One of the most common criticisms concerning pre-exposure prophylactics (PrEP), a medication that is proven to be highly effective at preventing HIV, is that gay and bi men who use PrEP will stop using condoms and thus start contracting more STIs. But a new study from the Williams Institute — a UCLA think tank that conducts rigorous, independent research on LGBTQ law and public policy — says HIV-prevention meds like Truvada aren’t to blame for a recent rise in STIS. Rather, the lead author of the PrEP study thinks a rise in gay men’s STI rates are due to “a constellation of different cultural factors,” including the rise of gay apps, decreased anxiety about HIV and a lack of STI testing among gay and bi men overall.
The PrEP study surveyed 470 gay and bisexual American men, roughly between the ages of 18 and 59, about their habits and attitudes on HIV-testing and PrEP use.
The study found that only 4.1% of those surveyed were on PrEP — itself a very low number. Those PrEP users were more likely than non-users to visit an LGBTQ clinic, most likely because doctors who prescribe PrEP require their patients to get an STI evaluation and complete blood work every three to six months.
One of the study’s lead researchers, Ilan H. Meyer, Distinguished Senior Public Policy Scholar at the Williams Institute, says, “Our data don’t support the idea that we can attribute the rise in STIs to PrEP use, at least not in a direct manner. I personally don’t think that’s what’s happening.”
He continues, “I would speculate it has more to do with a culture shift about sex. More people are having sex today. We’re in sort of a quiet sexual revolution when it comes to new identities, new labels and sexual behavior.”
However, the PrEP study also found that gay and bi men aren’t using it at nearly high enough rates, mostly because access and price remain significant barriers.
While older gay men and men living in urban areas are more likely to have heard of PrEP, the study says, more must be done to ensure bi men and men living in non-urban areas — who have it harder in terms of medical and societal stigma — hear more about PrEP as well.