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Another study indicated that PrEP use might encourage more open communication between partners regarding risk, thereby providing a space to discuss sexual and emotional needs. Studies conducted in the US found support for PrEP use within the context of long-term relationships but there were concerns about contracting other STIs.
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While research has focused on the sexual behaviour patterns of PrEP users in relation to casual sex, there is a lack of data on PrEP and the sexual behaviour of men in long-term relationships. When discussing statistics, a trend often describes an apparent difference between results that is not statistically significant. every year there are more HIV infections). In everyday language, a general movement upwards or downwards (e.g. Since 2018, government-subsidised PrEP has been available for key populations such as men who have sex with men. In larger states, such as New South Wales and Victoria, PrEP uptake has been rapid, from 2% in 2015 to 24% of all HIV-negative gay men in 2017. The acceptability and uptake of PrEP have been generally high among HIV-negative gay and bisexual men in Australia. As men now have other tools than condoms at their disposal, this may impact how men negotiate, and adhere to, safety agreements within their relationships. This has coincided with the rise of biomedical prevention, including treatment as prevention (TasP, or Undetectable = Untransmittable, U=U) and PrEP. In Australia, the number of relationships (where both partners were HIV negative) with negotiated safety agreements decreased from almost 40% in 2008 to 29% in 2017, according to behavioural surveillance data. While controversial, negotiated safety has been found to be effective when practised consistently. This refers to mitigating the risk of HIV and other STIs by partners agreeing to only have condomless sex with each other but to use condoms when having sex outside the relationship. “Negotiated safety” between HIV-negative men in open long-term relationships is a common practice. This research by Dr James MacGibbon and colleagues at the University of New South Wales was published in AIDS and Behavior. Additionally, 34% of PrEP users engaged in condomless casual sex despite being in relationships with agreements prohibiting it, and 13% of men not taking PrEP also engaged in condomless sex outside of their relationship when there was no agreement allowing for this. Nearly 40% of PrEP users in relationships had agreements that allowed for condomless sex with casual partners.
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A recent Australian study found that gay couples’ agreements regarding casual sex outside their relationships have changed markedly in the era of pre-exposure prophylaxis (PrEP).