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ComPrEmetidos: A Multidisciplinary Consensus to Transform HIV Prevention in Spain
Inmaculada Jarrín1, Nuria Fernandez2, Jorge Garrido3
1CoRIS Coordination Unit, National Center for Epidemiology and CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain.
AIDS Patient Care and Stds
|August 5, 2026
Summary
Pre-exposure prophylaxis (PrEP) access in Spain faces barriers like fragmented care and knowledge gaps. A consensus process developed a roadmap for decentralization and improved PrEP services to reduce HIV infections.
Area of Science:
- Public Health
- Infectious Disease Prevention
- HIV/AIDS Research
Background:
- HIV remains a significant public health issue in Spain despite advancements in treatment and prevention.
- Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, but its impact is limited by access, equity, adherence, and persistence challenges.
- Addressing these barriers is crucial for maximizing the population-level benefit of PrEP.
Purpose of the Study:
- To identify current barriers to PrEP adoption in Spain.
- To develop actionable solutions and an operational roadmap for improving PrEP services.
- To enhance the effectiveness of PrEP in reducing new HIV infections.
Main Methods:
- A structured consensus process involving 19 experts from diverse healthcare and community fields.
- Semi-structured interviews, multidisciplinary small-group sessions, and plenary workshops.
- Complementary surveys of 150 healthcare professionals and 95 PrEP users, with community representative input.
Main Results:
- Key challenges identified include fragmented hospital-centered access, capacity limitations, restrictive eligibility, knowledge deficits, and adherence issues.
- A decalogue of solutions was developed, emphasizing decentralization, equity, person-centered care, and innovation.
- The ComPrEmetidos consensus provides a roadmap to improve PrEP program performance in Spain.
Conclusions:
- Decentralization of PrEP services is a priority for improved access and equity.
- Enhancing healthcare professional and public knowledge is essential for effective PrEP implementation.
- Integrating innovation and addressing the needs of individuals for whom oral PrEP is insufficient are critical for reducing new HIV infections.
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