PrEP Use and Sexually Transmitted Infections Are Not Associated Longitudinally in a Cohort Study of Young Men Who Have Sex with Men and Transgender Women in Chicago


Our goal was to understand whether PrEP users are at increased risk for STIs, a key target in prevention efforts aimed at disrupting the spread of STIs and likely downstream HIV infection risk. Data were collected as part of RADAR, a cohort study of young men who have sex with men and transgender women (YMSM/TW) (aged 16–29) in Chicago. Longitudinal lagged regression models were utilized to assess the relationship between PrEP use and odds of rectal STI acquisition. Mediation models were also utilized to consider the potential pathway between PrEP use, condomless anal sex (CAS), and rectal STI. One hundred eighty-seven (16.2%) participants had a rectal STI at baseline. In both cross-sectional and longitudinal models, no significant association was observed between PrEP use and STI. In mediation models, PrEP use was significantly associated with increased CAS, however, CAS was not associated with STI status. We demonstrated that, overall, PrEP use was not associated with STIs among YMSM/TW but did observe that PrEP users were more likely to report increased participation in CAS at the subsequent study visit.

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This work was supported by grants from the National Institute on Drug Abuse at the National Institutes of Health (U01DA036939, PI: Mustanski; F32DA046313, PI: Morgan; R01MD013609, PI: Mustanski & Newcomb). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The sponsor had no involvement in the conduct of the research or the preparation of the article. The authors would like to thank the entire RADAR research team, particularly Dr. Thomas Remble and Antonia Clifford for overseeing the project and Daniel T. Ryan for data management. We also thank the RADAR participants for sharing their experiences with us.

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Correspondence to Ethan Morgan.

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Morgan, E., Dyar, C., Newcomb, M.E. et al. PrEP Use and Sexually Transmitted Infections Are Not Associated Longitudinally in a Cohort Study of Young Men Who Have Sex with Men and Transgender Women in Chicago. AIDS Behav 24, 1334–1341 (2020).

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  • HIV
  • PrEP
  • STI
  • Longitudinal