PrEP, STIs and kidney monitoring
It’s really clear now that PrEP protects against HIV if it’s taken properly. Recently the number of new HIV infections has started to go down, particularly in London, and we think that PrEP has a lot to do with this.
Unfortunately, rates of sexually transmitted infections (STIs) are going up. Some people think that this is because when you’re taking PrEP you’re likely to take more risks sexually and so be more likely to catch STIs.
Whether this is true or not is unclear; some studies suggest this but others don’t.
STI rates have been going up for a long time but we know that they were going up before PrEP started being widely used.
One of the most worrying things about these rising STI rates is that we’re starting to see some really serious complications. For example, in the past, people with syphilis tended to have relatively minor symptoms that settled quickly with reasonably simple treatments. Now we’re seeing increasing numbers of people with infections of the eyes and brain, which can sometimes lead to permanent damage.
Whatever the studies show, though, it’s really important to have STI check-ups regularly whether you’re taking PrEP or not.
We still advise that you use condoms as much as you can to reduce the risk of catching an STI, but having a check- up every 3 to 6 months (more frequently if you think you’ve been at risk or have symptoms) means that infections get picked up and can be treated more quickly with less risk that they’ll be passed on, and before they cause complications.
It’s also important that you have your kidney function checked before you start and while taking PrEP. This is because in some people, PrEP can cause kidney problems. In many sexual health clinics, you can have this done at the same time as your sexual health check-up.
So, keep safe and HIV-free and get tested for STIs!
Dr Nneka Nwokolo, consultant at 56 Dean Street
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