{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:12:36Z","timestamp":1782997956779,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The reimbursement of HIV pre\u2010exposure prophylaxis (PrEP) in Italy was expected to increase uptake and diversify users. We assessed changes in PrEP initiation patterns before and after reimbursement at a community\u2010based service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a monocentric retrospective cohort study that included all individuals who initiated PrEP between September 2017 and October 2024. Participants were stratified according to PrEP initiation before and after June 2023, when reimbursed PrEP was made available. Monthly PrEP initiations were analysed using single\u2010group interrupted time series analysis (ITSA) with segmented linear regression, including two intervention points (July 2020 and June 2023) and accounting for autocorrelation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 1394 individuals who initiated PrEP: 1019 (73.1%) before and 375 (26.9%) after June 2023. Participants were predominantly cisgender men (96.7%), gay, bisexual and other men who have sex with men (GBMSM) (95.1%) and white (82.1%). After reimbursement, modest differences were observed, including a higher proportion of white individuals (84.0% vs. 81.5%) and fewer lifetime sexual partners (\u226530 partners: 73.7% vs. 81.0%), while discontinuation rates remained similar. ITSA showed a marked immediate increase in PrEP initiations after the COVID\u201019 lockdown (+12.7\/month; 95% CI 9.3, 16.1), followed by a flat trend thereafter. PrEP reimbursement was not associated with a significant immediate increase (+4.7\/month; 95% CI \u22121.5, 10.9) and was followed by a negative change in the trend (\u22120.54\/month; 95% CI \u22120.92, \u22120.15).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this community\u2010based setting, reimbursed PrEP was not associated with a substantial increase in uptake or diversification of users, suggesting that additional implementation strategies beyond drug reimbursement may be required to improve equitable access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70209","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:20:38Z","timestamp":1771827638000},"page":"785-795","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Achieving reimbursable\n                    <scp>PrEP<\/scp>\n                    is insufficient to increase and diversify the users attending community\u2010based services"],"prefix":"10.1111","volume":"27","author":[{"given":"Enrico","family":"Caruso","sequence":"first","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Tavelli","sequence":"additional","affiliation":[{"name":"ICONA Foundation  Milan Italy"},{"name":"National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"De Bona","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"},{"name":"ASST Santi Paolo e Carlo  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Frattini","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Moschese","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"},{"name":"ASST Fatebenefratelli Sacco  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Muccini","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"},{"name":"IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Tesoro","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"},{"name":"ASST Santi Paolo e Carlo  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro Guido","family":"Soria","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"},{"name":"Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0073-1789","authenticated-orcid":false,"given":"Antonella D' Arminio","family":"Monforte","sequence":"additional","affiliation":[{"name":"ICONA Foundation  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Cernuschi","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4965-8789","authenticated-orcid":false,"given":"Roberto","family":"Rossotti","sequence":"additional","affiliation":[{"name":"Milano Checkpoint ETS  Milan Italy"},{"name":"ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"UNAIDS.Fact Sheet 2025. 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