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• W4285904161 abstract "Despite the many benefits of pre-exposure prophylaxis (PrEP), one unintended potential consequence is an increase in condomless anal sex. In a study by Molina et al., 77% of men who have sex with men (MSM) reported condomless anal sex at the commencement of PrEP. This rate increased to 86% at 18 month follow-up [[1]Molina J.M. Charreau I. Spire B. et al.Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: An observational cohort study.Lancet HIV. 2017; 4: e402-e410Abstract Full Text Full Text PDF PubMed Scopus (285) Google Scholar]. Men on PrEP have also reported more frequent sexual encounters with men who are either HIV positive or unknown status [[2]Newcomb M.E. Moran K. Feinstein B.A. et al.Pre-exposure prophylaxis (PrEP) use and condomless anal sex: Evidence of risk compensation in a cohort of young men who have sex with men.J Acquir Immune Defic Syndr. 2018; 77: 358-364Crossref PubMed Scopus (80) Google Scholar]. The lack of condom use is contributing to rising rates of sexually transmitted infections sexually transmitted infections, even when controlling for testing frequency [[3]Montaño M.A. Dombrowski J.C. Dasgupta S. et al.Differences in sexually transmitted infection risk comparing preexposure prophylaxis users and propensity score matched historical controls in a clinic setting.AIDS. 2019; 33: 1773-1780Crossref PubMed Scopus (10) Google Scholar]. These data on STI rates should not deter clinicians from prescribing PrEP. Rather, it highlights the importance of educating patients that, PrEP does not provide coverage against sexually transmitted infections and further underscores the importance of condom use during anal sex. On February 23, 2022, the Food and Drug Administration (FDA) released a statement announcing the approval of the One Male Condom for anal sex. This is the first condom to receive this distinction. Prior to this, condom use for anal sex was considered off label. The approval is based on results from a 2019 study comparing the failure rates of standard, fitted, and thin condoms during anal sex compared to vaginal sex. In this study of 252 MSM and 252 men who have sex with women (MSW), there were only nine breaks and seven slippage events during anal sex in MSM (1% failure rate) compared to the 26 breaks and 22 slippage events reported in MSW (1.9% failure rate). Standard performed the best with nine breaks and four slippage events, yet all three (standard, fitted, thin) had rates less than 2%, below the 5% threshold set by the FDA [[4]Siegler A.J. Rosenthal E.M. Sullivan P.S. et al.Levels of clinical condom failure for anal sex: A randomized cross-over trial.EClinicalMedicine. 2019; 17: 100199Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar]. We are hopeful that this announcement will help increase health equity as well as increase provider confidence in counseling surrounding condom use during anal sex. Our optimism may stem from prior data showing that 69% of MSM would be more likely to use condoms if the FDA approved the use in anal sex [[5]Siegler A.J. Ahlschlager L. Rosenthal E.M. et al.Utility of a US Food and Drug Administration (FDA) label indication for condoms for anal sex.Sex Health. 2020; 17: 91Crossref PubMed Scopus (1) Google Scholar]. Although too early to examine whether this authorization will increase uptake, this new FDA approval should provide an opportunity for clinicians to advocate for condom use more effectively for patients engaging in anal sex, especially for people using PrEP. These conversations will continue to be important with the advent of newer formulations of PrEP such as injectable cabotegravir." @default.
• W4285904161 created "2022-07-20" @default.
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• W4285904161 date "2022-08-01" @default.
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• W4285904161 title "Condom Use for Anal Sex in the Era of Pre-exposure Prophylaxis (PrEP)" @default.
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• W4285904161 doi "https://doi.org/10.1016/j.jadohealth.2022.05.014" @default.
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