Introduction
Pre-exposure prophylaxis (PrEP) services are associated with more diagnoses of sexually transmitted infections (STIs). This may encourage more people to start using PrEP. We wanted to see if testing and treating STIs right at the clinic could help more people begin and continue using PrEP.
Study Overview
From September 2023 to November 2024, we conducted a study with young women and their male partners. Participants were randomly assigned to receive either standard STI management or point-of-care (POC) testing for specific STIs. Everyone received counseling on HIV prevention and the option to take PrEP.
Results
We included 900 participants in the study. The average age was 20.4 years, and nearly half were female. In the POC testing group, 96% were tested for STIs, and 25% were diagnosed with at least one STI, with 84% receiving treatment. In the standard management group, only 7% reported STI symptoms, and 88% were treated.
Overall, 64% of participants in the standard management group and 62% in the POC group started PrEP. At one month, 41% of the POC group continued PrEP, compared to 46% in the standard group. At four months, 25% in the POC group were still on PrEP, while 19% in the standard group continued.
Participants who were treated for STIs had a higher rate of starting and continuing PrEP compared to those who were not treated.
Conclusions
Testing for STIs at the clinic did not significantly increase the number of people starting or continuing PrEP at one month but showed some improvement in persistence at four months. Treating STIs was linked to better uptake and continuation of PrEP. Integrating STI management into PrEP services could help more young people stay on PrEP.
Opportunities for Clinics and Patients
Based on the study results, clinics should:
- Set clear goals for increasing PrEP initiation and persistence.
- Use point-of-care diagnostics to quickly identify and treat STIs.
- Implement AI tools to track patient outcomes and improve service delivery.
- Start with pilot projects to test these strategies and measure their effectiveness.
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