Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2026
[Analysis of claims data on regional aspects of HIV pre-exposure prophylaxis and specialized treatment in selected regions of the Association of Statutory Health Insurance Physicians from 2019 to 2022].
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Valbert Frederik, Schmidt Daniel, Kollan Christian, Friebe Martin, Voulgaris Konstantinos, Gunsenheimer-Bartmeyer Barbara, Wasem Jürgen, Neumann Anja
Аннотация
INTRODUCTION: Since September 2019, HIV pre-exposure prophylaxis (PrEP) has been covered by German statutory health insurance for individuals at substantial risk of HIV infection. PrEP is considered as an effective way to prevent new HIV infections. To maximize the success of prevention, it is important that care structures reach and continuously involve as many people at increased risk of HIV infection as possible. The analyses reported here aim to describe PrEP and HIV care for people living in regions of the Brandenburg, Lower Saxony, Mecklenburg-Western Pomerania, and Schleswig-Holstein associations of statutory health insurance physicians (KV) (regions with a less developed HIV specialized care).
METHODS: In anonymous routine data from a statutory health insurance (BARMER) from 2019 to 2022, individuals using PrEP and individuals living with HIV and receiving specialized HIV care were selected. The KV region of the physicians who prescribed PrEP or provided HIV care was determined for these individuals. A descriptive comparison was carried out between the KV regions of the insured persons and the treating physicians.
RESULTS: Significant differences exist among the regions considered in terms of the proportion of people receiving PrEP in their KV region. While PrEP for users in Brandenburg is prescribed exclusively outside Brandenburg, 775 of the prescriptions for PrEP users in Lower Saxony are provided in their own region and only 164 prescriptions are provided in other KV regions. Mecklenburg-Western Pomerania and Schleswig-Holstein are situated between these two regions. A similar pattern emerges in HIV care. In Brandenburg, however, individuals are also provided HIV care in their own KV region. Both analyses demonstrate the importance of care structures, particularly in Berlin and Hamburg, for individuals from neighboring KV regions.
CONCLUSION: It can be observed that healthcare structures in Berlin and Hamburg provide a high proportion of care to PrEP users and people living with HIV from other KV regions. Additionally, the results may suggest that people who are unable to meet the associated mobility requirements may be underserved in regions where a large proportion of the selected persons receives services in other KV regions.
METHODS: In anonymous routine data from a statutory health insurance (BARMER) from 2019 to 2022, individuals using PrEP and individuals living with HIV and receiving specialized HIV care were selected. The KV region of the physicians who prescribed PrEP or provided HIV care was determined for these individuals. A descriptive comparison was carried out between the KV regions of the insured persons and the treating physicians.
RESULTS: Significant differences exist among the regions considered in terms of the proportion of people receiving PrEP in their KV region. While PrEP for users in Brandenburg is prescribed exclusively outside Brandenburg, 775 of the prescriptions for PrEP users in Lower Saxony are provided in their own region and only 164 prescriptions are provided in other KV regions. Mecklenburg-Western Pomerania and Schleswig-Holstein are situated between these two regions. A similar pattern emerges in HIV care. In Brandenburg, however, individuals are also provided HIV care in their own KV region. Both analyses demonstrate the importance of care structures, particularly in Berlin and Hamburg, for individuals from neighboring KV regions.
CONCLUSION: It can be observed that healthcare structures in Berlin and Hamburg provide a high proportion of care to PrEP users and people living with HIV from other KV regions. Additionally, the results may suggest that people who are unable to meet the associated mobility requirements may be underserved in regions where a large proportion of the selected persons receives services in other KV regions.