HIV in Brandenburg: Limited Access to PrEP & Treatment | 1200+ Cases Since 2001

Access to HIV prevention and treatment options remains unevenly distributed, even within developed nations. In the German state of Brandenburg, for example, specialized care for individuals with HIV is concentrated in areas near Berlin, creating challenges for residents in more rural parts of the state. Currently, only two dedicated clinics offer pre- and post-exposure prophylaxis (PrEP and PEP) – both located in Kleinmachnow and Blankenfelde-Mahlow, communities immediately bordering Berlin, according to Ulrich Widders, head of the infection control department at the Potsdam Ministry of Health.

Limited Access in a Sparsely Populated Region

This geographical concentration highlights a common issue in large, sparsely populated regions: delivering specialized medical services efficiently. Widders emphasized the important role played by AIDS support organizations in cities like Potsdam and Cottbus, which provide testing and counseling services. Many residents of Brandenburg also utilize healthcare facilities in Berlin. “We are making many efforts to ensure the care of people living with HIV, but it is not easy in a federal state like Brandenburg,” Widders stated.

The situation in Brandenburg reflects broader global challenges in ensuring equitable access to HIV prevention and treatment. While significant progress has been made in combating the HIV epidemic, disparities persist based on geography, socioeconomic status, and other factors. The availability of PrEP, in particular, is crucial for preventing new infections, but uptake is often hindered by logistical barriers, cost, and lack of awareness.

New Prevention Options and Increasing Access

Recent advancements in HIV prevention offer promising new tools to address these challenges. In July 2025, the World Health Organization (WHO) recommended the use of injectable lenacapavir (LEN) twice a year as an additional PrEP option. This represents a landmark policy shift that could significantly reshape the global HIV response. Lenacapavir, marketed as Yeztugo®, received FDA approval in the United States earlier in 2025, becoming the first and only long-acting injectable PrEP option offering six months of protection.

The development of lenacapavir addresses some of the key barriers to PrEP adherence. Traditional oral PrEP requires daily dosing, which can be challenging for some individuals. An injectable formulation administered every six months could improve adherence and reduce the risk of missed doses, ultimately enhancing its effectiveness. Gilead Sciences, the manufacturer of lenacapavir, has also partnered with six generic manufacturers to expand access to the drug in 120 countries, particularly those with high HIV incidence and limited resources.

PrEP Guidance and Clinical Recommendations

Current clinical guidance, as outlined by the CDC’s HIV Nexus, emphasizes the importance of offering PrEP to all sexually active adults and adolescents, regardless of reported risk factors. Any licensed prescriber can prescribe PrEP, removing a potential barrier to access. The CDC recommends that PrEP be considered as part of a comprehensive HIV prevention plan that includes discussing proper adherence, consistent condom use, and regular screening for other sexually transmitted infections (STIs).

The CDC also highlights the importance of taking a thorough sexual and substance use history to assess an individual’s risk of HIV and determine if PrEP is appropriate. For those who may benefit, PrEP medication and various administration methods should be offered to meet their specific needs. The National Clinician Consultation Center PrEPline (1-855-448-7737) is available to provide prescribing advice and address any questions healthcare providers may have.

HIV Incidence in Brandenburg and Emerging Trends

Since the implementation of the German Infection Protection Act in 2001, the state of Brandenburg has reported 1,297 HIV cases to the Robert Koch Institute (RKI). Of these, 934 were male and 363 were female. Widders noted a positive trend in the group most affected – men who have sex with men. However, he also observed a concerning increase in “a certain carelessness” since the end of the COVID-19 pandemic, suggesting a potential decline in adherence to safe sexual practices.

This observation underscores the need for continued public health messaging and education regarding HIV prevention. The easing of pandemic restrictions may have led to a sense of complacency, potentially increasing the risk of new infections. Maintaining awareness of HIV risk factors and promoting the use of available prevention tools, such as PrEP and condoms, remains crucial.

Barriers to PrEP Use

Despite the availability of effective prevention strategies, barriers to PrEP use persist. A literature review published in 2023 identified several challenges, including lack of awareness, stigma, cost, and logistical difficulties. Addressing these barriers requires a multifaceted approach that includes targeted education campaigns, affordable access to PrEP, and streamlined prescribing processes. The introduction of long-acting injectable formulations like lenacapavir may help overcome some of these hurdles by simplifying the dosing regimen and improving adherence.

effective HIV prevention requires a collaborative effort involving healthcare providers, public health organizations, and the communities most affected by the epidemic. By expanding access to innovative prevention tools, addressing systemic barriers, and promoting a culture of open communication and education, we can continue to make progress towards ending the HIV epidemic.