Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement

Background: In Germany, oral HIV pre-exposure prophylaxis (PrEP) was licensed in 2016. Health insurances have been covering the costs since 09/2019. This study compares the sociodemographic profiles of PrEP users before and after PrEP re-imbursement. Methods: Participants were recruited in a cross-s...

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Main Authors: Patrick Ahaus, Axel J. Schmidt, Adriane Skaletz-Rorowski, Mona Uhrmacher, Katja Serova, Arne Kayser, Janet Wach, Sandeep Nambiar, Norbert H. Brockmeyer, Anja Potthoff
Format: Article
Language:English
Published: Elsevier 2022-09-01
Series:Journal of Infection and Public Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1876034122001915
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author Patrick Ahaus
Axel J. Schmidt
Adriane Skaletz-Rorowski
Mona Uhrmacher
Katja Serova
Arne Kayser
Janet Wach
Sandeep Nambiar
Norbert H. Brockmeyer
Anja Potthoff
author_facet Patrick Ahaus
Axel J. Schmidt
Adriane Skaletz-Rorowski
Mona Uhrmacher
Katja Serova
Arne Kayser
Janet Wach
Sandeep Nambiar
Norbert H. Brockmeyer
Anja Potthoff
author_sort Patrick Ahaus
collection DOAJ
description Background: In Germany, oral HIV pre-exposure prophylaxis (PrEP) was licensed in 2016. Health insurances have been covering the costs since 09/2019. This study compares the sociodemographic profiles of PrEP users before and after PrEP re-imbursement. Methods: Participants were recruited in a cross-sectoral sexual health centre in Germany. baseline data were compared for 139 vs 138 individuals starting PrEP from 10/2017–12/2018 (pre-reimbursement cohort) and 09/2019–3/2020; respectively. The pre-reimbursement cohort was further analysed with respect to sexual behaviour and incident sexually transmitted infections (STIs). Results: There were no significant differences in the sociodemographic characteristics between the two cohorts. Almost all PrEP users were men-who-have-sex-with-men (MSM). Before reimbursement, fewer individuals used PrEP on a daily base, and more had used PrEP prior to enrolment. During follow-up (pre-reimbursement cohort), the number of sexual and condomless intercourse partners increased, so did the proportion engaging in Chemsex. Incidences of infections with C.trachomatis, N.gonorrhoeae, M.genitalium, and T.pallidum were 45.2; 36.8; 30.1; and 9.2, respectively, per 100 person-years. Conclusion: The goal to make PrEP available to a broader range of people with the covering of costs was only partially reached. Medically supervised use is important to detect and treat STIs.
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spelling doaj.art-fd5392181846417689d754d69bcc41be2022-12-22T03:08:38ZengElsevierJournal of Infection and Public Health1876-03412022-09-01159955960Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursementPatrick Ahaus0Axel J. Schmidt1Adriane Skaletz-Rorowski2Mona Uhrmacher3Katja Serova4Arne Kayser5Janet Wach6Sandeep Nambiar7Norbert H. Brockmeyer8Anja Potthoff9Interdisciplinary Immunological Outpatient Clinic, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Germany; WIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, GermanySigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom; Division of Infectious Diseases, Cantonal Hospital St. Gallen, SwitzerlandInterdisciplinary Immunological Outpatient Clinic, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Germany; WIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, GermanyInterdisciplinary Immunological Outpatient Clinic, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Germany; WIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, GermanyInstitute of Educational Research, Ruhr Universität Bochum, Bochum, GermanyWIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, Germany; Aids Service Organization Bochum e. V., GermanyWIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, Germany; Local Health Authority Bochum, GermanyInterdisciplinary Immunological Outpatient Clinic, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Germany; WIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, GermanyInterdisciplinary Immunological Outpatient Clinic, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Germany; WIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, GermanyInterdisciplinary Immunological Outpatient Clinic, Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Germany; WIR – Walk In Ruhr – Center for Sexual Health and Medicine, Bochum, Germany; Corresponding author at: WIR – Walk In Ruhr, Center for Sexual Health and Medicine, Grosse Beckstrasse 12, 44787 Bochum, Germany.Background: In Germany, oral HIV pre-exposure prophylaxis (PrEP) was licensed in 2016. Health insurances have been covering the costs since 09/2019. This study compares the sociodemographic profiles of PrEP users before and after PrEP re-imbursement. Methods: Participants were recruited in a cross-sectoral sexual health centre in Germany. baseline data were compared for 139 vs 138 individuals starting PrEP from 10/2017–12/2018 (pre-reimbursement cohort) and 09/2019–3/2020; respectively. The pre-reimbursement cohort was further analysed with respect to sexual behaviour and incident sexually transmitted infections (STIs). Results: There were no significant differences in the sociodemographic characteristics between the two cohorts. Almost all PrEP users were men-who-have-sex-with-men (MSM). Before reimbursement, fewer individuals used PrEP on a daily base, and more had used PrEP prior to enrolment. During follow-up (pre-reimbursement cohort), the number of sexual and condomless intercourse partners increased, so did the proportion engaging in Chemsex. Incidences of infections with C.trachomatis, N.gonorrhoeae, M.genitalium, and T.pallidum were 45.2; 36.8; 30.1; and 9.2, respectively, per 100 person-years. Conclusion: The goal to make PrEP available to a broader range of people with the covering of costs was only partially reached. Medically supervised use is important to detect and treat STIs.http://www.sciencedirect.com/science/article/pii/S1876034122001915HIV-Pre-Exposure ProphylaxisSexual behaviourSexually transmitted infections (STIs)Men who have sex with men (MSM)Condom use
spellingShingle Patrick Ahaus
Axel J. Schmidt
Adriane Skaletz-Rorowski
Mona Uhrmacher
Katja Serova
Arne Kayser
Janet Wach
Sandeep Nambiar
Norbert H. Brockmeyer
Anja Potthoff
Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement
Journal of Infection and Public Health
HIV-Pre-Exposure Prophylaxis
Sexual behaviour
Sexually transmitted infections (STIs)
Men who have sex with men (MSM)
Condom use
title Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement
title_full Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement
title_fullStr Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement
title_full_unstemmed Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement
title_short Changes in the user profiles of HIV pre-exposure prophylaxis (PrEP) before and after PrEP reimbursement
title_sort changes in the user profiles of hiv pre exposure prophylaxis prep before and after prep reimbursement
topic HIV-Pre-Exposure Prophylaxis
Sexual behaviour
Sexually transmitted infections (STIs)
Men who have sex with men (MSM)
Condom use
url http://www.sciencedirect.com/science/article/pii/S1876034122001915
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