EACS2023: 729 ART access programme at Checkpoint BLN: high rate of late presentation among people living with HIV without health insurance in Berlin, Germany C. Weber , Y. Delsemmé , H. Klemm , S. Jäkel , J.J. Moreno Sotos , H. Backes , J. Kohl Checkpoint BLN, Berlin, Germany, Praxiszentrum Kaiserdamm, Berlin, Germany, Schwulenberatung Berlin gGmbH, Berlin, Germany, Senate Administration for Science, Health and Care, Berlin, Germany General data Abstract category: Access and delivery of care Abstract body Purpose: In Germany, undocumented migrants, unemployed citizens from EU countries and people from non-EU countries face high barriers to accessing the health care system. Thus, in case of an already existing or newly diagnosed HIV infection, they rely on voluntary and free support from the community and allied physician. Checkpoint BLN, in cooperation with the Clearingstelle Berlin, has launched an access programme for HIV-infected people without health insurance in 2020, which offers free access to health care for PLWHA with low income. Method: We conduct a descriptive analysis of patient records. All patients presented between 01/01/2021 and 31/12/2022 and were seen at least once by a social worker and an experienced HIV physician at Checkpoint BLN. Patients had to have lived in Berlin for six months. Results: The mean age of the 118 participants (pt) was 33 years (IQR: 29; 39). The patients' characteristics are shown in the table. The median time since first HIV diagnosis was approximately 3.8 years (SD: 6.070). At first visit, 24/118 (20%) had CD4 ≤350c/µl, 11/118 (9%) had CD4 between 351-500c/µl and 83/118 (70%)had CD4 >500c/µl. Five patients had to be hospitalised due to opportunistic infections. In addition, 36/118 (31%) had viral load (VL) >200cop/mL and 30/118 (26%) had VL ≥1000cop/mL. Referred to Checkpoint BLN by (n=118) n % Checkpoint BLN 59 50% Berliner Aidshilfe e.V. 36 31% other NGOs 12 10% med. institutions (hospitals, public health service etc.) 11 9% Gender (n=109) cis male 91 84% cis female 7 6% trans male 1 1% trans female 4 4% non binary 4 4% other 2 2% Sexual orientation (n=108) MSM 85 79% HET 22 20% other 1 1% Origin by continent (n=117) Europe 41 35% Central/South America 42 36% North America, Africa, Asia, Australia 34 29% Housing condition (n=62) roofless 5 8% homeless 10 16% insecure housing 32 52% inadequate housing 1 2% secure housing 14 23% Additional condition (n=118) Substance use 43 36% Sex work 18 15% Language mediation required* 38 32% *patient speaks no English, no German, no Spanish Conclusions: In this cohort, one in five patients had late presentation by definition (CD4≤350c/µl or AIDS-defining illness) at baseline, and more than a quarter had VL that was considered infectious. These findings underscore the urgency of equal access to health care regardless of health insurance status at both the individual health and public health levels. Currently, access to health care for PLWHA in Berlin is only possible within the framework of this programme. This programme must be expanded and made permanent. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 1 2 3 1 4 1 1 2 3 4 41
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