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Correspondence
Failure of on-demand pre-exposure prophylaxis: the risk of HIV drug resistance
  1. Angelo Roberto Raccagni1,
  2. Elena Bruzzesi1,
  3. Nicola Gianotti2,
  4. Michela Sampaolo3,
  5. Diana Canetti2,
  6. Antonella Castagna2,4,
  7. Silvia Nozza2
  1. 1 Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
  2. 2 Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
  3. 3 Microbiology Unit, San Raffaele Hospital, Milano, Italy
  4. 4 Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
  1. Correspondence to Dr Angelo Roberto Raccagni, Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano 20132, Italy; raccagni.angelo{at}hsr.it

https://doi.org/10.1136/sextrans-2021-055354

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    Dear Editor,

    A man aged 32 years who self-described as men who have sex with men (MSM) started on-demand pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir (FTC/TDF) based on reporting 30 partners within the last 24 weeks, not using condoms in 50% of sex acts, use of gamma-hydroxybutyric acid during sex and previous STI diagnoses (Smith score=37).1 Over 1 year, we conducted 3-monthly STI screening and HIV-RNA testing. He tested HIV-negative at months 0, 3, 6 and 9. At month 12, he reported missing a single PrEP dose 1 month earlier due to gamma-hydroxybutyric …

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    Footnotes

    • Handling editor Anna Maria Geretti

    • Contributors SN visited the individual and contributed to writing the article. ARR contributed to writing the article. EB, DC and AC contributed to the review of the article. NG visited the individual and contributed to the review of the article. MS performed HIV resistance tests and contributed to the review of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.