{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:24:09Z","timestamp":1771547049801,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"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\/501100016375","name":"Ministerium f\u00fcr Soziales und Integration Baden-W\u00fcrttemberg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016375","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>In Germany, the incidence of bacterial sexual transmitted infections (STI) is on the rise and still high for HIV infections. The Center for Sexual Health Freiburg (CSHF) was established to offer low threshold access for STI\/HIV counseling, testing, HIV pre-exposure prophylaxis (PrEP), and on-site treatment. The objective of this study was to analyze the performance of CSHF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Longitudinal study that includes all clients presenting between 1 May 2020 and 28 February 2021 at CSHF and willing to sign informed consent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study period, 536 clients presented at CSHF of whom 417 clients were included in the study resulting in 668 client contacts. Clients' median age was 28.1 years (range: 18.0\u201373.1), 55.9% were men, 42.0% were women, 0.3% were transman, and 1.7% were not binary. Clients' sexual orientation was heterosexual (56.6%), homosexual men (26.2%), and bisexual (13.6%). STI screening resulted in the detection of any STI in 3.4% (95% confidence interval (CI): 0.7\u20136.1) of women, in 3.1% (95% CI: 0.0\u20136.5) of heterosexual men, and in 22.2% (95% CI: 13.0\u201331.5) of men having sex with men (MSM) not taking PrEP. Eighty-one MSM received PrEP with a total follow-up of 57.3 person-years and 0.44 STIs per person-year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The substantial burden of STI in the study population emphasizes the need for regular and low threshold STI screening services. The concept of CSHF may facilitate access to STI\/HIV counseling, testing, and PrEP for a wide spectrum of people and may prove to be an important contribution to the efforts to reduce STI and HIV incidence in Germany.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.793609","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T10:31:22Z","timestamp":1650882682000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Closing Sexual Health Service Gaps With a New Service Model in Germany: Performance of an on-Site Integrated, Cross-Sectoral, Low Threshold Sexually Transmitted Infections\/HIV Counseling and Treatment Service"],"prefix":"10.3389","volume":"10","author":[{"given":"Matthias C.","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Usadel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Fahrh\u00f6fer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winfried V.","family":"Kern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Hoffmeister","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siegbert","family":"Rieg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"B1","unstructured":"HIV and AIDSIn: ECDC. Annual epidemiological report for 2016.2022"},{"key":"B2","unstructured":""},{"key":"B3","unstructured":"JansenK\n          Syphilis in Deutschland im Jahr 2019 \u2013 Neuer H\u00f6chststand von Infektionen.2020"},{"key":"B4","unstructured":"Gesundheit - Monatsberichte. S\u00e4chsisches Staatsministerium f\u00fcr Soziales und Gesellschaftlichen Zusammenhalt."},{"key":"B5","unstructured":"European Centre for Disease Prevention Control.2020"},{"key":"B6","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1186\/s12879-016-1915-2","article-title":"Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?","volume":"16","author":"Lallemand","year":"2016","journal-title":"BMC Infect Dis."},{"key":"B7","first-page":"483","article-title":"Sch\u00e4tzung der Zahl der HIV-Neuinfektionen und der Gesamtzahl von Menschen mit HIV in Deutschland","volume":"46","author":"an der Heiden","year":"2019","journal-title":"Stand Ende 2018"},{"key":"B8","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s12879-020-4831-4","article-title":"STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany","volume":"20","author":"Jansen","year":"2020","journal-title":"BMC Infect Dis."},{"key":"B9","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/0956462419886775","article-title":"2018 UK national guideline for the management of infection with Neisseria gonorrhoeae","volume":"31","author":"Fifer","year":"2020","journal-title":"Int J STD AIDS."},{"key":"B10","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/0956462415615443","article-title":"2015 UK national guideline for the management of infection with Chlamydia trachomatis","volume":"27","author":"Nwokolo","year":"2016","journal-title":"Int J STD AIDS."},{"key":"B11","unstructured":"2020 diagnostic and therapy guideline of the German STI Society."},{"key":"B12","unstructured":"EACS Guidelines Version 10.0."},{"key":"B13","unstructured":"2008 counselling, diagnostic and treatment guideline of the German STI Society."},{"key":"B14","unstructured":"European Centre for Disease Prevention Control.2014"},{"key":"B15","unstructured":"Bundesgesundheitsministerium."