{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:46Z","timestamp":1787017006102,"version":"build-2736575974"},"reference-count":29,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,5,27]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Among users of oral HIV pre-exposure prophylaxis (PrEP), condom use is low and incidence of sexually transmitted infections (STIs) is high, hence guidelines recommend STI screening every 3\u20136 months. Identifying individuals with higher asymptomatic STI risk for targeted screening may offer an opportunity to reduce the burden of STI screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the Netherlands, PrEP has been offered through the National PrEP Pilot Program since 2019, which includes screening every 3 months. We included data of all individuals who received care through the PrEP programme between July 2019 and June 2022 and attended at least one PrEP care visit. STI-related symptoms and notification of possible STI exposure by sexual partners are recorded during each visit. We assessed the predictors of any chlamydia, gonorrhoea or syphilis infection diagnosed during routine asymptomatic STI screening (ie, no reported symptoms or partner notification) using logistic regression and calculated risk scores from coefficients of the multivariable logistic regression model. We estimated the sensitivity and specificity for the optimal prediction score cut-off.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 11 035 included individuals (97% men who have sex with men), 14 926 bacterial STIs (9114 diagnosed during routine asymptomatic screening) were diagnosed during a median of 24 months (IQR 15\u201330) of follow-up. We found that PrEP users who engaged in sex work, had condomless anal sex, participated in group sex or chemsex (ie, use of gamma-hydroxybutyrate\/gamma-butyrolactone, mephedrone or crystallised methamphetamine during sex), injected drugs or used alcohol or non-chemsex-related drugs during sex had an increased risk of STIs diagnosed during routine asymptomatic screening. PrEP users born in the Netherlands and those who attended college or university had a lower STI risk. A risk score using these covariates resulted in a sensitivity of 0.55 (95% CI 0.54 to 0.56) and specificity of 0.55 (95% CI 0.54 to 0.55). Individuals eligible for STI screening accounted for 54% of STIs diagnosed during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using routinely available demographic and behavioural data, it was not possible to construct a well-performing risk score to identify individuals at high risk of STIs diagnosed during routine asymptomatic screening. Other factors, methods or ways to analyse data may be needed to increase predictive capacity for STI risk scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056506","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T05:25:17Z","timestamp":1749187517000},"page":"17-23","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Regression-based risk scores using sociodemographic and sexual behaviour data do not predict asymptomatic sexually transmitted infections among HIV PrEP users"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-1501","authenticated-orcid":false,"given":"Vita Willemijn","family":"Jongen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"},{"name":"Stichting hiv monitoring, Amsterdam, Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-7002","authenticated-orcid":false,"given":"Maarten","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, Netherlands"},{"name":"Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands"},{"name":"Amsterdam Public Health research Institute (APH), Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6562-7029","authenticated-orcid":false,"given":"Daphne Amanda","family":"van Wees","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0881-5680","authenticated-orcid":false,"given":"Mark","family":"van den Elshout","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J P A","family":"Hoebe","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Maastricht, Netherlands"},{"name":"Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, Heerlen, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1236-6224","authenticated-orcid":false,"given":"Hannelore M","family":"G\u00f6tz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Rotterdam-Rijnmond, Rotterdam, Netherlands"},{"name":"Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, Netherlands"},{"name":"Amsterdam Public Health research Institute (APH), Amsterdam, Netherlands"},{"name":"Department of Dermatology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, Netherlands"},{"name":"Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands"},{"name":"Amsterdam Public Health research Institute (APH), Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0512-2109","authenticated-orcid":false,"given":"Elske","family":"Hoornenborg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, Netherlands"},{"name":"Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands"},{"name":"Amsterdam Public Health research Institute (APH), Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-758X","authenticated-orcid":false,"given":"Nicole H T M","family":"Dukers-Muijrers","sequence":"additional","affiliation":[{"name":"Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, Heerlen, Netherlands"},{"name":"Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands"},{"name":"Stichting hiv monitoring, Amsterdam, Netherlands"},{"name":"Amsterdam Institute for Immunology & Infectious Diseases (AII), Amsterdam, Netherlands"},{"name":"Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"2026081704400956000_102.1.17.1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"2026081704400956000_102.1.17.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506273"},{"key":"2026081704400956000_102.1.17.3","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":"2026081704400956000_102.1.17.