 This study examined the characteristics of a cohort of men who have sex with men, MSM, attending a secondary-level sexually transmitted infection, STI, center in Milan, Italy, who were prescribed pre-exposure prophylaxis, PREP, for health prevention. The majority of participants were white, educated, and had a median baseline age of 34.5 years. Most chose the daily-based PREP regimen over the event-based regimen. A significant increase in PREP counseling visits was observed over time. Partnership frequency, chemsex use, and history of STIs were associated with higher rates of chlamydia and other STIs at baseline. This article was authored by Diana Canetti, Antonella Castagna, Marco Riper, and others.