PrEP-associated screening reduces N. gonorrhoeae transmission but increases case notifications among MSM: a modeling study

The rapid scale-up of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men has coincided with rising rates of bacterial sexually transmitted infections (STIs), particularly Neisseria gonorrhoeae. This temporal association has raised concerns that PrEP may be driving a new STI epidemic. However, the epidemiological impact of PrEP reflects a trade-off between potential behavioral risk compensation, which increases transmission risk, and intensified clinical surveillance, which shortens infection duration. Determining whether PrEP amplifies or mitigates STI transmission therefore requires understanding how these competing effects balance at the population level. To address this q