. .. References,

. .. Annexes,

, ? Il existe un schéma alternatif de prise discontinue ou à la demande, hors AMM, qui a été étudié chez des HSH dans le cadre de l'essai IPERGAY

, 2 h et 24 h avant le rapport sexuel, ? 2 ème prise : 1 comprimé à prendre environ 24 h (+/-2 h) après la première prise ? 3 ème prise : 1 comprimé à prendre environ 24 h (+/-2 h) après la deuxième prise ? En cas de rapports répétés

J. M. Molina, I. Charreau, B. Spire, L. Cotte, C. J. Capitant et al., Efficacy, safety, and effect on sexual behavior of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: an observational cohort study, Lancet HIV, vol.4, issue.9, pp.402-412, 2017.

C. Cazanave, L. E. Manhart, and C. Bébéar, Mycoplasma genitalium, an emerging sexually transmitted pathogen, Med Mal Infect, vol.42, issue.9, pp.381-92, 2012.

J. S. Jensen, M. Cusini, M. Gomberg, and H. Moi, European guideline on Mycoplasma genitalium infections, J Eur Acad Dermatol Venereol, vol.30, issue.10, pp.1650-1656, 2016.

M. Deborde, S. Pereyre, M. Puges, C. Bébéar, A. Desclaux et al., High prevalence of Mycoplasma genitalium infection and macrolide resistance in patients enrolled in HIV Pre-exposure Prophylaxis program, Med Mal Infect, 2019.

J. Dionne-odom, W. M. Geisler, K. J. Aaron, K. B. Waites, A. O. Westfall et al., High Prevalence of Multidrug-Resistant Mycoplasma genitalium in Human Immunodeficiency Virus-Infected Men Who Have Sex with Men in Alabama, Clin Infect Dis, vol.66, issue.5, pp.796-804, 2018.

A. Touati, O. Peuchant, J. S. Jensen, C. Bébéar, and S. Pereyre, Direct detection of macrolide resistance in Mycoplasma genitalium isolates from clinical specimens from France byuse of real-time PCR and melting curve analysis, J Clin Microbiol, vol.52, issue.5, pp.1549-1555, 2014.

C. Allam, C. Charre, H. Salord, C. Fernandez, P. Caillon et al., Screening for Neisseria gonorrhea and Chlamydia trachomatis infections in men who have sex with men: should the three sites be systematically collected?, Med Mal Infect, vol.48, issue.4, p.96, 2018.

S. Napierala-mavedzenge and H. A. Weiss, Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis, AIDS, vol.23, issue.5, pp.611-631, 2009.

, BASHH UK national guideline for the management of infection with Mycoplasma genitalium, 2017.

T. Read, C. K. Fairley, G. L. Murray, J. S. Jensen, J. Danielewski et al., Outcomes of resistance-guided sequential treatment of Mycoplasma genitalium infections: a prospective evaluation, Clin Infect Dis, 2019.

M. Deborde, S. Pereyre, M. Puges, C. Bébéar, A. Desclaux et al., High prevalence of Mycoplasma genitalium infection and macrolide resistance in patients enrolled in HIV Pre-exposure Prophylaxis program

. Onu-sida, Fiche d'information -Dernières statistiques sur l'état de l'épidémie de sida

C. Delaugerre, C. Gatey, M. L. Chaix, and J. M. Molina, La prévention pré-exposition au VIH-1 par les antirétroviraux, la PrEP, Virologie, vol.20, issue.3, pp.147-57, 2016.

M. W. Traeger, S. E. Schroeder, E. J. Wright, M. E. Hellard, V. J. Cornelisse et al., Effects of Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection on Sexual Risk Behavior in Men Who Have Sex With Men: A Systematic Review and Meta-analysis, Clin Infect Dis, vol.67, issue.5, pp.676-86, 2018.

N. Kojima, D. J. Davey, and J. D. Klausner, Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men, AIDS, vol.30, issue.14, pp.2251-2253, 2016.

C. Cazanave, L. E. Manhart, and C. Bébéar, Mycoplasma genitalium, an emerging sexually transmitted pathogen, Med Mal Infect, vol.42, issue.9, pp.381-92, 2012.

