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For Gay Men, HIV PrEP and Sexual Risk Are Not Necessarily Bedfellows

October 22, 2013

Many in the gay community have concerns that pre-exposure prophylaxis (PrEP) may increase sexual risk-taking and actually lead to an increase in the transmission of HIV and other sexually transmitted infections (STIs). Some, however, are challenging that notion: A new study published in the Journal of Acquired Immune Deficiency Syndromes shows that the overall rates of sexual risk taking in a group of HIV-negative men who have sex with men (MSM) on PrEP fell or remained stable during the 24 months of the study.

The study sought to evaluate any changes in the sexual behaviors of men who were put on a daily PrEP regimen consisting of the U.S. FDA-approved drug Truvada (tenofovir/FTC). In the randomized, double-blind, placebo-controlled trial, 373 HIV-negative men reporting anal sex in the past 12 months were enrolled in San Francisco, Atlanta and Boston. At the end of the trial, researchers found no evidence that HIV-negative gay men who knew they had the protection of PrEP increased their risk behaviors.

In fact, recreational drug use -- not PrEP -- led to riskier behavior, according to the study. The researchers said:

We found that substance use (including poppers, amphetamines, and sexual performance-enhancing drugs) was associated with increased reported risk ... Services to link substance using MSM into counseling and treatment should be considered in future PrEP programs.

What do you think? Is PrEP the wrong target when we discuss reducing risk factors? Would you take PrEP daily? Read the rest of the study on NATAP and comment below.

Mathew Rodriguez is the editorial project manager for and

Follow Mathew on Twitter: @mathewrodriguez.

Copyright © 2013 Remedy Health Media, LLC. All rights reserved.

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This article was provided by TheBody.

Reader Comments:

Comment by: Tim Mon., Nov. 4, 2013 at 1:37 am UTC
A valid study give us the conclusion the sponsors at the top of the page desperately want to see in print. Media is beholden to the interest of its advertisers, not its audience.
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Comment by: Jamie (Melbourne, Australia) Sat., Oct. 26, 2013 at 2:00 am UTC
This research has little validity. 50% of participants were given a placebo and only 50% were given PrEP, in a double-blind study design and ALL participants were counselled that they may only be taking a placebo. Therefore no-one knew whether they were getting PrEP or a useless placebo, so why would any rational participant change their risk-taking behaviour???

Just to emphasise this aspect, the authors report that over 75% of participants didn't know what they were taking or assumed they were taking the placebo. The 75% figure is a little scary as, assuming the study was well administered, in fact 100% of the participants didn't know what they were getting ...
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Comment by: Jamie (Melbourne, Australia) Mon., Oct. 28, 2013 at 3:18 am UTC
Further, it may be of interest to analyse the risk behaviour of the roughly 25% who believed, probably many incorrectly, that they were on the proper treatment (PrEP).

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