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IntroductionItaly receives thousands of immigrants every year, some of whom seek asylum to escape the hostility and violence related to homophobia in their home countries. Lesbian, gay, bisexual, transgender, intersex, queer/questioning (LGBTQI+) immigrants in Italy are disproportionately affected by HIV. In Italy, ‘people born abroad’ are a high-risk population who are least likely to be aware of their HIV status. This demonstrates an acute lack of access to timely HIV testing. This study, thus, aimed to understand the facilitators and barriers to health services among this population in Italy.MethodWe conducted 33 semi-structured interviews and two focus group discussions (n=14) in Italian, English and Spanish languages. We recruited participants through community-based organizations in North, Central and Southern Italy. Eligibility included: migrated to Italy ≤10 years ago, identified as LGBTQI+, ≥18 years old. Participants were from South America, Asia and Africa. Audio files were transcribed and translated into English. Phronetic iterative process was used to analyze data. Ethical review was approved by the University of Missouri (IRB# 2104686).ResultsThe mean age was 30.5 years (SD=8.5). Average years in Italy was 4.8 years (SD=6.61). Sixteen (50%) were cismen, 4 (23.5%) were ciswomen, 5 (15.6%) transwomen, 2 (6.3%) transmen and 5 (15.6%) identified as non-binary. These themes emerged: stigma and discrimination due to intersecting minority identities, language difference and lack of support. Regarding LGBTQI+ identity, race and immigrant experience, a participant said, ‘In Italy-I always say homophobia stripped me of respect, racism stole my dignity.’ Another participant recounted their experience of filling out forms at a health center, ‘They bring you to a point of anger and you enter the stereotype of a racialized person, of someone who is always angry. A person who insults you, who throws documents in your face, for them you must stay calm,’ highlighting institutional discrimination. Participants also spoke about the rising cost, ‘I used to pay 150€ for Tessera Sanitaria. But they increased it to 700–800€. It’s incredible, wild.’ Among facilitators, participants mentioned having the support of community health organizations gave them confidence to seek and understand HIV/STI prevention information and connect with services. One participant said, ‘This place helps you remove that shame, bring out that boldness in you to meet up with someone and get some information.’ (Table 1)Abstract OC59 Table 1Themes of Barriers and Facilitators of Accessing Healthcare Services for LBGTQI+ Immigrant in ItalyConclusionLGBTQI+ immigrants in Italy experience individual and structural barriers to access HIV/STI prevention and treatment services, including stigma, discrimination and lack of communication services. This group seem to navigate the health system with the help of community health organizations. Communication technologies could potentially bridge the gap of information to reach a wider population of immigrants in need physical and psychological healthcare.

BackgroundIn Italy, the majority of PrEP users are gay, bisexual and other men who have sex with men (GBMSM), while other populations - cisgender women, transgender women, transgender men and non-binary individuals with a cervix - face considerable barriers in accessing PrEP information and services. This study explores potential barriers to PrEP awareness and HIV testing for these populations. The initial hypothesis was that these groups are not being adequately informed about PrEP when tested for HIV.Materials and MethodsTo validate this hypothesis, Brescia Checkpoint and Anlaids Torino conducted a survey targeting cisgender women, transgender women, transgender men and non-binary individuals with a cervix. It was distributed across multiple regions and informal networks, including social media and community-based platforms. The responses were collected through Google Forms. Data were analyzed using descriptive statistics. The survey complied with GDPR regulation.ResultsA total of 765 respondents participated in the survey (table 1), with 56.3% not having been tested for HIV in the past two years, mainly due to lack of knowledge on where or how to get tested (37.1%), absence of recent sexual activity (23%), fear or shame (21.1%), the misconception that monogamy is a protection (18.1%), and lack of time (16.5%) as described in figure 1.Among those tested, 72.2% were not informed about PrEP by testing providers (table 2). Only 20% of those tested in STI/infectious disease departments had access to information. In contrast, checkpoints were more effective, with 55% receiving PrEP-related guidance. However, HIV associations provided information to only 29% of those tested.Indeed, insufficient information (32.9%) is one of the key factors preventing these populations from initiating PrEP, along with no perceived risk (34.8%) and socioeconomic barriers (33.5%) as displayed in figure 2.Twelve people of all respondents reported using PrEP.Abstract OC58 Table 1Survey respondents demographics and responses according to testing in the last 2 yearsAbstract OC58 Table 2Survey Respondents Informed about PrEP by testing providersAbstract OC58 Figure 1Main reasons for not getting tested in the last 2 years[Figure omitted. See PDF]Abstract OC58 Figure 2Factors Preventing PrEP Initiation[Figure omitted. See PDF]ConclusionThis study confirms our initial hypothesis that these populations are not being adequately informed about PrEP, particularly in institutional healthcare settings. Checkpoints’ work to inform cisgender women, transgender women, transgender men and non-binary individuals with a cervix about PrEP remains insufficient.It is crucial that STI/infectious disease departments, together with the Italian HIV community, join forces to expand HIV testing awareness and provide comprehensive PrEP education and combination prevention counseling to ensure equitable HIV prevention access for all.

BackgroundIn September 2024, Lombardy expanded eligibility for HPV vaccination. Now it is available for free to all individuals up to 26 years of age and to all individuals engaging in risky sexual behaviors, although HPV is transmissible beyond traditional risk categories: via skin-to-skin contact, even with condom use.Prevention efforts often remain limited to specific populations, such as gay, bisexual and other men who have sex with men and young adolescents. Lombardy’s policy marks a crucial step in increasing vaccine accessibility for all, especially for sexually active adults of all genders and sexualities.Brescia Checkpoint was established in 2024 and is the first local community-based organization providing comprehensive sexual health services, including HPV vaccination promotion.Material and MethodsBetween November 2024 and February 2025, Brescia Checkpoint offered free and confidential rapid HIV and syphilis testing once a month. During pre-test counselling, all clients completed an anonymous questionnaire and discussed with peer providers about HPV and vaccination benefits.The unvaccinated were informed by peers that the physician conducting the tests could sign a document recommending their eligibility for free HPV vaccination under the new regional guidelines. This initiative leveraged the physician’s authority to facilitate free vaccination at public centers and to empower individuals to get vaccinated. To reinforce support, clients were encouraged to report any barriers encountered.Results61 clients received HIV and syphilis testing, and 36.1% of them were already vaccinated for HPV. Among those vaccinated, 8 (36.4%) had purchased the vaccine out-of-pocket. The majority of clients were not vaccinated for HPV (63.9%), all of them were willing to get vaccinated and received the recommendation from the physician. Demographic data revealed that HPV vaccination rates were higher among gay and bisexual men (45.5%). Significant gaps in vaccination coverage can be seen in all populations, particularly among young people under 26 years of age and those over 30 years, despite the extended eligibility criteria (table 1). No client reported experiencing barriers at vaccination centers.Abstract SC1 Table 1HPV vaccination coverage among HIV/syphilist testing clients, by age, sexual orientation, gender identity, place of residence, employment statusConclusionsThis initiative highlights the crucial role of community-based organizations in bridging gaps in HPV vaccine access through peer-mentorship and collaboration with physicians. We firmly believe that this approach strengthens public health efforts beyond traditional clinical settings. Providing individuals with strong peer and physician support could enable them to effectively prioritize their health.We plan to investigate further the effectiveness of vaccination recommendations issued within our program in increasing vaccination uptake. This experience could serve as a replicable model in other settings and contribute to a more comprehensive HPV prevention strategy.

BackgroundDoxyPEP, a post-exposure prophylaxis comprising 200 mg of doxycycline administered up to 72 hours following condomless sexual intercourse, has demonstrated efficacy in reducing the incidence of bacterial sexually transmitted infections (STIs). Three randomized clinical trials - ANRS Ipergay, ANRS Doxyvac, and DoxyPEP - have exhibited a reduction of over two-thirds in chlamydia and syphilis among gay, bisexual and other Men who have sex with men (GBMSM) and transwomen. Despite its potential, antimicrobial resistance (AMR) remains a concern. Currently, both SIMIT and HIV organizations have yet to offer formal position statements regarding DoxyPEP.Material and methodsIn March 2024, Plus and Plus Roma conducted a survey among users of the ‘Sex Check’, a protocol following GBMSM at high risk of STIs, to assess their knowledge and use of DoxyPEP. A total of 395 surveys were distributed electronically, with 168 answers, among whom 32 people lived with HIV, 126 were on Pre-Exposure Prophylaxis (PrEP), and 10 were neither on PrEP nor living with HIV.ResultsAmong 168 respondents, 88 (52%) individuals knew about DoxyPEP. Of these, 23 (14%) reported using DoxyPEP between 2023 and 2024: 15 people used it less than 5 times, 4 more than 10 times, 4 only once.Notably, 17 of these individuals utilized DoxyPEP following group sex encounters. 14 individuals acquired DoxyPEP through personal networks or at-home availability and 9 via formal medical prescriptions.23 (14%) individuals would never use DoxyPEP and 51 (30%) reported never having had the chance to use it. Interestingly, 35 (21%) respondents, who were previously unaware of PrEP, expressed interest in using it after receiving information through the survey, while 36 (21%) indicated a need for additional information.Concerning AMR, 68 expressed beliefs in its potential to exacerbate antibiotic resistance (39%), 40 disagreed (24%), 61 were uncertain (37%).ConclusionsAlthough the survey is limited to two community-based settings, more than half of the GBMSM survey participants reported having previous knowledge of DoxyPEP and some of the respondents already use DoxyPEP. A significant portion obtained it outside the formal medical system, facing a heightened chance of incorrect use. Only a small segment declared that they would never take DoxyPEP, indicating a potential for wider adoption in the future.Given the lack of ongoing research on AMR in this context, it is crucial to understand SIMIT’s position through a clear statement, guiding future research and interventions effectively, simultaneously useful for sector associations and the development of community campaigns.