Universität zu Köln

Mysior, Patryk, Tenberken, Erik, Stecher, Melanie, Vehreschild, Joerg-Janne, Schafberger, Armin, Perea, Ines, Brillen, Anna-Lena, Bartmeyer, Barbara, Esser, Stefan, Bremer, Viviane, Marcus, Ulrich, Hoffmann, Daniel ORCID: 0000-0003-2973-7869 and Streeck, Hendrik (2020). Rapid Uptake of Pre-Exposure Prophylaxis After Significant Price Reduction in Germany Highlights Importance of Pre-Exposure Prophylaxis Accessibility. Aids Res. Hum. Retrovir., 36 (9). S. 721 - 734. NEW ROCHELLE: MARY ANN LIEBERT, INC. ISSN 1931-8405

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Abstract

Pre-Exposure Prophylaxis (PrEP) has been widely accepted as an effective method to prevent HIV infections, but high costs precluded a widespread use in Germany. A novel distribution pathway of tenofovir-disoproxil fumarate and emtricitabine PrEP was implemented, which reduced monthly PrEP costs by 16-fold in Germany. Over a period of 6 months, we recorded prescription data, demographics, and sexual behavior of PrEP users, including self-reported sexually transmitted infections (STIs), alcohol and drug use. Within a month, prescriptions almost doubled from 585 to 1,009 and reached a cumulative number of 6,059 at the end of the 6-month observation period. Extrapolation of the data suggests an estimated maximal number of PrEP users of the order of 10,000. PrEP users demonstrated to be a population of well-educated men (407/686) who have sex with men (629/686), median age 38 (range:18-71), and of German descent (571/686). The majority used PrEP to compensate for risk of HIV infection when having condomless anal intercourse (372/686). At start of PrEP implementation, the majority perceived their own risk to acquire HIV as none to medium (78.6%; n = 539), while only a subset (18.8%; n = 129) considered themselves to be at high or very high risk for HIV infection. In contrast, within the last 6 months, 28.4% of the PrEP users had an STI diagnosis and over 70% had condomless anal intercourse with more than 6 partners. Taken together, our data from PrEP implementation in Germany demonstrate a large uptake once it became affordable in individuals who wish to compensate for HIV risk when having condomless anal intercourse.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mysior, Patryk UNSPECIFIED UNSPECIFIED UNSPECIFIED Tenberken, Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Stecher, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg-Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED Schafberger, Armin UNSPECIFIED UNSPECIFIED UNSPECIFIED Perea, Ines UNSPECIFIED UNSPECIFIED UNSPECIFIED Brillen, Anna-Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Bartmeyer, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Esser, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bremer, Viviane UNSPECIFIED UNSPECIFIED UNSPECIFIED Marcus, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Daniel UNSPECIFIED orcid.org/0000-0003-2973-7869 UNSPECIFIED Streeck, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-334055
DOI:	10.1089/aid.2019.0237
Journal or Publication Title:	Aids Res. Hum. Retrovir.
Volume:	36
Number:	9
Page Range:	S. 721 - 734
Date:	2020
Publisher:	MARY ANN LIEBERT, INC
Place of Publication:	NEW ROCHELLE
ISSN:	1931-8405
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STIGMA Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33405