D. L. Couldwell, D. Jalocon, M. Power, N. J. Jeoffreys, S. Chen et al., Mycoplasma genitalium: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney, Sex Transm Infect, vol.94, issue.6, pp.406-416, 2018.

M. Deborde, Enjeux et mise en place des consultations PrEP au CHU de Bordeaux en 2016, état des lieux à un an, 2017.

M. Ducours, L. Alleman, M. Deborde, O. Peuchant, S. Peryere et al., Incidence et résistance aux antibiotiques des IST chez les PrEPeurs bordelais : bilan à 2 ans

L. Alleman, Le gonocoque chez les usagers de PrEP, étude observationnelle sur 30 mois à partir de la cohorte bordelaise, 2018.

S. Haute-autorité-de-la, La prophylaxie pré-exposition (PrEP) au VIH par le Truvada, 2017.

S. Haute-autorité-de-la, Réévaluation de la stratégie de dépistage de l'infection à VIH en France, 2017.

, Commission Nationale d'Evaluation des Dispositifs Médicaux et des Techniques de Santé. EDEN, préservatif masculin lubrifié, 2018.

, Commission Nationale d'Evaluation des Dispositifs Médicaux et des Techniques de Santé. Sortez couverts !, préservatifs masculins lubrifiés

A. J. Rodger, V. Cambiano, T. Bruun, P. Vernazza, S. Collins et al., Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy, JAMA, vol.316, issue.2, pp.171-81, 2016.

F. Santé-publique, Bulletin de santé publique infection à VIH. Point épidémiologique de mars 2019

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R. M. Grant, J. R. Lama, P. L. Anderson, V. Mcmahan, A. Y. Liu et al., Preexposure chemoprophylaxis for HIV prevention in men who have sex with men, N Engl J Med, vol.363, issue.27, pp.2587-99, 2010.

S. Mccormack, D. T. Dunn, M. Desai, D. I. Dolling, M. Gafos et al., Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial, Lancet Lond Engl, vol.387, pp.53-60, 2016.

J. Molina, C. Capitant, B. Spire, G. Pialoux, L. Cotte et al., On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection, N Engl J Med, vol.373, issue.23, pp.2237-2283, 2015.
URL : https://hal.archives-ouvertes.fr/halshs-01429281

A. Y. Liu, S. E. Cohen, E. Vittinghoff, P. L. Anderson, S. Doblecki-lewis et al., Preexposure Prophylaxis for HIV Infection Integrated With Municipal-and Community-Based Sexual Health Services, JAMA Intern Med, vol.176, issue.1, pp.75-84, 2016.

J. Molina, I. Charreau, B. Spire, L. Cotte, C. J. Capitant et al., Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: an observational cohort study, Lancet HIV, vol.4, issue.9, pp.402-412, 2017.
URL : https://hal.archives-ouvertes.fr/hal-01963237

J. L. Marcus, L. B. Hurley, C. B. Hare, D. P. Nguyen, T. Phengrasamy et al., Preexposure Prophylaxis for HIV Prevention in a Large Integrated Health Care System: Adherence, Renal Safety, and Discontinuation, JAIDS J Acquir Immune Defic Syndr, vol.73, issue.5, pp.540-546, 2016.

A. European-medicines, Human medicines. Truvada. Key facts, 2018.

, Plus de 10 000 personnes ont initié une prophylaxie pré-exposition (PrEP) au VIH par Truvada ou génériques -Point d'Information, Agence Nationale de la Sécurité du médicament et des produits de santé

, Groupe d'experts sous la direction du Pr Philippe Morlat et sous l'égide du CNS et de l'ANRS. Prophylaxie pré-exposition

, Groupe d'experts sous la direction du Pr Philippe Morlat et sous l'égide du CNS et de l'ANRS. Prise en charge médicale des personnes vivant avec le VIH: prévention et dépistage

. Santé-publique--epidémie-d'hépatite-a-en-france-et-en-europe, , 2017.

, Ministère des solidarités et de la santé -Calendrier des vaccinations et recommandations vaccinales, 2018.

V. Pilkington, A. Hill, S. Hughes, N. Nwokolo, and A. Pozniak, How safe is TDF/FTC as PrEP? A systematic review and meta-analysis of the risk of adverse events in 13 randomised trials of PrEP, J Virus Erad, vol.4, issue.4, pp.215-239, 2018.

