New paper (Parker): Enhanced Screening and STI Diagnoses after PrEP Initiation
New paper led by Anna Parker in Epidemiology: Enhanced Screening and Bacterial Sexually Transmitted Infection Diagnoses after HIV Pre-Exposure Prophylaxis Initiation. A self-controlled case series compared gonorrhea and chlamydia diagnosis rates before and after PrEP initiation among 9,143 commercially insured US males in MarketScan claims (2016–2019). Diagnoses rose for gonorrhea (IRR 3.47, 95% CI 2.57–4.72) and chlamydia (IRR 3.59, 2.50–5.27), mostly at extragenital sites. Against a Bayesian model of increased screening with no change in infection risk, observed rates exceeded expectations by 8% to 14%, with intervals including no excess. Increased asymptomatic screening accounted for about 80% of the rise in each infection, suggesting screening, rather than risk compensation, may explain most of it.
