AIDS and Behavior

, Volume 23, Issue 7, pp 1841–1845 | Cite as

Increases in Pre-exposure Prophylaxis Use and Decreases in Condom Use: Behavioral Patterns Among HIV-Negative San Francisco Men Who have Sex with Men, 2004–2017

  • Yea-Hung Chen
  • John Guigayoma
  • Willi McFarland
  • Jonathan M. Snowden
  • Henry F. RaymondEmail author
Original Paper


Using data from the National HIV Behavioral Surveillance of men who have sex with men (MSM), we estimated the prevalence of sexual behaviors among HIV-negative San Francisco MSM between 2004 and 2017. We estimate a recent increase in the 1-year prevalence of pre-exposure prophylaxis (PrEP) use, from 9.8% in 2014 to 44.9% in 2017. Over that same period, we estimate a decrease in the prevalence of consistent condom use, from 18.5 to 9.4%, and an increase in the percent of individuals with multiple condomless anal intercourse partners. We conclude that while risks for HIV infection may be decreasing among San Francisco MSM due, in part, to increases in PrEP use, the population faces increased risks for other sexually transmitted infections (STIs). Because PrEP alone does not protect against other STIs, we strongly recommend that PrEP users use condoms when possible, routinely screen for STIs, and disclose infections with sexual partners.


Men who have sex with men (MSM) Pre-exposure prophylaxis (PrEP) Condomless anal intercourse Serosorting Seroadaptive behaviors 



This study was funded by CDC (Grant Number NU62PS005077).

Compliance with Ethical Standards

Conflict of interest

All authors declare no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.San Francisco Department of Public HealthSan FranciscoUSA
  2. 2.School of Public HealthOregon Health & Sciences University–Portland State UniversityPortlandUSA
  3. 3.Department of Epidemiology, School of Public HealthRutgers UniversityPiscatawayUSA

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