G. Liegeon, A. G. Pialoux, G. Cotte, L. Tremplay, C. L. Capitant et al., Changes in kidney function among MSM initiating on demand TDF/FTC for HIV PrEP. CROI 2019, vol.960

C. B. Hare, J. Coll, P. Ruane, J. M. Molina, K. H. Mayer et al., The phase 3 discover study : daily F/TAF or F/TDF for HIV PreExposure Prophylaxis

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V. Nguyen, Z. R. Greenwald, H. Trottier, M. Cadieux, A. Goyette et al., Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV, AIDS Lond Engl, vol.32, issue.4, pp.523-553, 2018.

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K. T. Bernstein, J. L. Marcus, G. Nieri, S. S. Philip, and J. D. Klausner, Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion, J Acquir Immune Defic Syndr, vol.53, issue.4, pp.537-580, 2010.

F. Jin, G. V. Matthews, and A. E. Grulich, Sexual transmission of hepatitis C virus among gay and bisexual men: a systematic review, Sex Health, vol.14, issue.1, pp.28-41, 2017.

J. C. Price, J. E. Mckinney, P. Crouch, S. M. Dillon, A. Radix et al., Sexually Acquired Hepatitis C Infection in HIV-uninfected Men Who Have Sex with Men Using Pre-exposure Prophylaxis Against HIV, J Infect Dis, vol.2019, issue.9, pp.1373-1376, 2019.

L. Cotte, E. Cua, J. Reynes, F. Raffi, D. Rey et al., Hepatitis C virus incidence in HIV-infected and in preexposure prophylaxis (PrEP)-using men having sex with men, Liver Int Off J Int Assoc Study Liver, vol.38, issue.10, pp.1736-1740, 2018.
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S. A. Golub, S. Peña, R. Fikslin, M. Goldberg, and R. A. Partners, Not Condom Use, Drive STI Rates among PrEP Users in a Community Health Center

D. T. Duncan, S. H. Park, H. R. Hambrick, D. Ii, D. T. Goedel et al., Characterizing Geosocial-Networking App Use Among Young Black Men Who Have Sex With Men: A Multi-City Cross-Sectional Survey in the Southern United States, JMIR MHealth UHealth, vol.6, issue.6, p.10316, 2018.

A. Tomkins, R. George, and M. Kliner, Sexualised drug taking among men who have sex with men: a systematic review, Perspect Public Health, vol.139, issue.1, pp.23-33, 2019.

G. Pialoux, M. Hamidi, M. Danet, C. J. Lebrette, M. Haneche et al., Incidence des infections sexuellement transmissibles (ISTs) et impact de la consommation de nouvelles drogues de synthèse en contexte sexuel (CHEMSEX) dans une consultation PrEP

, Médecine Mal Infect, vol.47, issue.4, p.11, 2017.

M. Pakianathan, W. Whittaker, M. J. Lee, J. Avery, S. Green et al., Chemsex and new HIV diagnosis in gay, bisexual and other men who have sex with men attending sexual health clinics, HIV Med, vol.19, issue.7, pp.485-490, 2018.

S. Drückler, M. S. Van-rooijen, and H. De-vries, Chemsex Among Men Who Have Sex With Men: a Sexualized Drug Use Survey Among Clients of the Sexually Transmitted Infection Outpatient Clinic and Users of a Gay Dating App in Amsterdam, the Netherlands, Sex Transm Dis, vol.45, issue.5, pp.325-356, 2018.

A. Hegazi, M. J. Lee, W. Whittaker, S. Green, R. Simms et al., Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics, Int J STD AIDS, vol.28, issue.4, pp.362-368, 2017.

, Infection par le VIH et les IST bactériennes

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P. Brosselin, P. Troude, M. Shelly, H. Benmansour, E. Cambau et al., Apport du dépistage multisites chez les HSH dans le diagnostic des infections à Chlamydia et gonocoque : résultats d'une étude réalisée dans un CeGIDD parisien, Rev Épidémiologie Santé Publique, vol.66, p.37, 2018.

C. Allam, C. Charre, H. Salord, C. Fernandez, P. Caillon et al., Dépistage des infections à Neisseria gonorrhoeae et Chlamydia trachomatis chez les hommes ayant des relations sexuelles avec des hommes : faut-il prélever systématiquement les 3 sites ?, Médecine Mal Infect, vol.48, issue.4, p.96, 2018.

