[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-402284-en":59,"doc-seo-402284-105":81},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":72,"language":73,"language_code":74,"site_id":75,"html_lang":74,"table_of_contents":76,"faqs":77,"seo_title":78,"seo_description":66,"update_tm":79,"read_time":80,"preview_page_count":4},402284,962090883219,"RuangKosong","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","HIV pre-exposure prophylaxis (PrEP) use in Germany - 2017-2020 estimation and unmet needs","Data on PrEP use in Germany is collected irregularly, prompting an assessment of the number of PrEP users among men who have sex with men (MSM) and how PrEP use evolved from 2017 to 2020. The study combines prescription records, survey-based estimates of on-demand/intermittent versus daily use, and online profiles to model user counts under multiple assumptions. It links intention data to regional unmet needs and reports persistent inequalities despite substantial growth in PrEP use.","| |  |\n| --- | --- |\n| |  |\n| |  |\n|  􀂦 \u003Cbr>Robert Koch Institute\u003Cbr>\u003Cbr>Robert Koch Institute\u003Cbr>\u003Cbr>Robert Koch Institute\u003Cbr>\u003Cbr>Robert Koch Institute | |\n| \u003Cbr> HIV pre-exposure prophylaxis, Men who have sex with men, Germany  February 25th, 2021\u003Cbr> [https://doi.org/10.21203/rs.3.rs-156075/v2](https://doi.org/10.21203/rs.3.rs-156075/v2)\u003Cbr> 􀁱 􀅏 This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License |  |\n\nBackground: Data on PrEP use in Germany is not collected systematically. We aim to estimate the number of PrEP users among men having sex with men (MSM) and describe PrEP use in Germany from 2017 through 2020. Moreover, we analyse whether PrEP needs expressed in 2017 could have been met by the expansion of PrEP until 2020.  \nMethods: We estimated the number of PrEP users using drug prescription data, information on on-demand/intermittent PrEP use from online surveys, and number of online pro¦les indicating PrEP use, based on varying assumptions about the proportion of on  \ndemand/intermittent and daily PrEP users and on the average number of PrEP pills used. Factors associated with intention to use PrEP were identi¦ed by a multivariable logistic regression analysis among respondents to an online survey. We estimated the number of MSM in need for PrEP in 2017 based on four groups de¦ned among the survey respondents, combining respondents intending to use PrEP and respondents indicating substantial sexual risks. We used data and assumptions on self-selection biases to estimate a range for the absolute size of these groups among gay men in Germany.  \nResults: Depending on assumptions, we estimated a total of 15,600 to 21,600 PrEP users in Germany by the end of June 2020, which corresponds to between 40 and 55% of men with the intention to use PrEP in 2017. Distributions of PrEP users from different data sources and PrEP prescriptions by federal state in Germany were highly correlated, except for major deviations for Berlin with a higher proportion of prescriptions in Berlin compared to the proportion of survey participants using PrEP. A correlation between the regional distribution of intention to use PrEP in 11/2017 and actual PrEP use by 06/2020 suggested an unequal regional distribution of unsatis¦ed needs. The number of men with unmet PrEP needs ranged between 27,500 and 93,000 in 06/2020 .  \nConclusions: PrEP use in Germany has increased considerably between 10/2017 and 06/2020, but large regional inequalities persist. Results suggested that PrEP is not fully accessible and that there is a need to expand services and encourage demand.  \nLegal HIV pre-exposure prophylaxis (PrEP) use started in Germany in 2016 when the European Medicines Agency (EMA) approved the use of tenofovir-emtricitabine for HIV-PrEP (1) . With o¨cial approval of this two-drug combination for HIV-PrEP, any physician in Germany was allowed to prescribe these drugs for PrEP use. Yet accessibility remained severely restricted due to prohibitive costs (approximately € 800/month) in the absence of affordable generics in Germany and no legal alternatives to obtain and import cheaper generics from outside the European Union (2) .  \nPrEP activists had discovered and promoted a loophole for accessing affordable generics from abroad that relied mainly on a regulationspeci¦c for the United Kingdom (UK) allowing import of generics from outside of the European Union (EU) for personal use. This allowed importing the drugs into the UK and forwarding them by mail from UK to Germany without customs control. However, the number of people in Germany who used this channel or used other informal sources to obtain drugs for use as PrEP remained limited. After the patent for tenofovir-emtricitabine had expired, in October 2017 a pharmacist from Cologne exploited a rarely used clause of the German regulatory framework and made a cheap generic version of tenofovir-emtricitabine accessible as monthly supply packaged for individ","cbCaibNmTJcK1UK4","https://ap.wps.com/l/cbCaibNmTJcK1UK4","pdf",1329551,23,"English","en",105,"# Background\n# Methods\n# Results\n# Conclusions\n# Legal and policy context","[{\"question\":\"What time period and population does the study focus on?\",\"answer\":\"The analysis covers PrEP use in Germany from 2017 through 2020 and focuses on men who have sex with men (MSM).\"},{\"question\":\"How does the study estimate the number of PrEP users?\",\"answer\":\"It uses drug prescription data, survey information on on-demand/intermittent PrEP use, and counts from online profiles, applying varying assumptions about use patterns and pill consumption.\"},{\"question\":\"What were the main findings about PrEP use and unmet needs in Germany?\",\"answer\":\"Estimated PrEP users rose to 15,600–21,600 by end of June 2020, but unmet needs remained substantial (27,500–93,000 men). Regional inequalities persisted, with evidence suggesting unsatisfied needs were distributed unequally.\"}]","HIV pre-exposure prophylaxis (PrEP) use in Germany - 2017-2020 estimation and unmet needs | PDF",1790528741,58,{"code":4,"msg":82,"data":83},"ok",{"site_id":75,"language":74,"slug":84,"title":65,"keywords":85,"description":66,"schema_data":86,"social_meta":140,"head_meta":142,"extra_data":144,"updated_unix":145},"hiv-pre-exposure-prophylaxis-prep-use-in-germany-2017-2020-estimation-and-unmet-needs","",{"@graph":87,"@context":139},[88,102,122],{"@type":89,"itemListElement":90},"BreadcrumbList",[91,95,97,100],{"item":92,"name":93,"@type":94,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":96,"name":9,"@type":94,"position":14},"https://docshare.wps.com/document/",{"item":98,"name":35,"@type":94,"position":99},"https://docshare.wps.com/document/healthcare/",3,{"item":101,"name":65,"@type":94,"position":19},"https://docshare.wps.com/document/hiv-pre-exposure-prophylaxis-prep-use-in-germany-2017-2020-estimation-and-unmet-needs/402284/",{"url":101,"name":65,"@type":103,"image":104,"author":109,"headline":65,"publisher":111,"fileFormat":114,"inLanguage":74,"description":66,"dateModified":115,"datePublished":116,"encodingFormat":114,"isAccessibleForFree":117,"interactionStatistic":118},"DigitalDocument",{"url":105,"@type":106,"width":107,"height":108},"https://docshare.wps.com/thumbnails/hiv-pre-exposure-prophylaxis-prep-use-in-germany-2017-2020-estimation-and-unmet-needs/402284.png","ImageObject",300,407,{"name":63,"@type":110},"Person",{"url":92,"name":112,"@type":113},"DocShare","Organization","application/pdf","2026-11-06","2026-09-27",true,{"@type":119,"interactionType":120,"userInteractionCount":29},"InteractionCounter",{"@type":121},"ViewAction",{"@type":123,"mainEntity":124},"FAQPage",[125,131,135],{"name":126,"@type":127,"acceptedAnswer":128},"What time period and population does the study focus on?","Question",{"text":129,"@type":130},"The analysis covers PrEP use in Germany from 2017 through 2020 and focuses on men who have sex with men (MSM).","Answer",{"name":132,"@type":127,"acceptedAnswer":133},"How does the study estimate the number of PrEP users?",{"text":134,"@type":130},"It uses drug prescription data, survey information on on-demand/intermittent PrEP use, and counts from online profiles, applying varying assumptions about use patterns and pill consumption.",{"name":136,"@type":127,"acceptedAnswer":137},"What were the main findings about PrEP use and unmet needs in Germany?",{"text":138,"@type":130},"Estimated PrEP users rose to 15,600–21,600 by end of June 2020, but unmet needs remained substantial (27,500–93,000 men). Regional inequalities persisted, with evidence suggesting unsatisfied needs were distributed unequally.","https://schema.org",{"og:url":101,"og:type":141,"og:title":65,"og:site_name":112,"og:description":66},"article",{"robots":143,"canonical":101},"index,follow",{"doc_id":61,"site_id":75},1791096566]