Interdisciplinary 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.
Sigma 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, Switzerland.
J Infect Public Health. 2022 Sep;15(9):955-960. doi: 10.1016/j.jiph.2022.07.012. Epub 2022 Jul 28.
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.
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).
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.
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.
德国于 2016 年批准了口腔 HIV 暴露前预防（PrEP）。自 2019 年 9 月起，健康保险开始覆盖 PrEP 的费用。本研究比较了 PrEP 报销前后 PrEP 使用者的社会人口学特征。
参与者在德国的一个跨部门性健康中心招募。比较了 2017 年 10 月至 12 月（报销前队列）和 2019 年 9 月至 3 月期间分别开始使用 PrEP 的 139 名和 138 名个体的基线数据。报销前队列进一步分析了性行为和性传播感染（STI）的发生率。
两个队列的社会人口学特征无显著差异。几乎所有 PrEP 用户均为男男性行为者（MSM）。在报销前，每天使用 PrEP 的人数较少，而在登记前使用 PrEP 的人数较多。在随访期间（报销前队列），性伴侣和无保护性行为的数量增加，化学性交的比例也增加了。沙眼衣原体、淋病奈瑟菌、生殖支原体和梅毒螺旋体的感染发生率分别为每 100 人年 45.2、36.8、30.1 和 9.2。
将 PrEP 覆盖范围扩大到更多的人并报销费用的目标仅部分实现。医学监督使用对于检测和治疗 STI 很重要。
