2024/09/27 by Eline Wijstma, Vita W. Jongen, Anders Boyd +4
paper · doi:10.1097/qad.0000000000004027
Objective: The Dutch HIV preexposure prophylaxis (PrEP) pilot provided subsidized PrEP care to maximum 2900 individuals at a time in Amsterdam. Populations with expected barriers to accessing PrEP elsewhere were prioritized for program inclusion. We evaluated their prior sexual health service engagement and PrEP need. Design: Cross-sectional analysis using enrolment data. Methods: We included individuals ever enrolled in the PrEP program at the Center for Sexual Health (CSH) Amsterdam between 2019 and 2023. We calculated the proportion belonging to higher-priority groups (i.e., Results: 2004/4075 (49%) individuals enrolled belonged to higher-priority groups. LCA showed three classes of prior engagement: “newly engaged” (14%, n = 551) were new to the CSH-Amsterdam; “PrEP initiators” (40%, n = 1642) previously visited the CSH-Amsterdam but had not used PrEP; “PrEP experienced” individuals (46%, n = 1882) previously accessed PrEP. Higher-priority groups were more often “newly engaged” or “PrEP-initiators” than “PrEP-experienced”. Higher-priority groups less often had condomless anal sex with casual partners or chemsex in the prior 6 months. Positivity of bacterial STI was similar between higher-priority ( n = 300/2004, 15.0%) and lower-priority ( n = 315/2071, 15.2%) groups. 13/14 HIV diagnoses at enrolment were in higher-priority groups. Conclusion: Higher-priority populations had less often previously used sexual health services and accounted for most new HIV diagnoses at enrolment. Engaging these populations in sexual healthcare, including PrEP, should be stressed.