scaling-up HIV pre-exposure prophylaxis (PrEP) care. With the introduction of PrEP, there was apprehension that condom use would decline and sexually transmitted infections (STIs) would increase. To inform sexual health counselling and STI screening programmes, we aimed to study sexual behaviour and STI incidence among men who have sex with men (MSM) and transgender women who use long-term daily or event-driven PrEP. METHODS AND
findingsThe Amsterdam PrEP demonstration project (AMPrEP) was a prospective, closed cohort study, providing oral daily PrEP and event-driven PrEP to MSM and transgender women from 2015 to 2020. Participants could choose their PrEP regimen and could switch at each three-monthly visit. STI testing occurred at and, upon request, in-between 3-monthly study visits. We assessed changes in numbers of sex partners and condomless anal sex (CAS) acts with casual partners over time using negative binomial regression, adjusted for age. We assessed HIV incidence and changes in incidence rates (IRs) of any STI (i.e., chlamydia, gonorrhoea, or infectious syphilis) and individual STIs over time using Poisson regression, adjusted for age and testing frequency. A total of 367 participants (365 MSM) commenced PrEP and were followed for a median 3.9 years (interquartile range [IQR] = 3.4-4.0). Median age was 40 years (IQR = 32-48), 315 participants (85.8%) self-declared ethnicity as white and 280 (76.3%) had a university or university of applied sciences degree. Overall median number of sex partners (past 3 months) was 13 (IQR = 6-26) and decreased per additional year on PrEP (adjusted rate ratio [aRR] = 0.86/year, 95% confidence interval [CI] = 0.83-0.88). Overall median number of CAS acts with casual partners (past 3 months) was 10 (IQR = 3-20.5) and also decreased (aRR = 0.92/year, 95% CI = 0.88-0.97). We diagnosed any STI in 1,092 consultations during 1,258 person years, resulting in an IR of 87/100 person years (95% CI = 82-92). IRs of any STI did not increase over time for daily PrEP or event-driven PrEP users. Two daily PrEP users, and no event-driven PrEP users, were diagnosed with HIV during their first year on PrEP. Study limitations include censoring follow-up due to COVID-19 measures and an underrepresentation of younger, non-white, practically educated, and transgender individuals.
conclusionsIn this prospective cohort with a comparatively long follow-up period of 4 years, we observed very low HIV incidence and decreases in the numbers of casual sex partners and CAS acts over time. Although the STI incidence was high, it did not increase over time.
trial registrationThe study was registered at the Netherlands Trial Register (NL5413) https://www.onderzoekmetmensen.nl/en/trial/22706.
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