Fewer people diagnosed with HIV as effects of PrEP become visible

The number of new HIV diagnoses in the Netherlands decreased in 2021, just like in other years, according to the HIV Monitoring Foundation (SHM). Last year, an estimated 427 people were diagnosed with HIV. According to the foundation, the effects of PrEP, a medicine people with an increased risk of HIV can take to prevent infection, are becoming visible for the first time.

The number of new diagnoses for 2020 was initially estimated at 411 but has since been adjusted to 450. The foundation always makes an estimate for the annual report, explained infectiologist Marc van der Valk of SHM. That is because a new diagnosis isn’t always immediately passed on to the foundation, sometimes taking several years. The figure for 2021 may also change in the future.

Of the 427 diagnoses from last year, 250 cases involved men who have sex with men, 105 involved men with other sexual preferences, and 72 involved women. Thirteen people died of AIDS, the disease caused by HIV.

Some men who have sex with men are on PrEP. They are more often treated at an STI outpatient clinic than other groups and are, therefore, regularly tested for HIV. If they get the virus, they are more quickly diagnosed than other groups, for whom it can sometimes take years before they discover their infection. In 2021, there was a “sharp drop” in the number of recent infections among men who have sex with men. According to Van der Valk, the researchers attribute that to PrEP use. “Part of the people who would have ended up with an early HIV infection in the past are now adequately protected by PrEP,” Van der Valk explained.

According to the foundation, not everyone who wants to use PrEP can get access to the drug yet. Of those who contracted HIV between 2018 and May this year, 660 people were not on PrEP. Of these, 44 indicated that they would have liked to use the drug but could not access it. Four people were on a waiting list. The actual number of people who contracted HIV, even though they would have wanted to use PrEP, may be higher, said Van der Valk. This is because not every healthcare institute registers the PrEP data with every diagnosis.

PrEP stands for Pre Exposure Prophylaxis. It is a combination of HIV inhibitors. People at increased risk of contracting HIV can take PrEP to protect themselves against the virus. In addition to men who have sex with men, these include trans men or -women who have sex with men and some sex workers.