German-Austrian AIDS conference (DÖAK) 2025. Poster Nr. 194.
Authors: Axel J Schmidt, Daniel Schmidt, Dirk Sander, Silke Klumb
Abstract
Background. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention for HIV prevention.
Its adaption among men-who-have-sex-with-men (MSM) is vital for achieving public health goals.
This study assesses PrEP coverage across 95 postal code areas (PCAs) in Germany, identifying underserved regions and visualising supply-demand gaps using geographic data.
Methods: We used geo data from the German Ministry of Health (gesund.bund.de) to locate physicians qualified to prescribe PrEP under statutory health insurance (supply).
MSM populations (excluding HIV-diagnosed men) engaging in anal sex with multiple partners in the same regions (demand) were estimated (EMIS-2017 data). Standardisedsupply-demand ratios (SSDRs) were calculated, ranging from 0 to 1.
Postal code areas for Berlin (10,12,13), Hamburg (20,22), Munich (80,81), and Ruhr (44,45) were merged for the maps.
Findings: By Q3/2024, 455 physicians across Germany were prescribing PrEP. The highest MSM concentrations were in postal code areas 10xxx (Berlin; k=10.7), 20xxx (Hamburg; k=6.8), and 80xxx (Munich; k=4.0). Despite large prescriber numbers in these three cities (N=79, N=31, and N=32), SSDRs were moderate (0.39, 0.50, and 0.47).
Conversely, the highest SSDRs were observed in areas with lower MSM concentrations, including PCAs 54xxx (Trier), 77xxx (Offenburg), 93xxx (Regensburg), and 39xxx (Magdeburg). Notably, 21 PCAs had no qualified prescribers, and 20 had only one.
Interpretation: PrEP supply is uneven across Germany, with better coverage in some regions with lower MSM concentrations but strong engagement from community organisations, while many major cities remain underserved.
Addressing these disparities requires targeted efforts to increase the number of PrEP prescribers, particularly in urban hubs with significant MSM populations. Improved planning is crucial to ensure equitable access and reduce HIV transmission nationwide.