PrEP uptake on the rise and condom use declines in gay men

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Some parts of Australia show an increase in uptake of pills that can prevent contracting HIV but also a sharp drop in condom use among men having sex with men. This was found in a major study and is cause for concern.

AIDS preventing pills are called Pre-exposure prophylaxis, or PrEP. These are once daily pills that can, to some extent prevent infection with HIV by preventing transmission of the virus. The pill has led people to become complacent and abandon use of safe sex practices, the study notes. Experts have called this phenomenon “risk compensation”.

This new study was published in the latest issue of the Lancet HIV journal. The study speaks of caution in implanting PrEP without adequate support in the form of patient education that could encourage the use of condoms for sex.

For this study over 17,000 gay and bisexual men were recruited from the Victoria and New South Wales regions. In these areas there is a high rate of uptake of the PrEP.

Over the period between 2013 and 2017, the number of HIV negative people who took PrEP for HIV prevention rose from a mere 2 percent to 24 percent. Over this time, the researchers note, men having unprotected sex with other men rose from 1 percent to 16 percent.

Condom use declined from 46 percent to 31 percent during this time. Men who were not on PrEP also were having unprotected anal sex and this rose from 30 percent to 39 percent. Only good trend was the falling numbers of HIV positive individuals in these two states.

According to lead author Prof Martin Holt at the University of New South Wales, there is a rapid decline in condom use and this is associated with increase in PrEP uptake in the community. It is however too early to say what the long-term effects of this would be, he added.

He called for better monitoring and evaluation of the effects of PrEP on sexual practices and behaviours among both PrEP users and non-users he said. Community sex education regarding PrEP as well as condom use should be upped he said.

According to experts it has been some time that condom use is declining among men having sex with men and PrEP availability is only one of the causes. Due to condom-less sex becoming rampant there is a rise in incidences of gonorrhoea and syphilis.

Despite rise in condom-less sex there is a decline in HIV because those who are diagnosed are rapidly put on anti-HIV pills that prevent them from spreading the infection believe researchers. This is the reason who there is a decline in the number of HIV positive individuals despite lower condom use.

Deborah Gold, chief executive of the National Aids Trust in the UK called this situation unique to Australia. She said that condom use and PrEP use among people is actually being proactive and taking responsibility of one’s HIV transmission risk among HIV negative individuals.

Source: https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(18)30072-9/fulltext

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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