{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T18:04:32Z","timestamp":1785002672099,"version":"3.55.0"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003107","name":"Bundesministerium f\u00fcr Gesundheit","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003107","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023448","name":"Robert Koch-Institut","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023448","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Objectives of this study, as part of a nation-wide HIV pre-exposure prophylaxis (PrEP) evaluation project, were to determine the incidence of infections with HIV, chlamydia, gonorrhea, syphilis, hepatitis A\/B\/C in persons using PrEP, and to describe the health care funded PrEP use in Germany. Additionally, factors associated with chlamydia\/gonorrhea and syphilis infections were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Anonymous data of PrEP users were collected at 47 HIV-specialty centers from 09\/2019\u201312\/2020. Incidence rates were calculated per 100 person years (py). Using longitudinal mixed models, we analyzed risk factors associated with sexually transmitted infections (STIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>4620 PrEP users were included: 99.2% male, median age 38\u00a0years (IQR 32\u201345), 98.6% men who have sex with men (MSM). The median duration of PrEP exposure was 451\u00a0days (IQR 357\u2013488), totaling 5132 py. Four HIV infections were diagnosed, incidence rate 0,078\/100py (95% CI 0.029\u20130.208). For two, suboptimal adherence was reported and in the third case, suboptimal adherence and resistance to emtricitabine were observed. One infection was likely acquired before PrEP start. Incidence rates were 21.6\/100py for chlamydia, 23.7\/100py for gonorrhea, 10.1\/100py for syphilis and 55.4\/100py for any STI and decreased significantly during the observation period. 65.5% of syphilis, 55.6% of chlamydia and 50.1% of gonorrhea cases were detected by screening of asymptomatic individuals. In a multivariable analysis among MSM younger age, PrEP start before health insurance coverage and daily PrEP were associated with greater risk for chlamydia\/gonorrhea. Symptom triggered testing and a history of STI were associated with a higher risk for chlamydia\/gonorrhea and syphilis. A significantly lower risk for chlamydia\/gonorrhea and syphilis was found for observations during the COVID-19 pandemic period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found that HIV-PrEP is almost exclusively used by MSM in Germany. A very low incidence of HIV\u00a0infection and decreasing incidence rates of STIs were found in this cohort of PrEP users. The results were influenced by the SARS-CoV-2 pandemic. Rollout of PrEP covered by health insurance should be continued to prevent HIV infections. Increased PrEP availability to people at risk of HIV infection through the elimination of barriers requires further attention. Investigation and monitoring with a longer follow-up would be of value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-022-01919-3","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T12:04:05Z","timestamp":1664280245000},"page":"665-678","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in 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CK is small shareholder in companies manufacturing antiretroviral drugs. SS has received honoraria for lectures, conference sponsorship and participation on advisory boards from Abbvie, Gilead, Janssen, GSK, MSD, ViiV Healthcare, Theratechnologies. SVS has received honoraria and study compensation from companies developing and marketing antiretroviral drugs and is shareholder of various pharmaceutical companies including ones developing and marketing antiretroviral drugs. KS has received honoraria for lectures, conference sponsorship and participation at advisory boards from Abbvie, Gilead, Janssen, MSD, ViiV Healthcare, Hexal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All patient data collected in NEPOS were generated during routine care. The data collected were anonymous. No direct patient survey or sampling took place within NEPOS. No human samples were collected and send to the RKI. The Ethics Committee of the Berlin Chamber of Physicians reviewed the project and waived the need for ethical approval or informed consent, as it involves only retrospective anonymous data (Eth-KB 03\/20). We confirm that all methods were performed in accordance with the relevant guidelines and regulations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}