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Condoms used less: HIV protection increases the risk of other communicable diseases


ZEIT ONLINE | News, backgrounds and debates

London (dpa) - According to a study, those who take preventive measures against the infection with the AIDS virus HIV can be at high risk of developing another sexually transmitted disease.

Doctors diagnosed tripper, chlamydia or syphilis in almost three quarters of patients who used pre-exposure prophylaxis against HIV (PrEP) within the first year, researchers on Jason Ong from the London School of Hygiene and Tropical Medicine in London report in the specialist magazine « JAMA Network Open ». For a long time, experts have feared that “vaccination against AIDS” will result in users of condoms being used less frequently and increasing the risk of infection with other sexually transmitted diseases.

The scientists around Ong, including employees of the World Health Organization (WHO), had evaluated 88 studies from five continents on the use of PrEP and its medical support. PrEP is a combination of drugs that effectively protects against infection with HIV. The prerequisite is that the patents do not carry the HI virus.

While 23.9 percent of patients were diagnosed with gonorrhea, chlamydia or syphilis in the initial examination for PrEP, the number of diseases rose to 72.2 percent within the first year of using PrEP.

The figures are not surprising for Armin Schafberger from Deutsche Aidshilfe in Berlin. However, he points out that the study does not take into account the type and scope of the medical examinations and diagnoses. This can be seen, for example, in the fact that gonorrhea, chlamydia and syphilis were detected much more frequently in countries with high average incomes than in countries with low or medium average incomes. "If you take a closer look, you will find more," emphasizes Schafberger - because those who have no symptoms are also examined for diseases.

Similar studies, albeit with less data, with similar results have already been carried out, said Schafberger. He had actually hoped from the current analysis that the data would be used to provide clear recommendations for medical support for PrEP. It remains unclear whether combating infections without symptoms with antibiotics benefits the patient or does more harm - for example because the frequent use of antibiotics can lead to resistance.

Schafberger also sees something positive in the high number of diagnoses: "They show that PrEP treatment actually reaches groups who have a high risk of sexually transmitted diseases." This is a good opportunity for preventive measures. Because during the PrEP treatment, the patients have to be checked for HIV every three months. The German-Austrian PrEP guidelines also recommend tests for hepatitis C (every six to twelve months), syphilis (every three months), gonorrhea (every three to six months) and chlamydia (every three to six months).

The figures published by the Robert Koch Institute a few days ago show that sexually transmitted diseases cannot be neglected in this country either: In 2018, the number of new cases of syphilis in Germany was 7223, which was on a similar level to the previous year (7140). The risk of infection differs in the federal states: there were 36 cases per 100,000 inhabitants in Berlin, only 4.3 in Thuringia. The national average was 8.8 people affected per 100,000 inhabitants.

Source: zeit

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