Dynamics of STIs during and after the COVID-19 pandemic in PrEP-cohort - Outpatient center Study at University Medical Center Hamburg-Eppendorf (UKE)

Sep 27, 2026

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Pre-exposure prophylaxis (PrEP) remains highly effective for HIV prevention, yet regular screening for other sexually transmitted infections (STIs) is essential because COVID-19 may have shifted sexual behavior and STI epidemiology. This outpatient cohort study at the University Medical Center Hamburg-Eppendorf (UKE) analyzes 3,778 tests from 701 individuals across Q1 2020 to Q4 2023 to assess quarterly diagnoses and positivity for gonorrhea, syphilis, and chlamydia. Results show elevated gonococci after restrictions eased, chlamydia and syphilis stability, and a need for STI-specific prevention.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

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Background

Methods

Results

Conclusions

Outpatient center – Department for infectious diseases, University Medical Center HamburgEppendorf, Hamburg, Germany Dynamics of STIs during and after the COVID-19 pandemic in PrEP-cohort at the University Medical Center Hamburg-Eppendorf (UKE) Steinhaus N. J. 1, Almahfoud M. 1, Weimann L. 1, Matthews H. 1, Diekhoff P.1, Pollich S. 1, Jordan S. 1,2, Koch T.2, Schäfer G. 3, Hüfner A. 1, Schmiedel S. 1,2 Schulze zur Wiesch J. 1,2, Degen O. 1 1 Outpatient center – Department for infectious diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany 2 I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3 Infektionsmedizinisches Centrum Hamburg (ICH) Study Center, Hamburg, Germany. Background: Pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective in reducing the risk of HIV infection in high-risk populations. Besides HIV prevention, regular screening for other sexually transmitted infections (STIs) remains critical due to potential shifts in sexual behavior and STI epidemiology. The COVID-19 pandemic has significantly impacted social interactions and may have altered sexual behavior, potentially influencing the transmission patterns of non-HIV STIs. This study aims to assess the changes in diagnoses and positivity rates for gonorrhea, syphilis, and chlamydia among PrEP users at the University Medical Center Hamburg-Eppendorf (UKE) during and after the pandemic. Total number of STI diagnoses 40 20 0 Total Number of Tests Over Time (n=3778) Q4 ' 19 Q1 '20 Q2 '20 Q3 '20 Q4 '20 Q1 '21 Q2 '21 Q3 '21 Q4 '21 Q1 '22 Q2 '22 Q3 '22 Q4 '22 Q1 '23 Q2 '23 Q3 '23 Q4 '23 Q1 '24 Q2 '24 Q4 ' 19 Q1 '20 Q2 '20 Q3 '20 Q4 '20 Q1 '21 Q2 '21 Q3 '21 Q4 '21 Q1 '22 Q2 '22 Q3 '22 Q4 '22 Q1 '23 Q2 '23 Q3 '23 Q4 '23 Q1 '24 Q2 '24 Results: - Analysis of 3778 tests from 701 individuals revealed 522 positive diagnoses overall - Diagnoses included 215 gonococcal, 61 syphilis and 246 chlamydia infections - Stable positivity rates for chlamydia and syphilis, and low gonococci rates during lockdowns (Q2 ‘20 – Q1 ‘21), followed by an increase in gonococci starting in Q4 ‘21 and remaining elevated in 2022 (p=0 .08) - Comparing Covid- and Non-Covid periods showed higher chlamydia positivity rates during 2022 (vs. 2021; p=0, 172), while gonococci rates were elevated 2022 (vs. 2021; p=0, 174); syphilis positivity stayed consistently low with a slight decline after Q2 ’22 (p=0 . 16) - Stabilization from Q3 ‘22 through Q4 ‘23 , with chlamydia and gonococci at a higher baseline positivity rate (Gonococci: 95%-CI=4 .71–7 .69; Chlamydia: 95%-CI=5 .84–8 . 14); syphilis remained unchanged Methods: At the Outpatient center for Infectious Diseases at the University Medical Center Hamburg-Eppendorf (UKE), we have been following a PrEP cohort since October 2020 as part of an ongoing prospective observational study. We use recurring online questionnaires (RedCapy), standard blood tests and STI tests. We analyzed the data collected in the period from Q1 2020 to Q4 2023 . Positivity rates were calculated for each quarter during and after the pandemic using RedCapy and Excely. We used AI tools (DeepLy, ChatGPTy) for translation and text editing. Standard descriptive statistic methods were employed. STI Positivity Rate (%) Relative to Testing Volume 10% 5% 0% chlamydia Q4 ' 19 Q1 '20 Q2 '20 Q3 '20 Q4 '20 Q1 '21 Q2 '21 Q3 '21 Q4 '21 Q1 '22 Q2 '22 Q3 '22 Q4 '22 Q1 '23 Q2 '23 Q3 '23 Q4 '23 Q1 '24 Q2 '24 10% 5% 0% syphilis Q4 ' 19 Q1 '20 Q2 '20 Q3 '20 Q4 '20 Q1 '21 Q2 '21 Q3 '21 Q4 '21 Q1 '22 Q2 '22 Q3 '22 Q4 '22 Q1 '23 Q2 '23 Q3 '23 Q4 '23 Q1 '24 Q2 '24 10% 5% 0% gonococci Q4 ' 19 Q1 '20 Q2 '20 Q3 '20 Q4 '20 Q1 '21 Q2 '21 Q3 '21 Q4 '21 Q1 '22 Q2 '22 Q3 '22 Q4 '22 Q1 '23 Q2 '23 Q3 '23 Q4 '23 Q1 '24 Q2 '24 Conclusions: ➢ Th

FAQs

What is the study’s main aim regarding STIs in a PrEP cohort?

To assess changes in diagnoses and positivity rates for gonorrhea, syphilis, and chlamydia among PrEP users during and after the COVID-19 pandemic at UKE.

How many tests and individuals were analyzed?

The analysis included 3,778 tests from 701 individuals across quarters from Q1 2020 to Q4 2023.

What happened to gonorrhea (gonococci) positivity during and after lockdown periods?

Gonococci rates were low during lockdowns (Q2 ’20–Q1 ’21), then increased starting in Q4 ’21 and remained elevated through 2022.

Sep 27, 2026

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