J. S. Jensen, M. Cusini, M. Gomberg, and H. Moi, European guideline on Mycoplasma genitalium infections, J Eur Acad Dermatol Venereol, vol.30, issue.10, pp.1650-1656, 2016.

J. G. Tully, D. Taylor-robinson, D. L. Rose, R. M. Cole, and J. M. Bove, Mycoplasma genitalium, a New Species from the Human Urogenital Tract, Int J Syst Bacteriol, vol.33, issue.2, pp.387-96, 1983.

A. Blanchard and C. Bébéar, The evolution of Mycoplasma genitalium, Ann N Y Acad Sci, vol.1230, pp.61-65, 2011.

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S. Pereyre, C. L. Nadalié, and C. Bébéar, for the investigator group. Mycoplasma genitalium and Trichomonas vaginalis in France: a point prevalence study in people screened for sexually transmitted diseases, Clin Microbiol Infect, vol.23, issue.2, 2017.

D. L. Couldwell, D. Jalocon, M. Power, N. J. Jeoffreys, S. Chen et al., Mycoplasma genitalium: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney, Sex Transm Infect, vol.94, issue.6, pp.406-416, 2018.

B. Bercot, I. Charreau, C. Rousseau, C. Delaugerre, C. Chidiac et al., High prevalence and antibiotic resistance of Mycoplasma genitalium infections in MSM on PrEP

S. Napierala-mavedzenge and H. A. Weiss, Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis, AIDS Lond Engl, vol.23, issue.5, pp.611-631, 2009.

S. Soni, S. Alexander, N. Verlander, P. Saunders, D. Richardson et al., The prevalence of urethral and rectal Mycoplasma genitalium and its associations in men who have sex with men attending a genitourinary medicine clinic, Sex Transm Infect, vol.86, issue.1, pp.21-25, 2010.

M. Bissessor, S. N. Tabrizi, C. S. Bradshaw, C. K. Fairley, J. S. Hocking et al., The contribution of Mycoplasma genitalium to the aetiology of sexually acquired infectious proctitis in men who have sex with men, Clin Microbiol Infect, vol.22, issue.3, pp.260-265, 2016.

M. J. Lusk, P. Konecny, Z. W. Naing, F. L. Garden, R. G. Cumming et al., Mycoplasma genitalium is associated with cervicitis and HIV infection in an urban Australian STI clinic population, Sex Transm Infect, vol.87, issue.2, pp.107-116, 2011.

S. N. Mavedzenge, B. Van-der-pol, H. A. Weiss, C. Kwok, F. Mambo et al., The association between Mycoplasma genitalium and HIV-1 acquisition in African women, AIDS Lond Engl, vol.26, issue.5, pp.617-641, 2012.

, BASHH UK national guideline for the management of infection with Mycoplasma genitalium, 2017.

L. Roy, C. Pereyre, S. Hénin, N. Bébéar, and C. , French Prospective Clinical Evaluation of the Aptima Mycoplasma genitalium CE-IVD Assay and Macrolide Resistance Detection Using Three Distinct Assays, J Clin Microbiol, vol.55, issue.11, pp.3194-200, 2017.

L. Roy, C. Pereyre, S. Bébéar, and C. , Evaluation of two commercial real-time PCR assays for detection of Mycoplasma genitalium in urogenital specimens, J Clin Microbiol, vol.52, issue.3, pp.971-974, 2014.

, Collège des gynécologues et obstétriciens français en collaboration avec la société de pathologie infectieuse de langue française, Recommandations pour la pratique clinique. Les infections génitales hautes, mise à jour des recommandations, 2018.

, Australian STI Management Guidelines -Mycoplasma genitalium -[Internet], 2018.

T. Read, C. K. Fairley, S. N. Tabrizi, M. Bissessor, L. Vodstrcil et al., Azithromycin 1.5g Over 5 Days Compared to 1g Single Dose in Urethral Mycoplasma genitalium: Impact on Treatment Outcome and Resistance, Clin Infect Dis Off Publ Infect Dis Soc Am, vol.64, issue.3, pp.250-256, 2017.

