Confronting Rising STIs in the Era of PrEP and Treatment as Prevention


Purpose of Review

This study aims to review the epidemiology of sexually transmitted infections (STIs) among men who have sex with men (MSM) and suggest control measures.

Recent Findings

Despite declines in new HIV diagnosis, bacterial STIs among MSM have dramatically risen since the late 1990s. This increase occurred concurrent with introduction of effective antiretroviral therapy, the advent of electronic mechanisms for meeting sex partners and population-level changes in sexual behavior, including decreased condom use. HIV pre-exposure prophylaxis (PrEP) is now further diminishing condom use, though its impact on STIs is uncertain. A plan to confront the MSM STI epidemic should include increased HIV/STI testing promoted through expanded public health clinical infrastructure, health care system reform to improve the care of gender and sexual minorities and promote low-barrier care, re-invigorated condom promotion, and scientific innovation.


There is an urgent need to implement new STI control measures while continuing to expand PrEP use.

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Research reported in this publication was supported by NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, and NIDDK of the National Institutes of Health under award number AI027757.

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Correspondence to Meena S. Ramchandani.

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MRG has research support from Hologic and GSK. Other authors report no conflict of interest.

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Ramchandani, M.S., Golden, M.R. Confronting Rising STIs in the Era of PrEP and Treatment as Prevention. Curr HIV/AIDS Rep 16, 244–256 (2019).

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  • Sexually transmitted infections (STIs)
  • Pre-exposure prophylaxis (PrEP)
  • Men who have sex with men (MSM)