What is it about?
PrEP is an HIV prevention drug that requires users to undergo frequent screening for other STIs. While recent data suggests STI rates are rising among users, our model proves this is likely a "testing paradox": we are simply finding more cases because we are looking for them. By detecting and treating these infections early, PrEP programs actually lower the true spread of other STIs. Thus, a rise in reported cases can surprisingly be a sign of public health success.
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Why is it important?
Misinterpreting surveillance data can lead to dangerous public health decisions. We show that a rise in reported STI cases may be just an artifact of better testing, not a sign that the epidemic is worsening. This finding validates current PrEP strategies: as long as frequent screening is maintained, PrEP programs can successfully reduce HIV risk without letting other STIs run wild.
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This page is a summary of: Testing paradox may explain increased observed prevalence of bacterial STIs among MSM on HIV PrEP: A modeling study, Proceedings of the National Academy of Sciences, October 2025, Proceedings of the National Academy of Sciences,
DOI: 10.1073/pnas.2524944122.
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