Prevention of STIs and Other Comorbidities in HIV-Positive Men Who Have Sex with Men (PRESTO-HIV)

Effective HIV therapies have led to remarkable improvements in the health of those living with HIV, leading to significantly fewer health problems and near-normal life expectancy for those living with the virus. Despite this, there have been some concerning increases in some other infections and illnesses - key amongst these are sexually transmitted infections (STIs). Like HIV, these STIs disproportionately impact gay, bisexual, and other men who have sex with men (MSM). Over the last decade, we have seen record high syphilis rates in MSM, increasing antibiotic resistance in some STI organisms, and the emergence of new infections that were previously not seen (e.g. lymphogranuloma venereum, or LGV - caused by a type of chlamydia). Through a variety of different methods, including interviews and questionnaires with patients and health care providers, a randomized controlled trial of the antibiotic doxycycline as STI pre-exposure prophylaxis (PrEP), some basic science work on the microbiome, and a novel mathematical model combining HIV and STIs, our team proposes to further explore the issues of STI prevention in MSM, and determine some effective ways to reduce their negative impact.