Taking Club Drugs Increases STI Risk in PrEP Users

The HIV prevention drug PrEP has been show to decrease transmission of the virus among gay and bisexual men, but recent reports show that bacterial sexually transmitted infections (BSTIs) among PrEP users are on the rise. A team of researchers, including the Graduate School of Public Health & Health Policy Professor Christian Grov, surveyed PrEP users to identify how club drugs possibly interfered with dosages, and develop a more specific picture about BSTI risk. They published their results in the journal Sexually Transmitted Infections. 

The researchers interviewed gay and bisexual men, half of whom used club drugs (ketamine, ecstasy, GHB, cocaine, and methamphetamine). Those who reported using club drugs had 6.6 times the odds of acquiring a BSTI, which was associated with missing a PrEP dosage. PrEP users had a 55 percent chance of missing a dosage the same day they took club drugs, and a 60 percent chance of missing a dosage the following day. Comparatively, those who reported having more frequent anal sex without condoms had only 1.1 times odds of acquiring an BSTI. 

“The fact that club drug users demonstrated higher odds of [BSTIs], even after controlling for condomless sex, suggests other variables may be putting club drug users at a greater risk for exposure,” said Grov.

The authors hypothesized that PrEP users who also use club drugs could be at a unique risk of BSTIs, perhaps because of higher-risk sexual networks. “We know that club drugs and sex often go hand in hand, and our findings may point to a concentration of STIs that are being passed between club drug users,” said Grov. But more research is needed to confirm this theory.

In the meantime, screening PreP users for club drug use may help focus education and intervention programs. “When you’re observing higher rates of STIs in this group, you want to make sure you’re providing appropriate education, testing and treatment services for these individuals,” said Grov.

Grov co-authored a previous PrEP study about social stigmas and attitudes surrounding the medication with doctoral student Mark Pawson.

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“Club drug users had higher odds of reporting a bacterial STI compared with non-club drug users”

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Christian Grov (Department Chair and Professor, Community Health and Social Sciences) | Profile 1

Colleges and Schools
Graduate School of Public Health & Health Policy

Bonus Content
“How substance use affects adherence to PrEP among gay and bisexual men” (SPH News)
“Social Stigmas Hamper Use of HIV-Prevention Drug” (SUM)

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