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Are we reaching the at-risk patient populations for HIV and other STI?

Boesecke, C., Kimhofer, T., Tocha, C., Schubert, O., Rybak, R., Kuhlen, K., Klaes, C. and Rockstroh, J.K. (2021) Are we reaching the at-risk patient populations for HIV and other STI? In: Conference on Retroviruses and Opportunistic Infections, 6 - 10 March 2021, Virtual.


Published clinical and epidemiological data on individuals persons undergoing anonymous testing for sexually transmitted diseases (STI) in Germany are sparse. Here we report annual results of STI screenings and survey data from a large community based STI testing Checkpoint in Cologne, Germany.

From January 2017 to December 2019, data on STI screening, clinical, demographic, sexual information was anonymously recorded for individuals attending the Checkpoint in Cologne. Visitors were screened for HIV, syphilis, chlamydia, gonorrhea and hepatitis C using point of care testing kits. Positive tests were validated.

Overall, screening was performed on 11,456 visitors aged 16 to 85 years. Three main reasons were identified: recent HIV risk situation (46%), routine testing (29%), beginning of a new relationship (24%). The largest visitor group constituted men who have sex with men (MSM, 44%), followed by men who have sex with women (MSW, 29%), women having sex with men (WSM, 22%). MSM engaged on average with a higher number of sex-partners than MSW and WSM with 36% having 2-5 sex-partners and 10% having ? 26 per year. The annual number of visitors on PrEP (96% MSM) increased steadily, with a total of 29 visitors in 2017, 54 in 2018 and 123 in 2019 (p<0.001). The MSM group had the highest disease frequency (chlamydia: 140, gonorrhea: 123, syphilis: 88, HIV: 56, HCV: 2). STI frequency in PrEP users was highest for chlamydia/gonorrhoea (7%, 9% and 12% for 2017, 2018 and 2019, respectively). One PrEP user tested positive for HIV. In all other groups, chlamydia was the most prevalent infection while both HCV cases occurred among MSM. Despite increased PrEP prevalence in Germany since 2017 (covered by health insurance from 09/2019 onwards) no decline in HIV infection rates was observed with 20, 29 and 24 cases in 2017, 2018 and 2019, respectively (p=0.46). 56 new HIV infections were seen in MSM, 4 in MSW, 7 in WSM. 58% of newly diagnosed individuals indicated that a significant risk situation had occurred in the recent past, followed by 33% indicating routine testing.

Checkpoint was able to detect relevant STIs in 5% of all visitors thereby underling the importance of community-based testing sites. Despite increased HIV awareness and PrEP roll-out MSM remain at highest risk for contracting HIV (and HCV) highlighting the continuous need for educational activities as well as low-threshold and cost-free STI screening capacities.

Item Type: Conference Item
Murdoch Affiliation(s): Health Futures Institute
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