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy182"},{"key":"2026081704400956000_102.1.17.5","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":"2026081704400956000_102.1.17.6","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2021.0219"},{"key":"2026081704400956000_102.1.17.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004328","article-title":"Sexual behaviour and incidence of sexually transmitted infections among men who have sex with men (MSM) using daily and event-driven pre-exposure prophylaxis (PrEP): Four-year follow-up of the Amsterdam PrEP (AMPrEP) demonstration project cohort","volume":"21","author":"van den Elshout","year":"2024","journal-title":"PLoS Med"},{"key":"2026081704400956000_102.1.17.8","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003837"},{"key":"2026081704400956000_102.1.17.9","unstructured":"Nederlandse Vereniging van HIV Behandelaren (NVHB) . Nederlandse multidisciplinaire richtlijn pre-expositie profylaxe (PrEP) ter preventie van HIV (update 2022). Available: https:\/\/www.soaaids.nl\/files\/2022-07\/20220711-PrEP-richtlijn-Nederland-versie-3-update-2022.pdf [Accessed 13 Mar 2023]."},{"key":"2026081704400956000_102.1.17.10","unstructured":"Centers for Disease Control and Prevention . Preexposure prophylaxis for the prevention of HIV infection in the United States\u20142021 update: a clinical practice guideline. Available: https:\/\/www.cdc.gov\/hiv\/pdf\/risk\/prep\/cdc-hiv-prep-guidelines-2021.pdf [Accessed 31 May 2022]."},{"key":"2026081704400956000_102.1.17.11","unstructured":"Brady M , Rodger A , Asboe D , et al . BHIVA\/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP). 2018. Available: https:\/\/www.bhiva.org\/PrEP-guidelines"},{"key":"2026081704400956000_102.1.17.12","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2022-055439"},{"key":"2026081704400956000_102.1.17.13","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002522"},{"key":"2026081704400956000_102.1.17.14","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003676"},{"key":"2026081704400956000_102.1.17.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanepe.2023.100743","article-title":"Management of asymptomatic sexually transmitted infections in Europe: towards a differentiated, evidence-based approach","volume":"34","author":"Kenyon","year":"2023","journal-title":"Lancet Reg Health Eur"},{"key":"2026081704400956000_102.1.17.16","doi-asserted-by":"crossref","first-page":"e233","DOI":"10.1016\/S2352-3018(23)00299-0","article-title":"Effect of screening for Neisseria gonorrhoeae and Chlamydia trachomatis on incidence of these infections in men who have sex with men and transgender women taking HIV pre-exposure prophylaxis (the Gonoscreen study): results from a randomised, multicentre, controlled trial","volume":"11","author":"Vanbaelen","year":"2024","journal-title":"Lancet HIV"},{"key":"2026081704400956000_102.1.17.17","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2022-055488"},{"key":"2026081704400956000_102.1.17.18","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053825"},{"key":"2026081704400956000_102.1.17.19","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2024.1348686","article-title":"Incidence and spontaneous clearance of gonorrhea and chlamydia infections among men who have sex with men: a prospective cohort study in Zhuhai, China","volume":"12","author":"Lyu","year":"2024","journal-title":"Front Public Health"},{"key":"2026081704400956000_102.1.17.20","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25105","article-title":"Men who have sex with men more often chose daily than event-driven use of pre-exposure prophylaxis: baseline analysis of a demonstration study in Amsterdam","volume":"21","author":"Hoornenborg","year":"2018","journal-title":"J Int AIDS Soc"},{"key":"2026081704400956000_102.1.17.21","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2022-055608"},{"key":"2026081704400956000_102.1.17.22","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052052"},{"key":"2026081704400956000_102.1.17.23","unstructured":"Clayton P . CUTPT: Stata module for empirical estimation of cutpoint for a diagnostic test Boston College Department of Economics. 2013. Available: https:\/\/ideas.repec.org\/c\/boc\/bocode\/s457719.html"},{"key":"2026081704400956000_102.1.17.24","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1601600403"},{"key":"2026081704400956000_102.1.17.25","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.2947"},{"key":"2026081704400956000_102.1.17.26","doi-asserted-by":"crossref","first-page":"e670","DOI":"10.1016\/S2352-3018(24)00211-X","article-title":"Bacterial sexually transmitted infections among men who have sex with men and transgender women using oral pre-exposure prophylaxis in Latin America (ImPrEP): a secondary analysis of a prospective, open-label, multicentre study","volume":"11","author":"Torres Silva","year":"2024","journal-title":"Lancet HIV"},{"key":"2026081704400956000_102.1.17.27","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2021-055227"},{"key":"2026081704400956000_102.1.17.28","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00175-X"},{"key":"2026081704400956000_102.1.17.29","doi-asserted-by":"crossref","DOI":"10.2196\/51023","article-title":"Online-Mediated HIV Pre-exposure Prophylaxis Care and Reduced Monitoring Frequency for Men Who Have Sex With Men: Protocol for a Randomized Controlled Noninferiority Trial (EZI-PrEP Study)","volume":"12","author":"Groot Bruinderink","year":"2023","journal-title":"JMIR Res Protoc"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:40:49Z","timestamp":1786966849000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,6]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,16]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/sextrans-2025-056506"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056506","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,6]]}}}