Virological treatment outcome under HAART : does sex matter?

Background: In Germany, 17% of 59,000 persons living with HIV/AIDS are female. Accordingly, the research focus in clinical studies as well as in cohort analyses has been almost exclusively on HIV-positive men. As a consequence, there is an urgent need to characterize and evaluate the outcome of HAART in HIV-positive women and to identify special requirements of this particular patient population. Methods: Cross-sectional multicentre (n = 31 centres) evaluation to observe characteristics of 1,557 HIV-positive women receiving medical care in Germany between June 2007 and March 2008. Data acquisition was performed using standardized questionnaires. Summary of results: Of 1,557 HIV-positive women studied, 1,191 (77%) received HAART. Mean age was 40 years and average time of known HIV-infection was 9 years. Risk of HIV transmission was: 40% heterosexual intercourse in Germany, 36% heterosexual intercourse in a high prevalence country; 17% IDU; 7% other reasons for transmission. 46% of the women had a migration background. Mean time on antiretroviral treatment was 7 years. 53% of the female participants had been treated with >2 HAART-regimens. 47% of the study subjects received a PI-based regimen, 33% a NNRTI-based regimen; 20% were on other combinations. The most commonly used PI and NNRTI were lopinavir/r and nevirapine, respectively. Only 48% of all women under HAART achieved a viral load <40 copies/ml. There was a significant difference between the PI-treated group with 44% patients <40 copies/ml and the NNRTI-treated group with 56% <40 copies/ml (p = 0.003). Conclusion: We found that HIV-positive women depicted an inferior virological response to HAART compared to those previously published in German cohort analyses dominated by men (response rates >75%). Possible differences in adherence or drug resistance may have impacted these results and are currently being evaluated in ongoing sub-analyses. Of note, the lack of a study arm with male patients is a limitation of this investigation. However, this is partly off-set by the fact that there are good comparative data in the male population found in other cohorts. We conclude that our results are in discordance to the popular assumption that there are no gender specific differences in virological treatment outcome of HAART

PrEP in Deutschland – Befragung der Deutschen Arbeitsgemeinschaft ambulant tätiger Ärztinnen und Ärzte für Infektionskrankheiten und HIV-Medizin (dagnä e.V.) in HIV-Schwerpunkteinrichtungen

Die Deutsche Arbeitsgemeinschaft ambulant tätiger Arztinnen und Arzte für Infektionskrankheiten und HIV-Medizin (dagnä e.V.) hat im Frühjahr 2025 eine Befragung zur PrEP-Versorgung in HIV-Schwerpunktzentren durchgeführt. Diese Befragung deckt das dritte und vierte Quartal 2024 ab und erfasst u. a. die Anzahl der Personen in der HIV-Schwerpunktversorgung sowie die Einschätzung der Zentren zu der antibiotischen Postexpositionsprophylaxe mit Doxycyclin zur Verringerung des Risikos von sexuell übertragbaren Infektionen.PrEP in Germany The German Association of Outpatient Physicians for Infectious Diseases and HIV Medicine (dagnä e.V.) conducted a survey on PrEP provision in HIV centers in spring 2025. This survey covers the third and fourth quarters of 2024 and includes, among other things, the number of people receiving HIV care and the centers' assessment of antibiotic post-exposure prophylaxis with doxycycline to reduce the risk of sexually transmitted infections

Исследования алгоритмов фазочастотного прослеживания сейсмических волн с равновесной и неравновесной обработкой

Создание эффективных алгоритмов фазочастотного прослеживания сейсмических волн с равновесной и неравновесной обработкой. Исследование их помехоустойчивости и разрешающей способности.Creation of efficient algorithms for phase-tracking of seismic waves with equilibrium and non-equilibrium processing. The study of their noise immunity and resolution

PrEP-Surveillance in Deutschland – Ergebnisse der vierten halbjährlichen Befragung in HIV-Schwerpunkteinrichtungen

Im Rahmen des vom Bundesministerium für Gesundheit geförderten Projekts „Surveillance der Versorgung mit der HIV-Präexpositionsprophylaxe innerhalb der GKV in Deutschland“ (PrEP-Surv) werden halbjährliche Befragungen zu Gebrauch und Versorgung mit der HIV-Präexpositionsprophylaxe (PrEP) in HIV-Schwerpunktzentren durchgeführt. In der vierten halbjährlichen Befragung ging es u. a. um die Anzahl der im Jahr 2022 und 2023 durchgeführten Hospitationen zum Erwerb der ärztlichen Berechtigung zur GKV-PrEP-Verordnung und eine Einschätzung zum Einnahmemodus sowie zur Wartezeit auf Termine zur PrEP-Beratung/-Initiierung und -Kontrolle für das letzte Halbjahr 2023 bis vor den PrEP-Lieferengpässen. Aufgrund der PrEP-Lieferengpässe gab es Anfang 2024 kurzfristig starke Einbrüche bei der Anzahl der PrEP-Verordnungen in Deutschland

PrEP-Surveillance in Deutschland – Ergebnisse der fünften halbjährlichen Befragung in HIV-Schwerpunkteinrichtungen