A. Touati, O. Peuchant, J. S. Jensen, C. Bébéar, and S. Pereyre, Direct detection of macrolide resistance in Mycoplasma genitalium isolates from clinical specimens from France by use of real-time PCR and melting curve analysis, J Clin Microbiol, vol.52, issue.5, pp.1549-55, 2014.

L. Roy, C. Hénin, N. Bébéar, C. Pereyre, and S. , Evaluation of a Commercial Multiplex Quantitative PCR (qPCR) Assay for Simultaneous Detection of Mycoplasma genitalium and Macrolide Resistance-Associated Mutations in Clinical Specimens, J Clin Microbiol, vol.55, issue.3, pp.978-987, 2017.
URL : https://hal.archives-ouvertes.fr/hal-01603858

L. Roy, C. Hénin, N. Pereyre, S. Bébéar, and C. , Fluoroquinolone-Resistant Mycoplasma genitalium, Southwestern France, Emerg Infect Dis, vol.22, issue.9, pp.1677-1679, 2016.

M. Kikuchi, S. Ito, M. Yasuda, T. Tsuchiya, K. Hatazaki et al., Remarkable increase in fluoroquinolone-resistant Mycoplasma genitalium in Japan, J Antimicrob Chemother, vol.69, issue.9, pp.2376-82, 2014.

T. Deguchi, S. Ito, M. Yasuda, Y. Sato, C. Uchida et al., Surveillance of the prevalence of macrolide and/or fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Japan, J Infect Chemother, vol.24, issue.11, pp.861-868, 2018.

J. Dionne-odom, W. M. Geisler, K. J. Aaron, K. B. Waites, A. O. Westfall et al., High Prevalence of Multidrug-Resistant Mycoplasma genitalium in Human Immunodeficiency Virus-Infected Men Who Have Sex With Men in Alabama, Clin Infect Dis, vol.66, issue.5, pp.796-804, 2018.

, Société française de dermatologie et de pathologie sexuellement transmissible -Mycoplasmes génitaux, 2016.

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, Infections sexuellement transmissibles : augmentation importante de la résistance du mycoplasma aux antibiotiques (macrolides)

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, Hippocrate Au moment d'être admis(e) à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité?

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux, individuels et sociaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté?, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité? ou leur dignité?. Même sous la contrainte

, Admis(e) dans l'intimité? des personnes, je tairai les secrets qui me sont confiés

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, RESUME : Objectif : il existe peu de données sur les infections sexuellement transmissibles (IST) chez les usagers de Prophylaxie Pré-Exposition (PrEP) en France. Notre objectif était d'évaluer la prévalence et l'incidence des principales IST bactériennes (Chlamydia trachomatis (Ct), Neisseria Gonorrhea (Ng), syphilis, et Mycoplasma genitalium (Mg)) dans cette population, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses : que je sois déshonoré(e) et méprisé(e) si j'y manque, vol.26, pp.3-17, 2016.

, Son traitement est complexe du fait de l'apparition de résistances aux antibiotiques. Le dépistage systématique des asymptomatiques n'est plus recommandé. Objective: few data are available about sexually transmitted infections (STIs) in PreExposure Prophylaxis (PrEP) users in France. We conducted a study to evaluate the prevalence and incidence of antimicrobial resistance to the main STIs (Chlamydia trachomatis (Ct), Neisseria Gonorrhea (Ng), syphilis, and Mycoplasma genitalium (Mg)) during a PrEP program, Methods: prospective study in Bordeaux University Hospital, vol.74, pp.7-35, 2016.

, STIs were diagnosed. The incidence was 89.8 for 100 person-years (PY) (CI 74.1-108, p.25

, Primary macrolide resistance of Mg was 71%. Four cases of acquired resistance after azithromycin first-line treatment were observed. Conclusions: STIs are increasing among men who have sex with men on PrEP. Preventive measures should be enhanced. Based on increasing rates of macrolide and fluoroquinolone resistance in Mg, even if asymptomatic infection may facilitate Human Immunodeficiency Virus transmission, systematic screening of Mg is not recommended in PrEP programs, Discipline : maladies infectieuses Mots clés : PrEP (Prophylaxie Pré Exposition), IST (Infection Sexuellement Transmissible), HSH (Homme ayant des rapports Sexuels avec les Hommes), Mycoplasma genitalium Intitulé et adresse de l'UFR : université de