Misclassification of sexual health risks in a self-identified low risk cohort of men who have sex with men (MSM) enrolled in a community based PrEP program

ABSTRACT

The CDC recommends PrEP for MSM at substantial risk of HIV acquisition, leaving clinicians unsure whether to prescribe PrEP to MSM who do not disclose HIV risk factors. A longitudinal cohort of MSM requesting PrEP despite reporting during a clinical visit either 100% condom use or participation in oral sex only and no other risk factors was followed over 13 months at a community clinic in San Francisco to assess the accuracy of their HIV risk perception. Participants completed a sexual and substance use behavior questionnaire at baseline, outside of the clinical visit and were followed by quarterly HIV/STI testing and condom use change questionnaires. Condomless sex increased from 0% at baseline to 12% at month 1, peaked at 34% at month 7, and then decreased again to 8% at month 13. Rates of pharyngeal GC/CT varied from 7% at baseline to 12% at month 13, while rectal GC/CT decreased from 6% at baseline to 0% at month 13. The rate of syphilis was 1% both at baseline and at month 13, however, 11% and 15% of clients tested positive for syphilis at months 1 and 7 respectively.

KEYWORDS:

• MSM
• risk perception
• PrEP

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Kellie Freeborn http://orcid.org/0000-0002-9711-2249

Glen Milo Santos http://orcid.org/0000-0003-1009-5317

Additional information

Funding

This work was supported by National Institutes of Health (NIH) [grant number T32NR07081], National Institute of Nursing Research (NINR) [grant number F311NR016179-01A1].