title: Sexually transmitted infections and pre-exposure prophylaxis: challenges and opportunities among men who have sex with men in the US.
abstract: Pre-Exposure Prophylaxis (PrEP) has shown high efficacy in preventing human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) in several large clinical trials, and more recently in "real world" reports of clinical implementation and a PrEP demonstration project. Those studies also demonstrated high bacterial sexually transmitted infection (STI) incidence and raised the discussion of how PrEP may impact STI control efforts, especially in the setting of increasing Neisseria gonorrhoeae antimicrobial resistance and the increase in syphilis cases among MSM. Here, we discuss STIs as a driver of HIV transmission risk among MSM, and the potential opportunities and challenges for STI control afforded by expanded PrEP implementation among high-risk MSM.
authors.affiliation: Bridge HIV, San Francisco Department of Public Health, San Francisco, CA USA.
authors.forename: Hyman M
authors.initials: HM
authors.lastname: Scott
authors.affiliation: Division of Infectious Diseases: Global Health, Department of Medicine, University of California, Los Angeles, Los Angeles, CA USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D024881:Drug Resistance, Bacterial; D006069:Gonorrhea / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D065129:Pre-Exposure Prophylaxis; D012307:Risk Factors; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology / Q000517:prevention & control*; D013587:Syphilis / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
keywords: HIV; MSM; PrEP; STIs