Im Rahmen des vom Bundesministerium für Ge¬sundheit geförderten Projekts „Surveillance der Versorgung mit der HIV-Präexpositionsprophylaxe innerhalb der GKV in Deutschland“ (PrEP-Surv) werden halbjährliche Befragungen zu Gebrauch und Versorgung mit der HIV-Präexposi-tionsprophylaxe (PrEP) in HIV-Schwerpunktzent¬ren durchgeführt. Im Epidemiologischen Bulletin 17/2025 werden die Ergebnisse der fünften halbjährlichen Befragung vorgestellt. Dabei ging es u. a. um den Lieferengpass des Medikaments mit den Wirkstoffen Tenofovirdisoproxil/Emtricitabin (TDF/FTC) und dessen Auswirkungen auf die PrEP-Versorgung

Surveillance der Versorgung mit der HIV-Präexpositionsprophylaxe in Deutschland

Gesetzlich Krankenversicherte mit einem substanziellen HIV-Infektionsrisiko haben seit September 2019 Anspruch auf die HIV-Präexpositionsprophylaxe (PrEP). Basierend auf den Evaluationsergebnissen zur Einführung der PrEP innerhalb der gesetzlichen Krankenversicherung (GKV) verstetigt das RKI ab dem Jahr 2022 das Monitoring der PrEP-Versorgung in dem durch das BMG finanzierten Projekt „Surveillance der Versorgung mit der HIV-Präexpositionsprophylaxe innerhalb der GKV in Deutschland“ (PrEP-Surv). Die Laufzeit des Projektes ist für den Zeitraum 01.01.2022 bis zunächst 31.12.2023 vorgesehen. Der Beitrag fasst Kernaussagen der Befragung zur PrEP-Versorgung in deutschen HIV-Schwerpunktzentren in den Zeiträumen 01.01.2021 – 31.12.2021 sowie 01.01.2022 – 30.06.2022 zusammen

PrEP-Evaluation EvE-PrEP – Ergebnisse einer Befragung zum PrEP-Versorgungsgeschehen in HIV-Schwerpunktzentren des dagnä-Netzwerks

Seit September 2019 ist die Präexpositionsprophylaxe (PrEP) bei HIV-Infektion Teil des Leistungskatalo-ges der gesetzlichen Krankenversicherung (GKV). Mit der Einführung wurde auch eine Evaluation der neuen Leistung vorgesehen und ge¬setzlich festgeschrieben. In einer ersten umfassenden Auswertung einer Befragung zum Versorgungsgeschehen mit der GKV-PrEP in deutschen HIV-Schwerpunktzentren wurden u. a. allgemeine Daten zur PrEP-Versorgung und PrEP-Nutzung sowie spezifische Daten zu Versorgungsprozessen, etwa Testung und Behandlung asymptomatischer STI sowie STI-Prophylaxe, Beratung und Einleitung der HIV-PrEP betrachtet. Ergänzt wurde die Untersuchung durch vorangegangene Umfragen zum Einfluss der COVID-19-Pandemie auf die PrEP-Versorgung.Peer Reviewe

Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in Germany

Introduction 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. Methods Anonymous data of PrEP users were collected at 47 HIV-specialty centers from 09/2019–12/2020. Incidence rates were calculated per 100 person years (py). Using longitudinal mixed models, we analyzed risk factors associated with sexually transmitted infections (STIs). Results 4620 PrEP users were included: 99.2% male, median age 38 years (IQR 32–45), 98.6% men who have sex with men (MSM). The median duration of PrEP exposure was 451 days (IQR 357–488), totaling 5132 py. Four HIV infections were diagnosed, incidence rate 0,078/100py (95% CI 0.029–0.208). 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. Conclusions We found that HIV-PrEP is almost exclusively used by MSM in Germany. A very low incidence of HIV infection 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 valuePeer Reviewe

[Evaluating the introduction of HIV pre-exposure prophylaxis as a benefit of statutory health insurance (EvE-PrEP) : Highly effective protection against HIV without an increase in sexually transmitted infections].

BACKGROUND: We investigated the impact of HIV pre-exposure prophylaxis (PrEP) as a new service of the statutory health insurance (SHI) on the incidence of HIV and other sexually transmitted infections (STIs) in Germany. In addition, PrEP needs and access barriers were analyzed. METHODS: The following data were evaluated as part of the evaluation project: HIV and syphilis notification data and extended surveillance by the Robert Koch Institute (RKI), pharmacy prescription data, SHI routine data, PrEP use in HIV-specialty care centers, Checkpoint, the BRAHMS and PrApp studies, as well as a community board. RESULTS: The majority of PrEP users were male (98-99%), primarily aged between 25-45 years, and predominantly of German nationality or origin (67-82%). The majority were men who have sex with men (99%). With regard to HIV infections, PrEP proved to be highly effective. There were only isolated cases of HIV infections (HIV incidence rate 0.08/100 person years); in most cases the suspected reason was low adherence. The incidences of chlamydia, gonorrhea, and syphilis did not increase but remained almost the same or even decreased. A need for information on PrEP for people in trans*/non-binary communities, sex workers, migrants, and drug users emerged. Needs-based services for target groups at increased risk of HIV are necessary. DISCUSSION: PrEP proved to be a very effective HIV prevention method. The partly feared indirect negative influences on STI rates were not confirmed in this study. Due to the temporal overlap with the containment measures during the COVID-19 pandemic, a longer observation period would be desirable for a conclusive assessment