Or some people take it and engage in risky sexual behavior because they're now on it. I know more than a few people like that. Not everyone is a backwards hick, you're just virtue signalling.
STI incidence among MSM using PrEP
Men who have sex with men (MSM), particularly those who have indications for pre-exposure prophylaxis against HIV (PrEP), are at high risk for sexually transmitted infections (STI). In a study of nearly 3000 MSM in Australia who were initiating PrEP, the incidence of new chlamydia, gonorrhea, or syphilis over the subsequent year was 92 cases per 100 person-years [2]. Nearly half of the participants were diagnosed with an STI during the study period, with 25 percent of participants accounting for 75 percent of all STIs diagnosed; the risk of STI was proportional to the number of sexual partners and frequency of group sex. These data highlight the importance of frequent STI screening for MSM using PrEP.
2. Traeger MW, Cornelisse VJ, Asselin J, et al. Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. JAMA 2019; 321:1380.
We should remember though that what this demonstrates is a high correlation between PrEP use and risky sexual behaviour. It does not suggest that PrEP use encourages that behaviour - I don’t doubt that in some cases it does, but it’s difficult to think it does so generally.
Honestly, if you ask just about anyone in the community you'll find the general agreement is that PrEP does result in the decreased use of condoms, so it's not surprising that there is a general increase of other STDs.
But as more people start using PrEP and get tested regularly due to the general requirements, it is possible that STD rates will decline, but we're probably a few years away from seeing that in the statistics.
PrEP treatment also mandates regular STI testing. I wonder if it's possible to control for the higher diagnosis rate (e.g. would have been infected anyways just now know about it). And what is a comparable rate for the same population pre-PrEP?
I'd agree with you honestly, I'd suggest however that it's a very small minority, who probably have other concurrent factors, like drug or alcohol abuse. This is not sufficient reason to gatekeep the drug from those who would be responsible, and frankly not even a point worthy of mention.
But that's a society problem, not an individual issue. If someone requests protection from HIV, that's a serious problem for them. Other STIs you can cure, or are not as dangerous in effects.
