Both globally and in the United States, rates of sexually transmitted infections (STI) have been growing at an alarming rate. A major concern is that there is limited integration of broader sexual health services within pre-exposure prophylaxis (PrEP) provision programs, where risk for STI transmission is likely to be elevated.

A new systematic review and meta-analysis study of the global epidemiologic characteristics of STIs among individuals using PrEP shines light on both STI prevalence at initiation and during PrEP use. Results of the study, published in JAMA Network Open, indicate a high burden of STIs among both individuals starting and persistently using PrEP. Results suggest that PrEP provision is concentrated among those at high risk, but that more must be done to prevent STIs among those who persistently use the HIV prevention medication.

Investigators employed 9 databases to review studies reporting STI prevalence or incidence among PrEP users. Methodological quality of studies was evaluated using the Joanna Briggs Institute critical assessment tool for prevalence and incidence studies, and a random-effects meta-analysis was performed. The study team assessed outcomes including pooled STI prevalence within 3 months of PrEP initiation and STI incidence after 3 months of PrEP use.

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