{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T18:39:46Z","timestamp":1776105586709,"version":"3.50.1"},"reference-count":31,"publisher":"BMJ","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In many countries, HIV pre-exposure prophylaxis (PrEP) users are screened quarterly for STIs. We assessed the consequences of less frequent STI testing. We also assessed determinants of asymptomatic STI and potential for onward transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the AMPrEP study, we assessed the proportion of syphilis, and genital, anal, and pharyngeal chlamydia and gonorrhoea diagnoses which would have been delayed with biannual versus quarterly screening. We assessed the potential for onward transmission by examining reported condomless anal sex (CAS) in periods after to-be-omitted visits when screening biannually. We assessed determinants of incident asymptomatic STIs using Poisson regression and calculated individual risk scores on the basis of the coefficients from this model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 366 participants. Median follow-up was 47 months (IQR 43\u201350). 1,183STIs were diagnosed, of which 932(79%) asymptomatic. With biannual screening, 483 asymptomatic STIs (52%) diagnoses would have been delayed at 364 study visits. Of these visits, 129 (35%), 240 (66%) and 265 (73%) were followed by periods of CAS with steady, known casual or unknown casual partners, respectively. Older participants had a lower risk of asymptomatic STI (incidence rate ratio (IRR) 0.86\/10-year increase, 95% CI 0.80 to 0.92), while CAS with known (IRR 1.36, 95% CI 1.10 to 1.68) and unknown (IRR 1.86, 95% CI 1.48 to 2.34) casual partners and chemsex (IRR 1.51, 95% CI 1.28 to 1.78) increased the risk. The individual risk scores had limited predictive value (sensitivity=0.70 (95% CI 0.66 to 0.74), specificity=0.50 (95% CI 0.48 to 0.51)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Reducing the STI screening frequency to biannually among PrEP users will likely result in delayed diagnoses, potentially driving onward transmission. Although determinants for asymptomatic STIs were identified, predictive power was low.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2022-055439","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T17:20:38Z","timestamp":1652894438000},"page":"sextrans-2022-055439","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Can we screen less frequently for STI among PrEP users? Assessing the effect of biannual STI screening on timing of diagnosis and transmission risk in the AMPrEP Study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-1501","authenticated-orcid":false,"given":"Vita W.","family":"Jongen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanne M.L.","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marit","family":"Goedhart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes A.","family":"Bogaards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udi","family":"Davidovich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza","family":"Coyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry J.C.","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Prins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elske","family":"Hoornenborg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-7002","authenticated-orcid":false,"given":"Maarten F.","family":"Schim van der Loeff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"2022051810201090000_sextrans-2022-055439v1.1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"2022051810201090000_sextrans-2022-055439v1.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506273"},{"key":"2022051810201090000_sextrans-2022-055439v1.3","first-page":"909","article-title":"Will risk compensation accompany pre-exposure prophylaxis for HIV?","volume":"16","author":"Blumenthal","year":"2014","journal-title":"Virtual Mentor"},{"key":"2022051810201090000_sextrans-2022-055439v1.4","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25407","article-title":"Daily and event-driven pre-exposure prophylaxis for men who have sex with men in Belgium: results of a prospective cohort measuring adherence, sexual behaviour and STI incidence","volume":"22","author":"Vuylsteke","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"2022051810201090000_sextrans-2022-055439v1.5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy182"},{"key":"2022051810201090000_sextrans-2022-055439v1.6","doi-asserted-by":"crossref","first-page":"e447","DOI":"10.1016\/S2352-3018(19)30136-5","article-title":"Sexual behaviour and incidence of HIV and sexually transmitted infections among men who have sex with men using daily and event-driven pre-exposure prophylaxis in AMPrEP: 2 year results from a demonstration study","volume":"6","author":"Hoornenborg","year":"2019","journal-title":"Lancet HIV"},{"key":"2022051810201090000_sextrans-2022-055439v1.7","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1007\/s10461-018-2290-3","article-title":"High adherence to HIV pre-exposure prophylaxis and NO HIV seroconversions despite high levels of risk behaviour and STIs: the Australian demonstration study prelude","volume":"23","author":"Zablotska","year":"2019","journal-title":"AIDS Behav"},{"key":"2022051810201090000_sextrans-2022-055439v1.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.2947"},{"key":"2022051810201090000_sextrans-2022-055439v1.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0208107","article-title":"Incidence of sexually transmitted infections in men who have sex with men and who are at substantial risk of HIV infection - A meta-analysis of data from trials and observational studies of HIV pre-exposure prophylaxis","volume":"13","author":"Werner","year":"2018","journal-title":"PLoS One"},{"key":"2022051810201090000_sextrans-2022-055439v1.10","unstructured":"Nederlandse Vereniging van HIV Behandelaren (NVHB). HIV preexpositie profylaxe (PreP) richtlijn Nederland, gereviseerde versie 2. Nederlandse vereniging van HIV behandelaren (NVHB), 2019. Available: https:\/\/nvhb.nl\/wp-content\/uploads\/2019\/04\/PrEP-richtlijn-Nederland-versie-2-dd-15-april-2019.pdf [Accessed 15 Apr 2020]."},{"key":"2022051810201090000_sextrans-2022-055439v1.11","unstructured":"Centers for Disease Control and Prevention . Us public health service: preexposure prophylaxis for the prevention of HIV infection in the United States\u20142017 update: a clinical practice guideline., 2018. Available: https:\/\/www.cdc.gov\/hiv\/pdf\/risk\/prep\/cdc-hiv-prep-guidelines-2017.pdf"},{"key":"2022051810201090000_sextrans-2022-055439v1.12","unstructured":"Brady M , Rodger A , Asboe D . BHIVA\/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PreP). 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