Dealing with pre-exposure prophylaxis-associated condom migration: changing the paradigm for men who have sex with men
Richard A. CrosbyA College of Public Health at the University of Kentucky, 151 Washington Avenue, Lexington, KY 40506-0003, USA.
B The Kinsey Institute for Research in Sex, Gender, and Reproduction, 1165 East 3rd Street, Bloomington, IN 47405, USA.
C University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA.
D Corresponding author. Email: crosbyr3@gmail.com
Sexual Health 14(1) 106-110 https://doi.org/10.1071/SH16128
Submitted: 23 June 2016 Accepted: 29 July 2016 Published: 2 September 2016
Journal Compilation © CSIRO Publishing 2017 Open Access CC BY-NC-ND
Abstract
The behavioural aspects of pre-exposure prophylaxis (PrEP) are challenging, particularly the issue of condom migration. Three vital questions are: (1) at the population-level, will condom migration lead to increases in non-viral sexually transmissible infections?; (2) how can clinic-based counselling best promote the dual use of condoms and PrEP?; and (3) in future PrEP trials, what are the ‘best practices’ that should be used to avoid type 1 and type 2 errors that arise without accounting for condom use behaviours? This communication piece addresses each question and suggests the risk of a ‘PrEP only’ focus to widening health disparities.
Additional keywords: HIV/AIDS, measurement sexual behaviours, prevention, sexually transmissible infections.
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