Gravett RM, et al. - In order to determine the effect of preexposure prophylaxis (PrEP) on sexually transmitted infections (STIs) in men who have sex with men (MSM) in the Deep South of the United States, researchers undertook a retrospective analysis of adult MSM in this region and estimated the prevalence and incidence rate of bacterial STIs (chlamydia, gonorrhea, and syphilis) among them. Further, they sought the associated risk factors by linking incident STI to patient-reported outcomes. From 2014 to 2018, 139 MSM visited the clinic with a baseline bacterial STI prevalence of 11%. STIs were evident in 26 of 81 eligible MSM on PrEP with an incidence rate of 33.1 cases per 100 person-years. Those with incident STI exhibited significantly higher proportions of high PrEP adherence, multiple sexual partners, and inconsistent condom use; MSM with both high PrEP adherence and multiple sexual partners were noted to be at exceptionally high risk for bacterial STIs. Findings suggest the persistence of high-risk sexual behaviors following initiation of PrEP, emphasizing the significance of ongoing, intensive sexual health screening and interventions.