Abstract
HIV testing and pre-exposure prophylaxis (PrEP) are recommended in Germany for individuals at increased HIV risk. How-
ever, data on HIV testing, PrEP use, and PrEP knowledge among trans and non-binary people are limited. We analysed data
from the ‘Sexuelle Gesundheit in trans und nicht-binären Communitys’ (TASG) study, a participatory study on HIV/STI
and sexual health among trans and non-binary people in Germany. The study was designed, promoted, and analysed with
active involvement of community members. Participants were invited to complete an anonymous online survey between 1
March and 1 July 2022. The outcomes included HIV testing within the last 5 years, PrEP use, and PrEP-specific knowledge.
Predictors for HIV testing were identified using a bootstrap stepwise selection procedure. Among 2468 HIV-negative par-
ticipants with information on potential HIV risks, 21.5% had potential needs for HIV testing and PrEP. Of these, only 44.3%
(208/470, missing: 60) reported testing for HIV within the last 5 years. Older participants, those living in larger cities, and
those with higher education levels were more likely to have tested for HIV. Additionally, only 8.3% (38/459, missing: 71)
reported ever using PrEP. Among 451 participants with potential PrEP needs (missing: 79), only 57.4% knew at least one of
three key PrEP-related facts at the time of the survey. Our findings highlight substantial gaps in HIV testing and prevention
among trans and non-binary individuals in Germany with potential needs for these services. Reducing barriers to testing
and prevention is essential to enable broader access to these critical services.
Koppe et al. AIDS and Behavior (2025) 29:1608–1618
https://doi.org/10.1007/s10461-025-04631-z
