{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T10:29:56Z","timestamp":1769596196759,"version":"3.49.0"},"reference-count":8,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,12,6]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To review characteristics of individuals newly diagnosed with HIV following implementation of a national pre-exposure prophylaxis (PrEP) programme (comprehensive PrEP services, delivered in sexual health clinics) to inform future delivery and broader HIV prevention strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We extracted data from national HIV databases (July 2015\u2013June 2018). We compared sociodemographic characteristics of individuals diagnosed in the period before and after PrEP implementation, and determined the proportion of \u2018potentially preventable\u2019 infections with the sexual health clinic\u2013based PrEP delivery model used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Those diagnosed with HIV before PrEP implementation were more likely to be male (342\/418, 81.8% vs 142\/197, 72.1%, p=0.005), be white indigenous (327\/418, 78.2% vs 126\/197, 64.0%, p&lt;0.001), report transmission route as sex between men (219\/418, 52.4% vs 81\/197, 41.1%, p=0.014), and have acquired HIV in the country of the programme (302\/418, 72.2% vs 114\/197, 57.9% p&lt;0.001) and less likely to report transmission through heterosexual sex (114\/418, 27.3% vs 77\/197, 39.1%, p=0.002) than after implementation.<\/jats:p><jats:p>Pre-implementation, 8.6% (36\/418) diagnoses were \u2018potentially preventable\u2019 with the PrEP model used. Post-implementation, this was 6.6% (13\/197), but higher among those with recently acquired HIV (49\/170, 28.8%). Overall, individuals with \u2018potentially preventable\u2019 infections were more likely to be male (49\/49, 100% vs 435\/566, 76.9%, p&lt;0.001), aged &lt;40 years (37\/49, 75.5% vs 307\/566, 54.2%, p=0.004), report transmission route as sex between men (49\/49, 100% vs 251\/566, 44.3%, p&lt;0.001), have previously received post-exposure prophylaxis (12\/49, 24.5% vs 7\/566, 1.2%, p&lt;0.001) and less likely to be black African (0\/49, 0% vs 67\/566, 11.8%, p=0.010) than those not meeting this definition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The sexual health clinic\u2013based national PrEP delivery model appeared to best suit men who have sex with men and white indigenous individuals but had limited reach into other key vulnerable groups. Enhanced models of delivery and HIV combination prevention are required to widen access to individuals not benefiting from PrEP at present.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054732","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T19:07:42Z","timestamp":1610564862000},"page":"53-57","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Implementation of a national HIV pre-exposure prophylaxis service is associated with changes in characteristics of people with newly diagnosed HIV: a retrospective cohort study"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7139-5797","authenticated-orcid":false,"given":"Ceilidh","family":"Grimshaw","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-5630","authenticated-orcid":false,"given":"Claudia S","family":"Estcourt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4611-3786","authenticated-orcid":false,"given":"Rak","family":"Nandwani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5226-3695","authenticated-orcid":false,"given":"Alan","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9658-7798","authenticated-orcid":false,"given":"John Michael","family":"Saunders","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"key":"2024092104001276000_98.1.53.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00056-2"},{"key":"2024092104001276000_98.1.53.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110711"},{"key":"2024092104001276000_98.1.53.3","unstructured":"Health Protection Scotland. Surveillance report . HIV infection in Scotland: Quarterly report to 30 June 2018, 2018. Available: https:\/\/hpspubsrepo.blob.core.windows.net\/hps-website\/nss\/2500\/documents\/1_hiv-infection-quarterly-sept-2018.pdf [Accessed 14 May 2020]."},{"key":"2024092104001276000_98.1.53.4","unstructured":"Health Protection Scotland . Implementation of HIV PreP in Scotland: first year report, 2019. Available: https:\/\/hpspubsrepo.blob.core.windows.net\/hps-website\/nss\/2716\/documents\/3_implementation-of-hiv-prep-in-scotland-first-year-report.pdf [Accessed 23 Jul 2020]."},{"key":"2024092104001276000_98.1.53.5","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1093\/cid\/ciu251","article-title":"A paradigm shift: focus on the HIV prevention continuum","volume":"59 Suppl 1","author":"McNairy","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2024092104001276000_98.1.53.6","unstructured":"BHIVA . BHIVA\/BASHH\/BIA adult HIV testing guidelines 2020, 2020. Available: https:\/\/www.bhiva.org\/file\/5dfceab350819\/HIV-Testing-Guidelines.pdf [Accessed 16 Jun 2020]."},{"key":"2024092104001276000_98.1.53.7","unstructured":"Nakasone S , Young I , Estcourt C . Risk perception, safer sex practices and PreP enthusiasm: barriers and facilitators to oral HIV pre-exposure prophylaxis in black African and black Caribbean women in the UK, 2020. Available: https:\/\/sti.bmj.com\/content\/early\/2020\/06\/12\/sextrans-2020-054457 [Accessed 15 Jun 2020]."},{"key":"2024092104001276000_98.1.53.8","unstructured":"Adams E , Grimshaw C . Do hospital physicians know enough about HIV pre exposure prophylaxis? A survey of middle grade Hospital doctors to evaluate their clinical understanding of PreP. HIV Med spec issue Abstr 4th Jt Conf Br HIV Assoc Br Assoc sex health Hib Edinb, UK, 2018:s21\u2013152."}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2020-054732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T11:01:14Z","timestamp":1726916474000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2020-054732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,13]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,17]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/sextrans-2020-054732"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2020-054732","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,13]]}}}