[Users' Adherence and Off-Label Use of HIV-Pre-Exposure Prophylaxis]. / Nutzerseitige Adhärenz und Off-Label-Use der HIV-Prä-Expositionsprophylaxe.

INTRODUCTION: HIV-PrEP (HIV-Pre-Exposure Prophylaxis) has been available through German pharmacies in various package sizes since 2017. It can be used for daily dosing or as an intermittent product used as required. AIM: The aim of this survey was to record socio-demographic basic characteristics, the respondents' medical history regarding STI (sexual transmitted infections), previous PEP (Post-exposure prophylaxis) use, the system of PrEP use, the prior diagnostics carried out as well as the advice regarding the use of PrEP and information on whether PrEP was passed on to others. METHOD: A cross-sectional analysis was carried out in the form of a revised, self-developed multiple-choice questionnaire for 515 users within the network of HIV-competent pharmacies. RESULTS: Three-quarters of the exclusively male respondents were in the age group of 20-39 years. More than 80% used the PrEP according to recommendations. Approximately two-thirds had received PEP in the past. The same number also had, at least, one STI in previous years. The necessary previous diagnostics were mostly carried out; 7% of the PrEP is passed on to other users. CONCLUSION: The majority (approximately 2/3) of the PrEP users are high-risk users with regard to previous STI or previous PEP use, and use the PrEP according to recommendations. As a result of simpler prescribability and broader use, the importance of PrEP is expected to grow in future.

Basic knowledge among GP trainees regarding HIV pre- and post-exposition-prophylaxis.

INTRODUCTION: Preventing human immunodeficiency virus (HIV) infection is central to containing the HIV pandemic. For pre- and post-exposure prophylaxis (PrEP and PEP), drugs approved in Germany are available. Basic information on this should be obtained from physicians in further training to become specialists in General Practice (GP) since they may have to deal with this topic of high relevance for the health of patients at risk and also the physicians' health after a possible exposure in the professional context. METHODOLOGY: A multiple-choice questionnaire was handed out to doctors in further training in General Practice on seminar days of the Competence Centre for General Practice Saxony-Anhalt for an immediate answer. RESULTS: Of the 109 doctors, 73 completed the questionnaire. A general high relevance of the topic HIV was stated by 95%. In contrast, 71% said it was relevant for family doctor activities. The knowledge questions on the prevalence were answered correctly for all questions with less than 40%; 21% stated that they knew the indication prerequisite for a PEP; 49% answered the question about the period of the highest efficacy of PEP correctly. PrEP as a drug option for prophylaxis is known to a part of the respondents, 79% would prescribe PrEP, 69% were in favour of a health insurance benefit. DISCUSSION: The results show that the necessary basic knowledge about HIV is partly available. Basic knowledge on structured action in the fields of HIV testing, PEP and PrEP should be taught in a manner appropriate to the relevance of the topic in the context of the German general practice setting. Even a basic knowledge about PEP may help to ensure that the general practice teams receive proper measures after a possible exposition.

[Diagnosis and therapy of HIV infection - what does the family doctor need to know?] / Diagnostik und Therapie bei HIV-Infektion ­ was muss der Hausarzt wissen?

According to the Robert Koch Institute, the estimated HIV prevalence in Germany is 86 100. On-third of the affected persons is over 50 years old. Overall, the prognosis of patients with HIV infection depends crucially on the time of diagnosis. The unfounded stigmatization of affected patients stands in the way of today's treatment options as it did 30 years ago. Every practice of primary care must also take into consideration the medical care of HIV-infected people. The purpose of this article is to make the general practitioner aware of this topic and to prepare for the necessary procedure in everyday practice in this rare but not unlikely situation.