Sexual health: will PrEP and ‘U=U’ messages affect risk behaviours?


  • Jo Whelan
  • Medical News
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Despite higher than average rates of sexually transmitted infections (STIs) in people with HIV, HIV is too often seen in isolation from broader sexual health, according to a briefing from the Terrence Higgins Trust. In England, people living with HIV make up 0.2% of the population but account for 3% of all STI diagnoses.

  • The number of STI diagnoses in people with HIV rose by 30% in 2012-17, compared with a 6% fall in the general population.
  • Diagnoses of bacterial STIs (e.g syphilis and gonorrhoea) in people with HIV rose four-fold from 2009-15, whereas viral STI rates were relatively stable.
  • High rates of STIs partially reflect their increased prevalence in gay and bisexual men. However, men with HIV are disproportionately affected, accounting for 20% of all STI diagnoses in this group.
  • STI rates in women with HIV are double those in the general female population.

There is currently limited understanding of how PrEP and Can’t Pass It On/U=U messaging may affect sexual risk behaviours, the briefing says. However, accessing PrEP provides additional opportunities to engage with sexual health services and STI testing.  More work is needed on understanding the different factors that may affect sex and relationships for people living with HIV, and to ensure that appropriate sexual  health services are available and accessible.