PrEP and Self-Care in Focus: Optimizing Chlamydia and Gonorrhea Screening in Asymptomatic Men

• Grant number: 24/18896-5
• Support Opportunities: Scholarships in Brazil - Master
• Start date: September 01, 2025
• End date: May 31, 2027
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Karen Ingrid Tasca
• Grantee: Vitória Brito Lopes
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The global increase in sexually transmitted infections (STIs), such as chlamydia and gonorrhea, represents a serious public health problem, disproportionately affecting men who have sex with men (MSM), especially those using pre-exposure prophylaxis for HIV (PrEP). The high prevalence of asymptomatic cases, coupled with the common practice of screening solely in urine samples in most Health Services, raises a critical concern about the effectiveness of current strategies, since infection in other anatomical sites (oral and anal) may not be detected, potentially contributing to the transmission of these STIs, especially in this vulnerable population. This prospective and longitudinal study aims to investigate the incidence of chlamydia and gonorrhea in asymptomatic men using PrEP, and to compare the sensitivity of detecting these infections in different biological samples (urine, anal, and oropharyngeal swabs). Additionally, the project will explore the feasibility of implementing self-collection as a strategy to increase adherence and frequency of this 'multiple' screening in the routine of SUS (Unified Health System) health services. A cost-effectiveness analysis of the implementation, including the innovative 'pooling' of samples strategy, will also be conducted. The research will involve approximately 200 adult men followed up at 'SAEI-DAM', with three collections over approximately one year. It is expected that the results of this original study will provide robust evidence to optimize the screening guidelines for chlamydia and gonorrhea in PrEP users within the SUS, directly impacting public health and the quality of life of this population - especially in Brazilian territory, where routine STI screening recommendations have not yet been established. (AU)