},{"key":"B16","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s00103-021-03382-1","article-title":"Sexuelle Gesundheit und Medizin im WIR \u2013 Walk In Ruhr: Vorstellung des Zentrums und Ergebnisse der Evaluation","volume":"64","author":"Potthoff","year":"2021","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz."},{"key":"B17","unstructured":"Checkpoint BLN."},{"key":"B18","unstructured":"Startseite"},{"key":"B19","unstructured":""},{"key":"B20","unstructured":""},{"key":"B21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1136\/sextrans-2012-050929","article-title":"Prevalence of pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Germany","volume":"90","author":"Dudareva-Vizule","year":"2014","journal-title":"Sex Transm Infect."},{"key":"B22","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/jdv.16913","article-title":"Sexual behaviour, STI knowledge and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence in an asymptomatic cohort in Ruhr-area, Germany: PreYoungGo study","volume":"35","author":"Skaletz-Rorowski","year":"2021","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B23","unstructured":"2015 STD Treatment Guidelines2019"},{"key":"B24","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1056\/NEJMoa1011205","article-title":"Preexposure chemoprophylaxis for HIV prevention in men who have sex with men","volume":"363","author":"Grant","year":"2010","journal-title":"N Engl J Med."},{"key":"B25","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(15)00056-2","article-title":"Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial","volume":"387","author":"McCormack","year":"2016","journal-title":"Lancet."},{"key":"B26","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1056\/NEJMoa1506273","article-title":"On-demand preexposure prophylaxis in men at high risk for HIV-1 infection","volume":"373","author":"Molina","year":"2015","journal-title":"N Engl J Med."},{"key":"B27","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2019.24.7.1800398","article-title":"Cost-effectiveness and budget effect of pre-exposure prophylaxis for HIV-1 prevention in Germany from 2018 to 2058","author":"van de Vijver","year":"2019","journal-title":"Euro Surveill"},{"key":"B28","doi-asserted-by":"crossref","first-page":"e629","DOI":"10.1016\/S2352-3018(18)30215-7","article-title":"Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study","volume":"5","author":"Grulich","year":"2018","journal-title":"Lancet HIV."},{"key":"B29","unstructured":"2021"},{"key":"B30","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1097\/QAD.0000000000001519","article-title":"Medication adherence, condom use and sexually transmitted infections in Australian preexposure prophylaxis users","volume":"31","author":"Lal","year":"2017","journal-title":"AIDS."},{"key":"B31","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/QAD.0000000000001718","article-title":"Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV","volume":"32","author":"Nguyen","year":"2018","journal-title":"AIDS."},{"key":"B32","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1001\/jama.2019.2947","article-title":"Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection","volume":"321","author":"Traeger","year":"2019","journal-title":"JAMA."},{"key":"B33","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00105-020-04545-y","article-title":"HIV-Pr\u00e4expositionsprophylaxe-Versorgung in intersektoraler Zusammenarbeit","volume":"71","author":"Ahaus","year":"2020","journal-title":"Hautarzt."},{"key":"B34","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection on Sexual Risk Behavior in Men Who Have Sex With Men: A Systematic Review and Meta-analysis","volume":"67","author":"Traeger","year":"2018","journal-title":"Clin Infect Dis."},{"key":"B35","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/0956462417736431","article-title":"Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits","volume":"29","author":"Whitlock","year":"2018","journal-title":"Int J STD AIDS."},{"key":"B36","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1007\/s00103-021-03441-7","article-title":"Sexual behavior and prevention of sexually transmitted infections taking the SARS-CoV-2 pandemic into account. Data from a sexual healthcare and medicine center-WIR","volume":"64","author":"Brockmeyer","year":"2021","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz."},{"key":"B37","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1136\/sextrans-2020-054756","article-title":"Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey","volume":"97","author":"Reyniers","year":"2021","journal-title":"Sex Transm Infect."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.793609\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T10:31:41Z","timestamp":1650882701000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.793609\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,25]]},"references-count":37,"alternative-id":["10.3389\/fpubh.2022.793609"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.793609","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,25]]},"article-number":"793609"}}