[Monitoring of HIV pre-exposure prophylaxis in Germany based on statutory health insurance claims data].

BACKGROUND

Since September 2019, HIV pre-exposure prophylaxis (PrEP) has been covered by statutory health insurance (SHI) in Germany. The objectives of the PrEP-Surv study module presented here were to monitor PrEP usage from 2019 to 2022 and to examine the feasibility of using SHI claims data for an annual monitoring of PrEP provision.

METHODS

PrEP users were identified and analyzed using anonymized BARMER data from 2019 to 2022. The analyses included determining the number of PrEP users each year; describing the cohorts by age, gender, and treatment adherence; identifying HIV infections; and calculating the rates of sexually transmitted infections or infectious diseases (STIs).

RESULTS

The number of PrEP users increased from 1058 in 2019 to 3194 in 2022. Demographic characteristics remained largely unchanged, while the average censored treatment adherence decreased from 98% in 2019 to 91% and 92% in the subsequent years. Two HIV infections were observed in two individuals, but the transmissions presumably occurred outside of PrEP use. No clear changes in STI rates were observed.

DISCUSSION: The observed cohort appears to be comparable to other PrEP cohorts in Germany. The stability of the demographic characteristics possibly indicates that groups eligible for PrEP that were not reached at the beginning of PrEP reimbursement were subsequently also not reached. In addition to a description of PrEP care, a possible approach for the annual monitoring based on SHI claims data is presented.