HIV/STI counseling and testing services received by gay and bisexual men using pre-exposure prophylaxis (PrEP) at their last PrEP care visit.

BACKGROUND: Pre-exposure prophylaxis (PrEP) reduces risk of HIV infection for many gay and bisexual men (GBM); however, bacterial sexually transmitted infections (STIs) associated with decreasing condom use among users is of concern. Center for Disease Control and Prevention's guidelines for PrEP use recommend bacterial STI screening every six months. We sought to investigate comprehensive PrEP care, defined as: 1) discussion of sexual behavior, 2) blood sample, 3) urine sample, 4) rectal sample (rectal swab), and 5) throat sample (throat swab), provided at user's last PrEP appointment.

METHODS: PrEP-using GBM in New York City (n = 104) were asked about their last PrEP care visit. We examined associations of demographics (age, race/ethnicity, and education), recent number of condomless anal sex (CAS) events, time on PrEP, and healthcare provider type on receiving comprehensive care at last visit using fully-adjusted binary logistic regression.

RESULTS: At their last visit, nearly all men (94%) gave blood for testing, 88% provided a urine sample, and 77% discussed sexual behavior with their provider. However, only 51% reported having a rectal swab, and 48% an oral swab. Only 32% of men received comprehensive PrEP care at their last PrEP visit. Odds of receiving comprehensive care were significantly higher among younger men, men with a Bachelor's degree or more education, and those who reported more CAS.

CONCLUSIONS: Less than one-third of GBM received comprehensive HIV/STI counseling and testing at their last visit. These findings indicate further efforts are needed to prepare healthcare providers for prescribing and managing patients on PrEP.