With no effective vaccines for most STIs, and no other biomedical interventions with established preventive efficacy, condoms have remained the cornerstone of STI prevention for decades. However, biomedical advances in HIV prevention, including Treatment as Prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) may be changing sexual mixing patterns and condom use, with increasing concerns that they may inadvertently be contributing to increasing bacterial STI rates. The convergence of effective HIV treatment and prevention strategies with drastic increases in bacterial STIs, against a backdrop of waning effectiveness of conventional STI prevention efforts, produces an urgent need for novel STI prevention strategies and tools to mitigate STI-related complications.
This study has been designed to help determine preferences among men who have sex with men (MSM) regarding emerging STI prevention strategies. We are conducting this study to understand risk factors, current STI understanding and sexual health patterns among MSM. We are specifically seeking to determine the proportion of high-risk MSM who would be willing to use three hypothetical forms of biomedical STI prevention: a) doxycycline-based syphilis pre-exposure prophylaxis, b) doxycycline-based syphilis post-exposure prophylaxis and c) valacyclovir-based HSV pre-exposure prophylaxis. Because there may be a relationship between individuals’ willingness to accept future biomedical prevention strategies and their willingness to accept existing, proven strategies, it will also be of interest to understand willingness to use HIV PrEP and HPV vaccination, both of which are safe, effective, and increasingly available.