Closing Sexual Health Service Gaps With a New Service Model in Germany: Performance of an on-Site Integrated, Cross-Sectoral, Low Threshold Sexually Transmitted Infections/HIV Counseling and Treatment Service

Abstract

PurposeIn Germany, the incidence of bacterial sexual transmitted infections (STI) is on the rise and still high for HIV infections. The Center for Sexual Health Freiburg (CSHF) was established to offer low threshold access for STI/HIV counseling, testing, HIV pre-exposure prophylaxis (PrEP), and on-site treatment. The objective of this study was to analyze the performance of CSHF.MethodsLongitudinal study that includes all clients presenting between 1 May 2020 and 28 February 2021 at CSHF and willing to sign informed consent.ResultsIn the study period, 536 clients presented at CSHF of whom 417 clients were included in the study resulting in 668 client contacts. Clients' median age was 28.1 years (range: 18.0–73.1), 55.9% were men, 42.0% were women, 0.3% were transman, and 1.7% were not binary. Clients' sexual orientation was heterosexual (56.6%), homosexual men (26.2%), and bisexual (13.6%). STI screening resulted in the detection of any STI in 3.4% (95% confidence interval (CI): 0.7–6.1) of women, in 3.1% (95% CI: 0.0–6.5) of heterosexual men, and in 22.2% (95% CI: 13.0–31.5) of men having sex with men (MSM) not taking PrEP. Eighty-one MSM received PrEP with a total follow-up of 57.3 person-years and 0.44 STIs per person-year.ConclusionThe substantial burden of STI in the study population emphasizes the need for regular and low threshold STI screening services. The concept of CSHF may facilitate access to STI/HIV counseling, testing, and PrEP for a wide spectrum of people and may prove to be an important contribution to the efforts to reduce STI and HIV incidence in Germany.

Women’s sexually transmitted infections in primary care: General practitioners’ challenges and strategies – A qualitative study in Germany

“…Health services are offered by medical care providers (gynaecology, urology, dermatology, general medicine, STI clinics) but also by the local health authorities and NGOs. The latter focus on populations who experience difficulties in accessing the regular health system, they offer STI testing at low or no cost but can’t always provide STI treatment [ 11 ]. Patients can freely consult GPs, specialists, or other providers according to their preferences.…”