STI incidence and care discontinuation among HIV-PrEPusing black men who have sex with men in New Orleans, LA: a prospective cohort study

Black men who have sex with men (MSM) have continued to face disproportionately high rates of HIV and STIs, yet few studies specifically address STI risk in Black MSM, particularly those on HIV pre-exposure prophylaxis (PrEP). The aim of this study was to examine STI incidence (gonorrhea, chlamydia, and syphilis) and PrEP care discontinuation in a prospectively enrolled cohort of young Black MSM engaged in PrEP care. We enrolled 63 Black MSM PrEP users; total follow -up time was 81.8 person -years (PY). Mean age was 29.9 (SD 4.3); 45 participants (71%) had insurance, and 30 (48.4%) had an STI diagnosed in the year before enrollment. There were 56 STI infections over follow-up (6 syphilis, 18 chlamydia, 32 gonorrhea), yielding an STI incidence of 68.5/100PY. There were 2 incident cases of HIV (2.4/100PY). Additionally, 32 (51%) participants had PrEP discontinuations (either intermittent, i.e., missed visits, or complete loss to follow -up prior to the end of the study period). Overall, Black MSM PrEP users had suboptimal engagement in PrEP care and high rates of STIs and HIV. Further efforts are needed to enhance PrEP use and prevent STIs in this population.