Self-reported PrEP toxicity was uncommon among a cohort of longterm PrEP users, but cases of depression were frequent, according to findings published in AIDS. Edwina Wright, MD, PhD, and colleagues used survey results from 476 participants (99.8% cisgender men) to examine physical and mental health among long-term PrEP users. The median duration of PrEP use was 48 months (2,002 person years) and 81.7% of respondents were currently using the therapy. PrEP-related toxicity was infrequent; 2.9% reported bone fractures, 1.3% reported low bone density, and 4.0% reported kidney problems, all of which generally did not require PrEP cessation. Most participants (92.0%) said their health was “good” or “excellent,” and 22.6% reported better health since initiating PrEP, largely due to improved mental health. Only 6.2% reported a decline in health since starting PrEP, which was largely unrelated to the agent. The most frequent diagnoses in the cohort were hypertension (9.9%), depression (13.2%), and anxiety (14.9%). Moderate-to-severe depression, which was identified in 17.0% of the cohort, was associated with unemployment (adjusted OR, 3.90), regular cannabis use (adjusted OR, 2.49), and stopping PrEP (adjusted OR, 2.13).
