RESEARCH ARTICLE


Sexually Transmitted Infections in the PReP Era. Are Family Doctors Ready to Give Advice?



Carmen Rodríguez Cerdeira1, 2, *, Sánchez Blanco E3, Sánchez Blanco B4, Carnero Gregorio M1, 5
1 Efficiency, quality and costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur). SERGAS-UVIGO
2 Dermatology Service, Hospital do Meixoeiro and University of Vigo, Vigo, Spain
3 Postdoctoral Researcher, Conselleria de Educación, Xunta Galicia, Vigo. Spain
4 Predoctoral Researcher, Family Physician, EOXI, Vigo. Spain
5 Postdoctoral Researcher, University of Vigo, Vigo, Spain


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© 2017 Rodríguez Cerdeira et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Dermatology Service Meixoeiro hospital CHUVI, Vigo, C/Meixoeiro S/N 36200, Vigo, Spain; Tel: 0034986814517/ 0034600536114; Fax: 004986276416; E-mail: carmencerdeira33@gmail.com


Abstract

Background:

Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) as a method of HIV prevention is not without controversy, and there has been concern that it may lead its users to think that they no longer need other preventive measures such as condoms. Thus, healthcare providers are convinced that PrEP decreases condom use and increases sexually transmitted infections (STIs). This treatment has been studied in men who have sex with men, men and women in heterosexual HIV-discordant couples, and heterosexual men and women.

Objective:

The objective of this study was to review the current state of evidence on the association of PrEP with condom use, the incidence of STIs, and the change in sexual behaviours in populations with risky practices.

Materials and Methods:

PubMed (National Center for Biotechnology Information, Bethesda, MD, USA), Science Direct (Elsevier Ltd., Oxford, UK), and Google Scholar (Google Inc., Mountain View, CA, USA) search engines were used during the study. We used the terms HIV, PrEP, sexually transmitted infections (STIs), MSM, condom, heterosexual men / women to search the databases.

Results:

Here, we present evidence that daily oral treatment is safe and effective in these populations studied, especially when medication adherence is high. STI testing should include extra-genital testing regardless of PrEP use to prevent health deficits and onward transmission.

Conclusion:

Despite this safety and efficacy, we strongly advise that patients continue to use condoms as a prophylactic measure against other sexually transmitted diseases. This update addresses the benefits and precautions that must be taken when establishing PrEP treatment, focusing mainly on family doctorswho are best positioned to provide follow-up and advice to patients and their relatives.

Keywords: VIH, Pre-exposure prophylaxis (PrEP), Sexually transmitted infections, Syphilis, Gonorrhea, Chlamydia, Vulvovaginitis, Family Doctors.