- People living with HIV (PLWH) with histories of unhealthy alcohol use, especially those with partners using preexposure prophylaxis (PrEP), have elevated sexually transmitted infection (STI) risk.
Why this matters
- Frequent STI screening, discussions around STI prevention are especially important in HIV-infected men who have sex with men (MSM).
- Conduct enhanced outreach, targeted screening, sexual health counseling in MSM with unhealthy alcohol use history, partners on PrEP.
- 465 PLWH included.
- 32% (147) had HIV-positive partners only, 31% had ≥1 HIV-negative partner using PrEP (145), and 37% (173) had HIV-negative partners without reported PrEP use.
- 8% prevalence of any bacterial STI in past year.
- Multivariate: prevalence of STI was higher among PLWH with ≥1 partner on PrEP than those with HIV-negative partners not on PrEP (adjusted prevalence ratio [aPR], 2.99; 95% CI, 1.11-8.08).
- STI prevalence was higher among PLWH reporting abuse of alcohol (aPR, 1.53; 95% CI, 0.61-3.83), drugs (aPR, 1.97; 95% CI, 0.71-5.51), or both (aPR, 1.93; 95% CI, 1.75-4.97) before sex.
- Analysis of bacterial STI prevalence, associated correlates in a primary-care-based cohort of PLWH with unhealthy alcohol use history.
- Funding: NIH, Kaiser Permanente Northern California.
- Inability to characterise sexual networks, assess exposures/outcome temporality.
- Recall bias.
- Limited generalisability.