Official websites use. Share sensitive information only on official, secure websites. This is an open-access article distributed under the terms of the Creative Commons Attribution CC BY 4. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made. Despite increased use of pre-exposure prophylaxis PrEP in Germany, HIV infection rates are not declining and little is known about how this prevention method affects the prevalence of sexually transmitted infections STI among men who have sex with men MSM. We studied, in a large multicentre cohort, STI point prevalence, co-infection rates, anatomical location and influence of PrEP. The BRAHMS study was a prospective cohort study conducted at 10 sites in seven major German cities that enrolled MSM reporting increased sexual risk behaviour. At screening visits, MSM were tested for Mycoplasma genitalium MGNeisseria gonorrhoeae NGChlamydia trachomatis CT and Treponema pallidum TPand given a behavioural questionnaire. We screened 1, MSM in andwith At screening, participants The most common pathogen was MG in Among the participants with at least one STI, Infection prevalence was highest at anorectal site PrEP use was not statistically significant in adjusted models for STI PR: 1. Prevalence of asymptomatic STI was high, and PrEP use did not influence STI prevalence in MSM eligible for PrEP according to national guidelines. Keywords: Pre-Exposure Prophylaxis; Sexually Transmitted Diseases; How to fuck escort review website genitalium, Gonorrhea; Chlamydia; Syphilis. Globally, the number of diagnoses of sexually transmitted infections STI has steadily increased in recent years [ 1 ]. The World Health Organization WHO estimated that inthere were million new infections with Neisseria gonorrhoeae NGChlamydia trachomatis CTTreponema pallidum TP or Trichomonasis vaginalis TV [ 1 ]. While STI diagnoses have increased across the general population, men who have sex with men MSM are disproportionately affected [ 2 ]. In pooled analyses of MSM with sexual risk behaviours, the overall STI incidence rate was The expansion of pre-exposure prophylaxis PrEP against HIV, may be accompanied by a change in behaviours that impact acquisition of other STI. Other studies have not found such risk compensation but have described increased STI diagnoses as a consequence of improved case finding of asymptomatic infections when PrEP users are regularly screened [ 5 ]. In a meta-analysis of 88 studies examining gonorrhoea, chlamydia and syphilis among individuals using PrEP, the prevalence of these STI was In contrast, in a cross-sectional study of MSM in Germany, PrEP use was associated with increased odds of testing positive for at least one STI excluding HIV [ 7 ]. While several studies have examined the association between PrEP use and STI, many were secondary analyses of PrEP roll-out studies and consequently only examined STI among participants who initiated PrEP and did not include a comparison with non-users. In addition, most studies only tested for STI at one or two anatomical sites with a focus on gonorrhoea, chlamydia and syphilis, while ignoring other pathogens that are common among MSM such as the emerging sexually transmitted bacterium Mycoplasma genitalium MG. Our objective was to comprehensively quantify the prevalence of STI at the screening visit for entry into a cohort of MSM at risk for HIV infection and evaluate potential associations between PrEP use and STI. The Longitudinal Incidence Study in Subtype B-prevalent Region Among MSM at Risk for HIV Infection to Determine Feasibility of HIV Vaccine Efficacy Trials BRAHMS was a prospective study conducted at 10 sites in seven major German cities Berlin, Bochum, Cologne, Essen, Frankfurt, Hamburg and Munich that enrolled MSM at risk of HIV infection from 4 June to 3 July Individuals were eligible to enrol if they had a non-reactive HIV test, identified as male either at birth, chosen or intersexualwere 18—55 years-old and met either of the following two how to fuck escort review website criteria [ 1 ]: self-reported condomless anal intercourse with at least two unique male partners known to be living with HIV or with unknown HIV status in the past 24 weeks or [ 2 ] documented history of syphilis, acute hepatitis C or rectal infection with MG, NG or CT in the past 24 weeks. Individuals were excluded from study participation if they previously participated in a candidate HIV vaccine study or were concurrently participating in any study of investigational agents for HIV prevention or treatment. Participants were allowed to enrol if they were taking approved agents for pre- or post-exposure prophylaxis, use of which was systematically documented. At the screening visit to determine study eligibility, basic demographical data were collected and participants without HIV were counselled about PrEP. Blood was collected to test for HIV infection, active syphilis and hepatitis A, B and C. Urine and anal and pharyngeal swabs were collected to test for MG, NG, CT and TV. STI testing was performed according to standard diagnostic methods see the Supplement for additional information on diagnostic testing. All study visits also included risk reduction counselling, provision of condoms and condom-compatible lubricants, and completion of sexual behaviour questionnaires.
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