A medicine that's supposed to protect people from HIV might be encouraging them to engage in more frequent unprotected sex, according to a new study.
Researchers in Australia discovered that the more people at risk of HIV used this particular drug, called pre-exposure prophylaxis or PrEP, the less likely they were to use condoms.
It's not certain exactly what's causing the downturn in condom use, the researchers wrote in the Lancet HIV journal. But one speculation suggests that PrEP creates a sense of false security. Back when seatbelts laws went into effect, a number of studies suggested that drivers became more lenient with regard to road safety. Because of the sense of security the seatbelts seemed to provide, the drivers became more likely to speed or drive recklessly — a similar phenomenon might be occurring in the case of those who take PrEP.
Decreased condom usage is potentially alarming. The researchers think it will help fuel the already spreading epidemics of other sexually transmitted infections, including syphilis and gonorrhea. Add to that fears over HIV infections going back up as people stop using condoms and halt consistent PrEP intake.
But according to other researchers, PrEP might not be entirely responsible for this behavior. Condom use among gay and bisexual men has been declining for some time — one of the reasons is researched-backed knowledge that non-infected persons who take consistent HIV medication do not pass the virus during sex, as The Guardian reports.
What's PrEP And Why Do HIV-Negative People Take It?
PrEP can reduce the risk of catching HIV by 90 percent provided it's taken consistently. It's been on the market since 2012, and the Centers for Disease Control and Prevention has been recommending it since 2014.
But ultimately, the study still raises significant questions about introducing PrEP to high-level HIV infection countries without supplementing it with proper education that encourages condom use.
The research, which involved 17,000 gay and bisexual men in Australia's Victoria and New South Wales states, found that PrEP intake is increasingly being adopted: HIV-negative men taking the pills rose from 2 percent to 24 percent between 2013 and 2017. Over the same period, HIV-negative men on PrEP who engage in casual anal sex increased from 1 percent to 16 percent. Condom use, meanwhile, dropped from 46 percent to 31 percent.
Notably, the proportion of HIV-negative men who were not on PrEP but still had casual anal sex rose from 30 percent to 39 percent. At the same time, however, HIV diagnoses fell down in both states.
The HIV epidemic afflicts 36 million people globally and has taken away 35 million lives since it began spreading in the '70s, says the World Health Organization, which also notes that the virus killed a million people just last year. HIV has no known cure. It is spread though sex, blood, and from mother to child at birth.
Don't Blame The PrEP People
For many years, the only way to curb its spread has been by using condoms consistently during sex. But PrEP is changing the landscape, largely because people who take it think that when they do, it's safe not to use condoms all of a sudden.
However, people on PrEP are believed to be some of the most responsible ones when it comes to safe sex. Jim Pickett of the AIDS Foundation of Chicago thinks PrEP users are likely not wholly responsible for the spread of HIV, noting that these folk visit the doctor regularly.
"Those visits include a thorough STI screening. People on PrEP are getting excellent sexual health care."
A "more nuanced" approach to safe sex might be necessary now that condom-less sex is on the rise, thinks Kenneth Mayer, a medical research director for lesbian, gay, bisexual, transgender, and questioning-oriented Fenway Institute in Boston. Patients who don't want to use condoms, he says, should be counseled to consider PrEP but still make sure they attend STI screenings frequently.