{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:35:11Z","timestamp":1791221711987,"version":"4.1.0"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Since the recent introduction of preexposure prophylaxis (PrEP), several studies have reported a decrease in the use of condoms and a rise in STIs among users. This rise in risk behavior associated with the advent of PrEP is known as \u201crisk compensation.\u201d The aim of this study is to measure clinical and behavioral changes associated with the introduction of PrEP by analyzing condom use for anal intercourse, number of sexual partners, sexualized drug use and STI incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective descriptive study of PrEP users followed every 3months over a 2-year period spanning 2017\u20132019 in a referral clinic specializing in STI\/HIV in Madrid, Spain. One hundred ten men who have sex with men and transgender women underwent regular screening for STIs and hepatitis C virus (HCV) infection. Sociodemographic, clinical, and behavioral data were gathered for all subjects studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The risk compensation observed in this study consisted primarily of a lower rate of condom use, while the number of sexual partners and recreational drug consumption remained stable. We observed a very high incidence of STIs in this sample, particularly rectal gonorrhea and chlamydia. The factors shown to be independently associated with the presence of an STI on multivariate analysis were age below 30 years and over 10 sexual partners\/month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of STI acquisition was higher than expected, indicating a need for strategies to minimize this impact, particularly among younger individuals with a higher number of sexual partners.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0245925","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T07:30:22Z","timestamp":1612510222000},"page":"e0245925","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":47,"title":["Low use of condom and high STI incidence among men who have sex with men in PrEP programs"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9441-8031","authenticated-orcid":true,"given":"Oskar","family":"Ayerdi Aguirrebengoa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Vera Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Arias Ram\u00edrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Gil Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Puerta L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petunia","family":"Clavo Escribano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Ballesteros Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Lejarraga Ca\u00f1as","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Fernandez Pi\u00f1eiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Enrique","family":"Fuentes Ferrer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Garc\u00eda Lotero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Hurtado Gallegos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Raposo Utrilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Estrada P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Del Romero Guerrero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Rodr\u00edguez Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"pone.0245925.ref001","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1056\/NEJMoa1011205","article-title":"Preexposure chemoprophylaxis for HIV prevention in men who have sex with men","volume":"363","author":"R.M. Grant","year":"2010","journal-title":"N Engl J Med"},{"key":"pone.0245925.ref002","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/QAI.0b013e31828ece33","article-title":"Randomized trial of clinical safety of daily oral tenofovir disoproxil fumarate among HIV-uninfected men who have sex with men in the United States.","volume":"64","author":"L.A. Grohskopf","year":"2013","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0245925.ref003","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1056\/NEJMoa1110711","article-title":"Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana","volume":"367","author":"M.C. Thigpen","year":"2012","journal-title":"N Engl J Med"},{"key":"pone.0245925.ref004","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1016\/S0140-6736(13)61127-7","article-title":"Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): A randomised, double-blind, placebo-controlled phase 3 trial.","volume":"381","author":"K. Choopanya","year":"2013","journal-title":"Lancet"},{"key":"pone.0245925.ref005","first-page":"586","article-title":"Interim guidance for clinicians considering the use of preexposure prophylaxis for the prevention of HIV infection in heterosexually active adults.","volume":"61","author":"Centers for Disease Control, Prevention (CDC).","year":"2012","journal-title":"MMWR"},{"key":"pone.0245925.ref006","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(15)00056-2","article-title":"Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): Effectiveness results from the pilot phase of a pragmatic open-label randomised trial.","volume":"387","author":"S. McCormack","year":"2016","journal-title":"Lancet"},{"key":"pone.0245925.ref007","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1056\/NEJMoa1506273","article-title":"On-demand preexposure prophylaxis in men at high risk for HIV-1 infection","volume":"373","author":"J.M. Molina","year":"2015","journal-title":"N Engl J Med"},{"key":"pone.0245925.ref008","first-page":"2019","article-title":"La FDA aprueba un segundo medicamento para prevenir las infecciones de VIH como parte de sus esfuerzos continuos para poner fin a la epidemia de VIH.","volume":"03","author":"U.S. FOOD & DRUG ADMINISTRATION.","journal-title":"FDA NEWS RELEASE."},{"key":"pone.0245925.ref009","unstructured":"World Health Organization. WHO Expands recommendation on oral pre-exposure prophylaxis of hiv infection (PrEP). November; 2015."},{"key":"pone.0245925.ref010","article-title":"Recomendaciones sobre Profilaxis Pre-Exposici\u00f3n en adultos para la Prevenci\u00f3n de la Infecci\u00f3n por VIH en Espa\u00f1a.","author":"Grupo de Estudio de Sida de la SEIMC (GeSIDA).","year":"2016","journal-title":"Gu\u00edas Cl\u00ednicas"},{"key":"pone.0245925.ref011","unstructured":"Plan Nacional Sobre el Sida-Grupo de Expertos PrEP. Ministerio de Sanidad, Servicios Sociales e Igualdad. Profilaxis Preexposici\u00f3n al VIH en Espa\u00f1a. Enero 2018."},{"issue":"1","key":"pone.0245925.ref012","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S1473-3099(17)30540-6","article-title":"Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation","volume":"18","author":"V Cambiano","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"5","key":"pone.0245925.ref013","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection on Sexual Risk Behavior in Men Who Have Sex With Men: A Systematic Review and Meta-analysis","volume":"67","author":"MW Traeger","year":"2018","journal-title":"Clin Infect Dis"},{"key":"pone.0245925.ref014","doi-asserted-by":"crossref","unstructured":"Daniela Rojas Castro, Rosemary M Delabre and Jean-Michel Molina. Journal of the International AIDS Society 2019, 22(S6):e25351.","DOI":"10.1002\/jia2.25351"},{"key":"pone.0245925.ref015","unstructured":"Ministerio de Sanidad, Consumo y Bienestar Social. [Notas de Prensa El Sistema Nacional de Salud (SNS) financia la PrEP desde manana como medida de prevencion del VIH en personas de alto riesgo]. Press release. 31 October 2019, Madrid."},{"issue":"10","key":"pone.0245925.ref016","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1093\/cid\/civ778","article-title":"No New HIV Infections With Increasing Use of HIV Preexposure Prophylaxis in a Clinical Practice Setting","volume":"61","author":"JE Volk","year":"2015","journal-title":"Clin Infect Dis"},{"issue":"7","key":"pone.0245925.ref017","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1007\/s10461-018-2299-7","article-title":"Increases in Pre-exposure Prophylaxis Use and Decreases in Condom Use: Behavioral Patterns Among HIV-Negative San Francisco Men Who have Sex with Men, 2004\u20132017.","volume":"23","author":"YH Chen","year":"2019","journal-title":"AIDS Behav."},{"key":"pone.0245925.ref018","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.drugpo.2019.10.007","article-title":"Chemsex is not a barrier to self-reported daily PrEP adherence among PROUD study participants.","volume":"74","author":"C O\u2019Halloran","year":"2019","journal-title":"Int J Drug Policy."},{"issue":"4","key":"pone.0245925.ref019","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/QAD.0000000000001718","article-title":"Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV","volume":"32","author":"VK Nguyen","year":"2018","journal-title":"AIDS"},{"issue":"6","key":"pone.0245925.ref020","first-page":"457","article-title":"Does HIV pre-exposure prophylaxis use lead to a higher incidence of sexually transmitted infections? A case-crossover study of men who have sex with men in Los Angeles, California.","volume":"94","author":"MR Beymer","journal-title":"Sex Transm Infect. 2018 Sep"},{"issue":"3","key":"pone.0245925.ref021","doi-asserted-by":"crossref","first-page":"e0228998","DOI":"10.1371\/journal.pone.0228998","article-title":"Risk factors associated with sexually transmitted infections and HIV among adolescents in a reference clinic in Madrid.","volume":"15","author":"O Ayerdi Aguirrebengoa","year":"2020","journal-title":"PLoS ONE"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0245925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T07:31:02Z","timestamp":1612510262000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0245925"}},"subtitle":[],"editor":[{"given":"J. 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