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Publication Profiles

Low HIV incidence among women following sexually transmitted infection does not support national pre-exposure prophylaxis recommendations

Citation

Berzkalns AE, Barbee LA, Dombrowski JC, Golden MR. Low HIV incidence among women following sexually transmitted infection does not support national pre-exposure prophylaxis recommendations. AIDS. 2020;34(9):1429-1431. doi:10.1097/QAD.0000000000002561

Implementation stage:

Not available

Implementation outcomes reported:

Not available

Continuum target addressed:

Linkage to preventative care, HIV testing

Geography:

King County-WA

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers wanted to measure how often women in King County were diagnosed with HIV after syphilis, gonorrhea, or chlamydia. They examined whether the observed risk supported national guidance to offer HIV-prevention medicine after certain infections.

Plain Language Abstract

U.S. guidelines recommend offering pre-exposure prophylaxis, or PrEP, to women diagnosed with gonorrhea or syphilis, but local HIV risk after these infections may vary. Researchers analyzed King County, Washington, surveillance data from 2008 through 2018 to estimate new HIV diagnoses after women were diagnosed with syphilis, gonorrhea, or chlamydia. HIV incidence after gonorrhea was estimated at 0.06 cases per 100 person-years, meaning approximately six cases per 10,000 women followed for one year. After chlamydia, the estimate was 0.02 per 100 person-years, or about two cases per 10,000 women per year. No women reported with syphilis were subsequently diagnosed with HIV in the analyzed data. The authors concluded that the observed incidence was low and did not support using these sexually transmitted infection diagnoses alone as national PrEP indications for women. This surveillance analysis describes one county over a defined period. Very low event counts create uncertainty, and the findings do not mean that individual women with these infections have no HIV risk or should not receive a personalized prevention assessment.

Key Takeaways

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