The EZI-PrEP study, conducted from September 2021 to March 2024, aimed to assess the non-inferiority of less frequent PrEP monitoring among men who have sex with men in the Netherlands. The research was presented at the AIDS 2024.

Researchers compared six-monthly versus three-monthly STI screening and examined the impact on STI testing behavior and STI positivity. The preliminary analysis focuses on 428 participants with more than one PrEP follow-up visit by September 2023. These participants were divided into two groups 213 in the six-monthly arm and 215 in the three-monthly arm, contributing 512 person-years of follow-up. Key metrics compared include the two groups’ overall visit rates, additional STI visit rates, and STI positivity.

The study found that the overall visit rate in the six-monthly study arm was significantly lower than in the three-monthly arm (visit rate ratio of 0.70). However, the additional STI visit rate was notably higher in the six-monthly arm (visit rate ratio of 1.94). Despite the difference in visit frequencies, STI positivity rates were similar between the two groups, with 22.3% in the six-monthly arm and 20.5% in the three-monthly arm, showing no statistically significant difference (P=0.35). Additionally, the proportion of additional STI visits without STI-related symptoms or partner notification was slightly higher in the six-monthly arm (52.1% compared to 42.8% in the three-monthly arm), though this was not statistically significant (P=0.071).

The study concluded that patients who received PrEP and were monitored every six months had fewer overall visits but attended more additional STI visits compared with those monitored every three months. Importantly, the STI positivity rate did not differ significantly between the two groups.

These findings suggest that implementing six-monthly PrEP monitoring could reduce the burden on healthcare systems and lower costs without increasing STI positivity. However, further research is needed to fully understand the impact of six-monthly monitoring on STI transmission rates.

“These preliminary findings suggest that implementing six-monthly PrEP monitoring as standard-of-care could reduce the total number of visits without resulting in increased STI positivity, leading to cost reductions of PrEP programs,” the authors concluded.