{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:52:35Z","timestamp":1792785155330,"version":"4.5.0"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Bundesministerium f\u00fcr\n                        Gesundheit"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die HIV-Pr\u00e4expositionsprophylaxe (PrEP) gilt als eine effektive M\u00f6glichkeit\n                        zur Vermeidung von HIV-Neuinfektionen und ist in Deutschland seit September\n                        2019 f\u00fcr Menschen mit gesetzlicher Krankenversicherung mit einem\n                        substantiellen HIV-Infektionsrisiko erstattungsf\u00e4hig. Relevant f\u00fcr einen\n                        optimalen Erfolg der Pr\u00e4vention ist es, dass die Versorgungsstrukturen\n                        m\u00f6glichst viele Personen mit erh\u00f6htem HIV-Infektionsrisiko erreichen und\n                        kontinuierlich einbinden. Ziel der hier berichteten Analysen ist eine\n                        Deskription der PrEP- und HIV-Versorgung von Personen, die in den in Bezug\n                        auf die HIV-Schwerpunkt-Versorgung weniger ausgebauten Regionen der\n                        Kassen\u00e4rztlichen Vereinigungen (KV) Brandenburg, Niedersachsen,\n                        Mecklenburg-Vorpommern oder Schleswig-Holstein leben.<\/jats:p>\n                  <jats:p>In anonymen Routinedaten der BARMER aus den Jahren 2019 bis 2022 wurden\n                        Personen mit PrEP-Nutzung sowie Personen, die mit HIV leben, mit einer\n                        Versorgung entsprechend der Qualit\u00e4tssicherungsvereinbarung gem\u00e4\u00df \u00a7 135 Abs.\n                        2 SGB V, selektiert. F\u00fcr diese Personen wurden die KV-Region der \u00c4rztinnen\n                        und \u00c4rzte ermittelt, die die PrEP verschrieben beziehungsweise die\n                        HIV-Behandlung erbrachten. Deskriptiv wurde eine Gegen\u00fcberstellung der\n                        KV-Regionen vorgenommen, in der die Versicherten leben und in denen die\n                        behandelnden \u00c4rztinnen und \u00c4rzte praktizieren.<\/jats:p>\n                  <jats:p>Zwischen den betrachteten Regionen bestehen deutliche Unterschiede\n                        hinsichtlich der Rate an Personen, die in der KV-Region mit der PrEP\n                        versorgt wird, in der sie wohnt. W\u00e4hrend die PrEP brandenburgischer\n                        Nutzenden ausschlie\u00dflich au\u00dferhalb von Brandenburg verordnet werden, werden\n                        775 der Verordnungen von nieders\u00e4chsischen PrEP-Nutzenden in der eigenen\n                        Region erbracht und nur 164 Verordnungen in anderen KV-Regionen.\n                        Mecklenburg-Vorpommern und Schleswig-Holstein sind hierzwischen einzuordnen.\n                        Ein \u00e4hnliches Bild zeigt sich bei der HIV-Versorgung, mit der Ausnahme, dass\n                        hier auch in Brandenburg zu beobachten ist, dass Personen in der eigenen\n                        KV-Region versorgt werden. In beiden Analysen zeigt sich die Relevanz der\n                        Versorgungsstrukturen insbesondere in Berlin und Hamburg f\u00fcr die Versorgung\n                        von Personen aus den KV-Regionen der benachbarten Fl\u00e4chenstaaten.<\/jats:p>\n                  <jats:p>Beobachtet werden kann, dass Versorgungsstrukturen in beispielsweise Berlin\n                        oder Hamburg in hohem Ma\u00dfe PrEP-Nutzende und Personen, die mit HIV leben,\n                        aus anderen KV-Regionen mitversorgen. Zudem k\u00f6nnten die Ergebnisse darauf\n                        hinweisen, dass in Regionen, in denen ein Gro\u00dfteil der eingeschlossenen\n                        Personen Leistungen in anderen KV-Regionen beziehen, m\u00f6glicherweise Personen\n                        unterversorgt sind, die die damit verbundenen Mobilit\u00e4tsanforderungen nicht\n                        erf\u00fcllen k\u00f6nnen.<\/jats:p>","DOI":"10.1055\/a-2949-5865","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:08:33Z","timestamp":1790377713000},"source":"Crossref","is-referenced-by-count":0,"title":["Routinedatenanalyse r\u00e4umlicher Aspekte der\n                    HIV-Pr\u00e4expositionsprophylaxe und -Schwerpunkttherapie in ausgew\u00e4hlten\n                    KV-Regionen in den Jahren 2019 bis 2022"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0061-5841","authenticated-orcid":false,"given":"Frederik","family":"Valbert","sequence":"additional","affiliation":[{"name":"Universit\u00e4t Duisburg-Essen, Germany","place":["Essen"],"department":["Lehrstuhl f\u00fcr Medizinmanagement"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Robert Koch\u2010Institut, Deutschland","place":["Berlin"],"department":["Abteilung f\u00fcr Infektionsepidemiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kollan","sequence":"additional","affiliation":[{"name":"Robert Koch\u2010Institut, Deutschland","place":["Berlin"],"department":["Abteilung f\u00fcr Infektionsepidemiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Friebe","sequence":"additional","affiliation":[{"name":"Robert Koch\u2010Institut, Deutschland","place":["Berlin"],"department":["Abteilung f\u00fcr Infektionsepidemiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Voulgaris","sequence":"additional","affiliation":[{"name":"Robert Koch\u2010Institut, Deutschland","place":["Berlin"],"department":["Abteilung f\u00fcr Infektionsepidemiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Gunsenheimer-Bartmeyer","sequence":"additional","affiliation":[{"name":"Robert Koch\u2010Institut, Deutschland","place":["Berlin"],"department":["Abteilung f\u00fcr Infektionsepidemiologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Wasem","sequence":"additional","affiliation":[{"name":"Universit\u00e4t Duisburg-Essen, Germany","place":["Essen"],"department":["Lehrstuhl f\u00fcr Medizinmanagement"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Neumann","sequence":"additional","affiliation":[{"name":"Universit\u00e4t Duisburg-Essen, Germany","place":["Essen"],"department":["Lehrstuhl f\u00fcr Medizinmanagement"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e438","DOI":"10.1016\/S2352-3018(18)30132-2","article-title":"Viral suppression and HIV transmission in serodiscordant male couples: an\n                    international, prospective, observational, cohort study","volume":"5","author":"B R Bavinton","year":"2018","journal-title":"Lancet HIV"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1056\/NEJMoa1600693","article-title":"Antiretroviral Therapy for the Prevention of HIV-1 Transmission","volume":"375","author":"M S Cohen","year":"2016","journal-title":"N 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