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Just under 10% of men who have sex with men (MSM) in the UK take pre-exposure HIV prophylaxis (PrEP), compared with almost 30% who say would be “very likely” to use PrEP if it was available to them, a paper published in Eurosurveillance (10 October 2019) has revealed.
The researchers, from the National AIDS Trust; London School of Hygiene and Tropical Medicine; and Public Health England, used data from the European Centre for Disease Prevention and Control monitoring and the European MSM Internet Study (EMIS-2017) to calculate the approximate PrEP gap — the difference between non-HIV diagnosed MSM who were “very likely” to use PrEP if it were accessible to them and the proportion of non-HIV diagnosed MSM who currently use PrEP from any available source — of each country.
They found that the UK has a PrEP gap of around 20%.
The estimated PrEP gap ranged from 44.8% in Russia to 4.3% in Portugal. An overall estimate of the PrEP gap for Europe was calculated as 17.4%, equating to 500,000 MSM who would be very likely to use PrEP, but were not currently able to access it.
England and Wales were two of seven countries that reported PrEP availability only through a pilot research project. However, the report said that degree of access to PrEP in such projects “varied considerably”; in the 12 months up to March 2019, England and Wales saw 6,000 people access PrEP compared to 125 people in Ukraine.
Scotland was one of 14 countries that reported that it provided reimbursed PrEP either through insurance or from the public sector.
Cost was found to be the most important barrier to implementing in countries where PrEP was not nationally available and reimbursed.
