Characterising individuals with newly diagnosed HIV before versus during the era of PrEP: a descriptive time-series analysis of data from a sexual health centre in Amsterdam, the Netherlands, 2015 to 2024

BACKGROUNDWith widespread HIV pre-exposure prophylaxis (PrEP) implementation, the population with increased chance of HIV acquisition may have shifted.AIMThis study aimed to explore the characteristics of people diagnosed with HIV in Amsterdam, the Netherlands before and during the national PrEP programme (NPP).METHODSUsing data from the Public Health Service of Amsterdam, we included 647 individuals diagnosed with HIV between 1 January 2015 and 30 June 2024. Sociodemographic, sexual and PrEP-related characteristics collected at diagnosis were analysed cross-sectionally. We used multivariable logistic regression to assess determinants of being diagnosed with HIV during (1 August 2019-30 June 2024) vs before the NPP (1 January 2015-31 July 2019).RESULTSThe number of newly diagnosed HIV infections decreased from 425 before the NPP(range: 92-103 diagnoses/year) to 222 during the NPP(range: 34-52 diagnoses per year). In multivariable analysis, transgender and gender-diverse persons (aOR = 12.74; 95% CI: 2.84-57.11) and individuals who engaged in sex work (aOR = 4.88; 95% CI: 2.67-8.91) or condomless sex (aOR = 1.95; 95% CI: 1.15-3.30) in the 6 months before diagnosis were more likely to be diagnosed during than before the NPP. Of 270 individuals with available data, 42 (15.6%) had used PrEP before their diagnosis.CONCLUSIONSIn the period after NPP implementation, the proportion of individuals diagnosed with HIV who were transgender or gender-diverse, engaged in sex work, or had condomless sex increased. Accessibility of PrEP services needs to be improved and timely PrEP uptake facilitated among specific subpopulations.