Evidence Brief on European PrEP Usage
Pre-exposure prophylaxis (PrEP) is the use of an antiretroviral medication to prevent the acquisition of HIV infection by people who are uninfected. In April 2016, the European Centre for Diseases Prevention and Control (ECDC) held a meeting to discuss considerations for PrEP implementation in Europe. In preparation for this meeting, ECDC and the Hornet Gay Social Network collaborated on a rapid survey about PrEP use among men who have sex with men (MSM). The objective of this survey was to examine PrEP use among MSM, including access, health care engagement and likelihood of future use.
A shareable PDF version of this report with figures.
During the three days the survey was rolled out to Hornet users in Europe (23-25 April, 2016) a total of 8 543 people responded. Figure 1 shows the country breakdown of the survey respondents
Eleven percent of survey participants reported being HIV positive (Figure 2). However, only 51% of survey participants responded to this question, which might indicate a reluctance to disclosure HIV status within these kinds of online social and sexual networking environments.
Among respondents (n=8048) who did not report being HIV positive, 10% (n=793) said that they were currently taking PrEP (Figure 3). Of those on PrEP, 69% said their sexual health provider was aware that they were taking PrEP.
Where those respondents obtained Prep differed. The majority of respondents from France indicated that they had acquired PrEP through their physician/doctor. France is currently the only country in Europe where PrEP can be prescribed and where it is reimbursed under the health insurance scheme. For those currently on PrEP outside of France, the primary source of obtaining PrEP was through purchase via the Internet, followed by receipt via a physician/ doctor or through a research study (see Figure 4).
In terms of when respondents reported that they had had their last sexual health check, people on PrEP and those identified as being HIV positive reported having more recent sexual health checks than those who were HIV negative (figure 5). Respondents reported more recent sexual health checks if they acquired PrEP from a clinician or through a study (94% had a sexual health check during the past six months compared to 77% if they acquired PrEP through other sources).
In terms of understanding intentions to use PrEP in the community, approximately one in four of those not currently on PrEP agreed with the statement that they were likely to us PrEP in the next six months, whereas this rose to eight out of ten among those currently on PrEP (Figure 6).
The results from this survey show that the use of PrEP in the community is common (10%). When taking into account those who intend to use PrEP in the next six months, it becomes clear that the demand for PrEP among the sub-group of MSM responding to this survey is high. The high proportion of informal use of PrEP poses challenges for health systems. Specific concerns about online delivery of PrEP include how to promote adherence and provide follow-up care, as well as how to ensure that people are purchasing genuine drugs and reduce the risks associated with stock outs of drugs. It will be important to engage with community, peer and online initiatives to ensure that they promote consistent information and messages about PrEP.
About Hornet Gay Social Network: Hornet is the most international gay social network available in 26 languages with offices in North America, Europe, Asia, South America and Africa. Founded in 2011 with the mission to provide the best quality product, it has grown to 15 Million total and 3 Million monthly active users. Hornet is number one in key markets such as France, Russia, Brazil, Turkey, and Taiwan. To contact Hornet about HIV research and leveraging its social platform for health intervention reach out to Health Innovation Strategist Alex Garner firstname.lastname@example.org and visit https://hornetapp.com
Additional work on social networks and PrEP: