Abstract
BACKGROUND: HIV pre-exposure prophylaxis (PrEP) programme provides regular clinical follow-up and represents an opportunity to improve vaccination coverage against preventable infections. We evaluated vaccination uptake among PrEP users and described associated variables in a tertiary care center. METHODS: We conducted a retrospective study including individuals receiving PrEP at Tor Vergata University Hospital (Rome, Italy) from January 2021 to September 2025. Demographic and behavioral data were collected. Vaccination status for hepatitis B virus (HBV), hepatitis A virus (HAV), human papillomavirus (HPV), meningococcal B (MenB), and mpox was assessed at baseline and during follow-up. HAV, HBV, HPV and MenB vaccines are administered at the vaccination clinic inside the hospital. RESULTS: A total of 285 individuals were included (median age 35 years, IQR 31–43). Most participants were single (77.3%); 5% reported chemsex practices. At baseline, HBV vaccination coverage was 88.4% (243/275), including 45 booster doses; 2.7% showed serological evidence of resolved infection. HAV coverage was 27.8% (75/270); HPV coverage was 30% (81/280). After PrEP initiation, 37% (100/271) completed the MenB vaccination cycle and 13.7% received the first dose. After PrEP start, HPV vaccination cycle was started in 47.4% (128/270), resulting in an overall coverage of 77.3%. Mpox vaccination prevalence was 32% (88/271). Mpox vaccination was not administered at our center and was provided through external public health services. Overall, vaccination coverage was high for HBV and HPV, while HAV and MenB uptake remained suboptimal. CONCLUSIONS: PrEP services represent an important platform to enhance preventive care beyond HIV protection. Structured integration of vaccination strategies within PrEP clinics may improve coverage for recommended vaccines in high- risk populations. [Table: see text]