ArticleBMC public health2026
Analysis of potential barriers for PrEP non-users among PrEP-eligible MSM in Germany.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDaily oral pre-exposure prophylaxis (PrEP) provides effective protection against HIV. Since September 2019, the costs of PrEP have been covered by statutory health insurance in Germany. While a considerable fraction of PrEP-eligible individuals receives PrEP, coverage is inhomogeneous across Germany. This study aims to identify potential barriers associated with PrEP non-use among PrEP-eligible MSM.
methodsBased on the PrApp online cross-sectional study, we analyzed 1,027 PrEP users and 431 PrEP non-users. A PrEP indication was assumed for cis-MSM with a diagnosis of a bacterial STI (syphilis, gonorrhea, chlamydia) or hepatitis C (12 months), ≥ 2 sex partners or sexualized drug use (6 months). Characteristics between PrEP users and PrEP non-users were compared descriptively and using multivariable logistic regression.
resultsPrEP non-users were more likely to be aged 18–29 years old (P < 0.05, reference group: 30–39 years) and to engage in sexualized drug use (P < 0.001). The highest HIV-specialists density (P < 0.01, reference group: 6–9 HIV-specialists per 10,000 gay men) was associated with PrEP use. Persons with sexualized drug use were more likely to report daily PrEP use as a barrier (34.3% vs. 16.9%, adjusted P < 0.05). Fear of side effects (54.5%) was the most common barrier and might be more pronounced in PrEP non-users living in a federal state with a high HIV-specialists density (67.9% vs. 51.8%, adjusted P = 0.08). PrEP non-users living in a federal state with a low HIV-specialists density described not wanting to discuss their sex life with their doctor (29.5% vs. 16.0%, adjusted P = 0.08) as a reason for PrEP non-use.
conclusionsOur analyses indicated structural barriers to PrEP use in federal states with a low HIV-specialists density (physician density, non-anonymity). For those with theoretical PrEP access (high HIV-specialists density), fear of side effects could potentially be addressed by effective risk communication.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.