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P435 Use of condoms for the prevention of Sexually Transmitted Infections (STIs) among HIV Pre-Exposure Prophylaxis (PrEP) users
  1. Benjamin Bavinton1,
  2. Stefanie Vaccher2,
  3. Martin Holt3,
  4. Rebecca Guy4,
  5. Garrett Prestage1,
  6. Fengyi Jin2,
  7. Janaki Amin5,
  8. David Templeton6,
  9. Christine Selvey7,
  10. Iryna Zablotska-Manos8,
  11. Josephine Lusk9,
  12. Erin Ogilvie2,
  13. Tobias Vickers2,
  14. Don Smith10,
  15. Andrew Grulich11
  1. 1UNSW Sydney, The Kirby Institute, Sydney, Australia
  2. 2The Kirby Institute, UNSW Sydney, Sydney, Australia
  3. 3UNSW Sydney, Centre for Social Research in Health, Sydney, Australia
  4. 4Kirby institute, Sydney, Australia
  5. 5Macquarie University, Sydney, Australia
  6. 6RPA Sexual Health, Sydney, Australia
  7. 7NSW Ministry of Health, Sydney, Australia
  8. 8Sydney Medical School Westmead, University of Sydney, Sydney, Australia
  9. 9Short Street Centre, Sydney, Australia
  10. 10Albion Centre, Sydney, Australia
  11. 11Kirby Institute, the University of New South Wales, Sydney, Australia


Background HIV PrEP is highly effective at preventing HIV, but not STI, acquisition. We examined the use of condoms to prevent STIs among PrEP-users in the EPIC-NSW trial.

Methods Between March 2016 and April 2018, 9,708 individuals were enrolled. Analysis was restricted to participants who completed the optional end-of-study survey and were on-study for ≥1 year prior. STI diagnoses came from medical records; other data were from the end-of-study survey. We used multivariate logistic regression to assess independent associations between those agreeing with the statement, “I use condoms to avoid getting STIs” (“STI-condom-users”) and those disagreeing.

Results 2,915 participants were included; 92.5% were gay men. In the previous year, 54.2%, 25.6%, and 20.2% were diagnosed with no, one, and ≥2 STIs, respectively. 1,127 (38.7%) reported being STI-condom-users. In multivariate analysis, there was no difference in mean STIs diagnosed in the previous year (0.7 vs 0.8, p=0.244). STI-condom-users were younger (39 vs 41 years, p=0.004), less likely to live in a suburb with ≥10% gay men (24.8% vs 35.5%, p<0.001), less likely to report any condomless sex in the previous 6 months (85.9% vs 93.3%, p<0.001), and had been on-study less time (1.4 vs 1.6 years, p=0.003). STI-condom-users were more: concerned about acquiring STIs (95.1% vs 88.9%, p=0.025), likely to discuss STI results with partners (88.3% vs 79.8%, p<0.001), and likely to believe condoms prevent STI transmission (96.7% vs 89.6%, p<0.001). Fewer STI-condom-users had rejected a sexual partner for wanting to use condoms (9.6% vs 32.7%, p<0.001), while more had been rejected for wanting to use condoms (45.0% vs 26.2%, p<0.001).

Conclusion Most PrEP-users did not use condoms for STI prevention, despite strong beliefs in its effectiveness. STI-condom-users did not have fewer STIs, reflecting high levels of condomless sex. Our results suggest alternative methods of STI prevention should be trialled for PrEP-users.

Disclosure No significant relationships.

  • ART
  • PrEP
  • risk behaviour

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