STI and HIV Incidence Among German Test-Site Visitors

A study found 5% of German test-site visitors had a sexually transmitted infection. STI rates, including HIV incidence, were highest among men who have sex with men.

Germany has scaled up HIV pre-exposure prophylaxis (PrEP) dispersal amid the COVID-19 pandemic. Due to the scarcity of clinical and epidemiological research on the topic, one 2022 Annual Conference on Retroviruses and Opportunistic Infection (CROI) study sought to report data on individuals undergoing anonymous sexually transmitted infection (STI) testing in Germany.

The study, presented today at CROI by lead author Cristoph Boesecke, MD, recorded the results of large-scale STI testing in Cologne, Germany. From January 2017-December 2020, Boesecke and his team collected anonymously reported STI screening, clinical, demographic, and sexual information data. People who attended the Checkpoint were screened for HIV, hepatitis C, syphilis, chlamydia, and gonorrhea with point-of-care testing kits.

The investigators documented a total of 15153 Checkpoint visitors, ranging form 16-85 years of age. The top reasons given for seeking STI testing were HIV risk situation (40%), routine testing (23%), and entering a new relationship (21%). Most visitors were men who have sex with men (40%), followed by men who have sex with women (28%), and women who have sex with men (22%).

The annual number of visitors increased by 3% in 2018 and 6% in 2019, but dropped by 40% in 2020 during the COVID-19 pandemic. The frequency of MSM visitors steadily dropped from 46% in 2017 to 35% in 2020, while number of visitors increased for all other groups; women who have sex with women frequented the testing site 94% more often.

The annual number of visitors screened specifically for HIV decreased from 55% in 2017 to 42% in 2020. The number of chlamydia and gonorrhea tests increased from 17% in 2017 to 29% in 2020, and HCV tests increased from 4% to 9%, while syphilis testing remained constant at 19%.

MSM had the highest overall STI frequency, but MSW and WSM had a continuous increase in chlamydia infections. The number of MSM visitors taking PrEP increased 46% in 2018 and 52% in 2019 (+7% in 2020, likely affected by COVID-19 lockdown).

The investigators detected STIs in 5% of all clinic visitors, showing how vital community-based testing sites are despite COVID-19 lockdown restrictions. HIV PrEP rollout increased significantly, but MSM continue to be at the greatest risk of HIV infection.

The study, PrEP roll-out and COVID-19 are impacting community-based testing for HIV and other STI,” was presented virtually during the 2022 Annual Conference on Retroviruses and Opportunistic Infection (CROI).