PrEP in Europe - expectations, opportunities and barriers

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Global HIV infections are declining, but Europe sees an increase, especially in key populations like men who have sex with men (MSM).
• Disparities in European health systems and varying government commitment impact HIV prevention and care funding.
• Pre-exposure prophylaxis (PrEP) is currently only available in France, highlighting a significant gap in European HIV prevention strategies.

Purpose of the Study:

• To describe the current HIV epidemics within the WHO European region.
• To identify healthcare settings suitable for PrEP delivery.
• To estimate the need for PrEP among MSM and analyze barriers to access.

Main Methods:

• Commentary based on analysis of European HIV epidemics and healthcare system structures.
• Review of existing evidence on PrEP effectiveness and implementation challenges.
• Discussion of factors influencing PrEP adoption, including cost, policy, and health system capacity.

Main Results:

• Significant differences exist in health system capacity and financial commitment to HIV prevention across Europe.
• High-income countries have hesitated to adopt PrEP due to initial evidence gaps and current drug costs.
• Low- and middle-income countries face challenges in implementing PrEP due to limited health budgets and foreign aid.

Conclusions:

• Increasing momentum exists for PrEP implementation across European countries.
• PrEP offers a vital opportunity to enhance HIV prevention services and support for related infections.
• Overcoming barriers related to cost, health systems, and civil society investment is crucial for effective PrEP rollout.