The National Coalition of STD Directors (NCSD) has written a letter to the Centers for Disease Control (CDC) making a strong case for routine STD screenings every three months for persons on PrEP.
Based on data presented at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI), NCSD argues that sexually transmitted infections are extremely common among patients on PrEP and symptom assessment alone is often unreliable.
LOS ANGELES (March 23, 2016) AIDS Healthcare Foundation (AHF), the largest global HIV/AIDS organization, commends the National Coalition of STD Directors (NCSD) for advocating for regular STD screening intervals for Pre-Exposure Prophylaxis (PrEP) users in recent letters to the Centers for Disease Control (CDC). In their letter dated March 11, NCSD denounced the “lack of clear guidance to providers and patients on recommended routine STD screening intervals for PrEP users.” The relatively infrequent STD testing for PrEP patients, argues the NCSD, results in “less than optimal screening” and could “allow asymptomatic STDs to spread.”
While the CDC recommends STD screening every six months and symptom assessment every three months for PrEP users, data presented at the recent 2016 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston indicates that screening less frequently than three month intervals leaves a significant amount of active infections undetected. Although persons in monogamous serodiscordant relationships may not require frequent screening, the majority of PrEP users would greatly benefit from revised guidelines from the CDC. The study presented at CROI confirmed that condomless intercourse was highly common among PrEP users, resulting in an ample spread of sexually transmitted infections. Based on the existing PrEP testing guidelines, 34 percent of gonorrhea, 40 percent of chlamydia, and 20 percent of syphilis infections would have gone undetected for six-month intervals. Relying on symptom assessment alone at three-month intervals failed to detect an astonishing 77 percent of STDs, according to the study.
“Late last year the CDC reported that rates for the three most commonly-reported STDs in the United States were increasing rapidly for the first time since 2006,” said Michael Weinstein, President of AIDS Healthcare Foundation. “The agency must consider NCSD’s recommendation to amend its PrEP guidelines in order to halt the dangerous spread of infections among patients at an increased risk.”
AHF criticized the CDC in the past for its lack of emphasis on STD prevention for PrEP users. Late last month, the CDC unveiled a study that encourages rapidly increased PrEP use as a key strategy towards preventing as many as 185,000 HIV infections by 2020. The study never mentioned condoms, a critical method of curbing HIV and other sexually-transmitted infections. Last summer, on the third anniversary of Truvada’s FDA approval for PrEP, AHF raised concerns over the CDC’s recommendation for 500,000 high-risk Americans to begin PrEP while failing to consider poor patient adherence to the medication.