Evaluation der Einführung der HIV-Präexpositionsprophylaxe als Leistung der gesetzlichen Krankenversicherung (EvE‑PrEP)

Schmidt, Daniel; Kollan, Christian; Schewe, Knud; Hanhoff, Nikola; Rüsenberg, Robin; Friebe, Martin; Schikowski, Tim; Schink, Susanne Barbara; Marcus, Ulrich; Koppe, Uwe; Jansen, Klaus; Streeck, Hendrik; Ottensmeyer, Patrick; an der Heiden, Matthias; Bannert, Norbert; M’Bayo, Rosaline; Ceres, Maia; Weber, Lukas; Sweers, Holger; Schmidt, Axel Jeremias; Tietz, Helge; Danan, Emmanuel; Bendig, Jörg; Kloep, Stephan; Neumann, Anja; Valbert, Frederik; Wasem, Jürgen; Bartmeyer, Barbara; Bremer, Viviane; ,

doi:10.1007/s00103-023-03733-0

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…The results on PrEP pill coverage were also confirmed in routine data analyses conducted as part of the PrEP evaluation (33). Nevertheless, the proportion of non-SHI PrEP, as well as on-demand PrEP use remain somewhat uncertain and they could differ by PrEP prescription route (SHI vs. non-SHI) or change over time.…”

Section: Discussionmentioning

confidence: 57%

“…However, recent data from the 'PrEP evaluation' (EvE-PrEP) and the 'PrEP Suveillance' (PrEP-Surv) projects in Germany revealed gaps in PrEP provision and reaching capacity limits in some regions. In surveys among HIV specialty care centers in PrEP-Surv, 90% of centers indicated gaps in HIV care in rural areas and 76% of centers indicated gaps in HIV care due to a lack of PrEP prescribers in general (24). Discussions with the PrEP-Surv Community Advisory Board also suggested gaps in PrEP coverage including difficulties in finding a PrEP provider, waiting lists or long distances (20,33).…”

Section: Discussionmentioning

confidence: 99%

“…PrEP can be prescribed via statutory health insurance by certified HIV specialists, whereas other physicians need to undergo training or can prescribe PrEP on a self-payer basis (11). Statutory health insurance takes a central role in PrEP service delivery in Germany since 89.5% of PrEP users at HIV specialists receive PrEP through statutory health insurance (24). Statutory health insurance reimburses pharmacies for dispensed prescribed drugs via specialized pharmacy billing centers, which generate spatially resolved, electronically recorded prescription details.…”

Section: Data Sourcementioning

confidence: 99%

“…The introduction of PrEP as SHI benefit in Germany has been scientifically evaluated and a national PrEP surveillance is currently being established at the Robert Koch Institute (19-21). Estimates from these projects calculated between 15,600-21,600 PrEP users in Germany as of June 2020 (22) and approximately 32,000 PrEP users by the end of 2022 (20,23). However, these numbers are point estimates.…”

Section: Introductionmentioning

confidence: 99%

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Dynamics of HIV PrEP use and coverage during and after COVID-19 in Germany

Schmidt,

Duport,

Kollan

et al. 2023

Preprint

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Background Pre-exposure prophylaxis (PrEP) with oral emtricitabine/tenofovir disoproxil (FTC/TDF) proved highly efficient in preventing HIV. Since 09/2019, FTC/TDF-PrEP is covered by health insurances in Germany, if prescribed by licensed specialists. However, methods to longitudinally monitor progress in PrEP implementation in Germany are lacking. Methods Utilizing anonymous FTC/TDF prescription data from 2017–2021, we developed a mathematical model to disentangle HIV-treatment from PrEP prescriptions, as well as to translate PrEP prescriptions into number of PrEP users. We used the model to estimate past- and future PrEP uptake dynamics, to predict coverage of PrEP needs and to quantify the impact of COVID-19 on PrEP uptake on a national and regional level. Results We identified significant (p < 0.01) decelerating effects of the first- and second COVID-19-lockdown on PrEP uptake in 04/2020 and 12/2020. We estimated 26,159 (CI: 25,751 − 26,571) PrEP users by 12/2021, corresponding to 33% PrEP coverage of people in need. We projected 64,794 (CI: 62,956 − 66,557) PrEP users by 12/2030, corresponding to 67% PrEP coverage. We identified profound regional differences, with high PrEP coverage and uptake in metropoles and low coverage in more rural regions. Conclusions Our approach presents a comprehensive solution to monitor and forecast PrEP implementation from anonymous data and highlighted that the COVID-19 pandemic significantly decelerated PrEP uptake in Germany. Moreover, slow PrEP uptake in rural areas indicate that structural barriers in PrEP care, education or information exist that may hamper the goal of ending the AIDS epidemic by 2030.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dynamics of HIV PrEP use and coverage during and after COVID-19 in Germany

Schmidt,

Duport,

Kollan

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Hintergrund : Die HIV-Präexpositionsprophylaxe (PrEP) ist eine hocheffektive Präventionsmethode, bei der HIV-negative Menschen vorbeugend HIV-Medikamente einnehmen, um sich vor einer HIV-Infektion zu schützen. In Deutschland wird die PrEP bisher fast ausschließlich von MSM genutzt 1 . Bei Sexarbeitenden (SW) ist kein allgemein erhöhtes HIV-Risiko nachgewiesen, jedoch kann das individuelle Risiko durch andere Merkmale wie prekäre Lebenslagen, intravenösen Drogenkonsum oder männliche bzw.…”

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