EACS 2019 – Inadequate testing frequency is common in pre-exposure prophylaxis users

  • Cristina Ferrario — Agenzia Zoe
  • Conference Reports
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  • Inadequate testing frequency is common in German pre-exposure prophylaxis (PrEP) users.
  • Cost coverage for PrEP could improve PrEP use and warrants further investigation.

Why this matters?

  • Regular testing for HIV and sexually transmitted infections (STI) is required for safe use of HIV PrEP.

Study design

  • PrAPP study (WAVE 1; 24th July-1st November 2018): anonymous online survey, available in 6 languages.
  • PrEP users (n=2,118) recruited in Germany through geolocation dating apps for men who have sex with men (MSM), a community website and anonymous HIV/STI checkpoints.
  • Outcome: inadequate testing interval (>3 months for HIV and >6 months for STI).
  • Univariate logistic regression for demographic/economic, medical and sexual behaviour-related risk factors assessment.

Key results

  • Study population: median age 38 years, 80.83% male, 44.33% using PrEP for >6 months.
  • 87.1% of 1,834 participants reported being tested (any test: HIV/STI/renal function) during PrEP use; 11.0% reported no testing.
  • Among subjects tested during PrEP, 15.5% and 8.5% reported inadequate testing frequencies for HIV and STI, respectively.
  • Factors associated with inadequate testing frequency both for HIV and STI: on-demand or intermittent PrEP use, 1-10 anal sex partners within the last 6 months, always using a condom.
  • The main risk factor associated with inadequate testing: no tests prior to PrEP start.
  • Use of PrEP from informal sources and no physician test site was associated with inadequate HIV testing.
  • Self-payment for tests was associated with inadequate STI testing.
  • WAVE 2 already conducted (analyses ongoing), WAVE 3 planned for 2020.

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