Reduced problematic drug use among PrEP users: study

Users of the HIV prevention drug PrEP have shown less anxiety and significantly reduced problematic use of drugs, a new study has revealed.

The AmPrEP study in Amsterdam followed gay and bisexual men and trans women over three years, using questionnaires to ask about sexual behaviour, drug use, and mental health indicators.

Participants used PrEP either daily or on demand, where the medication is used in a specific pre- and post-sex regime rather than every day.

At the beginning of the study, 20% of participants showed signs of depression or anxiety disorders.

After three years, this dropped to 18%, with participants particularly reporting that they were less anxious about acquiring HIV, NAM has reported.

At the study’s baseline, 38% of participants reported problematic use of drugs, decreasing to 31% after three years.

The kinds of drugs used ranged from poppers and erectile dysfunction drugs to cocaine and methamphetamine.

A decrease in problematic alcohol use from 28% to 22% after three years was also found but not statistically significant.

Participants were also asked about their sexual compulsivity – how much they felt unable to control their sexual behaviour.

At baseline, 23% of study participants reported a degree of sexual compulsivity.

This dropped to just 10% after three years.

Participants in the study were mostly men, along with 1% trans women.

They had an average of 15 sexual partners in the three months prior to the study and were recruited from an Amsterdam sexual health clinic.

The researchers said the study was motivated by the need to evaluate fears that mental health issues, drug use, and sexual compulsivity may increase with PrEP, though it found the opposite.

Despite the associations found, the researchers stressed that the study results do not necessarily prove that PrEP causes these outcomes.

The study included regular counselling for participants, which may have been a factor in their improved wellbeing.

The researchers noted that the participants still had significant unmet mental health needs, with fewer reporting that they had sought help for issues such as anxiety than the general population.