Evidence map›Paper›PMID 41572245›Full record

ArticleBMC public health2026

PrEPped for COVID? The association between HIV-PrEP use and COVID-19 among men and gender diverse people who have sex with men: findings from three large online surveys in the United Kingdom.

Caisey V Pulford, Holly Mitchell, Jack Rg Brown, Alison R Howarth, David Reid, Hamish Mohammed, Gwenda Hughes, Catherine H Mercer, John Saunders

Abstract read
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Caisey V PulfordBlood Safety, Hepatitis, STIs and HIV Division, United Kingdom Health Security Agency (UKHSA), 61 Colindale Avenue, London, NW9 5EQ, UK. Caisey.V.Pulford@ukhsa.gov.uk.
Holly MitchellBlood Safety, Hepatitis, STIs and HIV Division, United Kingdom Health Security Agency (UKHSA), 61 Colindale Avenue, London, NW9 5EQ, UK.
Jack Rg BrownThe National Institute for Health & Care Research Health Protection Research Unit in Blood Borne & Sexually Transmitted Infections at University College London in partnership with United Kingdom Health Security Agency, London, UK.
Alison R HowarthThe National Institute for Health & Care Research Health Protection Research Unit in Blood Borne & Sexually Transmitted Infections at University College London in partnership with United Kingdom Health Security Agency, London, UK.
David ReidThe National Institute for Health & Care Research Health Protection Research Unit in Blood Borne & Sexually Transmitted Infections at University College London in partnership with United Kingdom Health Security Agency, London, UK.
Hamish MohammedBlood Safety, Hepatitis, STIs and HIV Division, United Kingdom Health Security Agency (UKHSA), 61 Colindale Avenue, London, NW9 5EQ, UK.
Gwenda HughesBlood Safety, Hepatitis, STIs and HIV Division, United Kingdom Health Security Agency (UKHSA), 61 Colindale Avenue, London, NW9 5EQ, UK.
Catherine H MercerThe National Institute for Health & Care Research Health Protection Research Unit in Blood Borne & Sexually Transmitted Infections at University College London in partnership with United Kingdom Health Security Agency, London, UK.
John SaundersBlood Safety, Hepatitis, STIs and HIV Division, United Kingdom Health Security Agency (UKHSA), 61 Colindale Avenue, London, NW9 5EQ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOral tenofovir and emtricitabine taken as pre-exposure prophylaxis (HIV-PrEP) is highly effective at reducing Human Immunodeficiency Virus (HIV) acquisition. Nucleotide analogues have also been shown to inhibit Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) polymerase activity in vitro, raising the question as to whether tenofovir-based HIV-PrEP could be useful for the prevention and treatment of COVID-19. We sought to examine the association between HIV-PrEP use and self-reported COVID-19 testing outcomes and respiratory symptoms among men and gender diverse people who have sex with men in the UK.

methodsParticipants completed online surveys deployed at three time points during the COVID-19 pandemic (Survey 1 (S1) 23/06/20 − 14/07/20; S2 23/11/20 − 12/12/20; S3 23/03/21 − 14/04/21), including men (cis/transgender), transwomen or gender-diverse people reporting sex with another man (cis/transgender) or non-binary person assigned male at birth. The outcome was self-reported COVID-19 testing and COVID-19 related respiratory symptoms including a new continuous cough, high temperature or loss of smell and/or taste during the most recent lookback period. All participants reporting taking HIV-PrEP in the past year were compared with those who did not. Analysis was performed using logistic regression, adjusting for sociodemographic and behavioural factors.

resultsAmong 4,544 participants living without HIV across three surveys (89.7% of all survey respondents), 21.4% (n = 970) reported recently using HIV-PrEP, 564 (12.4%) participants reported respiratory symptoms and 160 (3.5%) reported a positive COVID-19 test. There was a slight, non-statistically significant positive association between HIV-PrEP use and a COVID-19 positive test in the first survey-period (P1) (adjusted Odds Ratio (aOR) = 1.11, CI = 0.51–3.98). This positive association significantly increased across survey periods (P2: aOR = 4.26, CI = 1.21–14.97, P3: aOR = 9.02, CI = 2.69–30.31). There was a positive association between HIV-PrEP use and respiratory symptoms in the first survey-period (aOR = 1.45, CI = 1.03–2.03). However, this positive association reversed in survey-period 2 and 3 (P2: aOR = 0.62, CI = 0.40–0.95, P3: aOR = 0.45, CI = 0.28–0.72).

conclusionsWe found no evidence that HIV-PrEP use protected against COVID-19 among participants. Conversely, we identified a positive association between HIV-PrEP use and COVID-19 which may reflect uncaptured behaviours that increase COVID-19 exposure amongst those using HIV-PrEP. The decline in respiratory symptoms in HIV-PrEP users over time might reflect some immune protection following exposures to respiratory viruses through more social mixing or a direct impact of HIV-PrEP on symptom severity.

Indexed as

COVID-19HIV InfectionsHomosexuality, MalePre-Exposure ProphylaxisSexual and Gender MinoritiesAdolescentAdultEmtricitabineFemaleHumansMaleMiddle AgedPandemicsSARS-CoV-2Surveys and QuestionnairesTenofovirEmtricitabineTenofovirCOVID-19GBMSMHIVPrEPSurvey

Identifiers

PMID41572245
PMCPMC12911014

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.