Introduction

The use of pre-exposure prophylaxis (PrEP) is a safe and effective prevention option to all people at substantial risk of HIV acquisition, irrespective of gender. However, in most European countries PrEP services focus on key populations, in particular men who have sex with men (MSM). This study aims to explore PrEP availability and implementation for women across the European region.

Methods

An online survey was sent to all members of Women Against Viruses in Europe (WAVE) from 50 countries in September 2019. It consisted of 19 questions, including both multiple choice and free text answers.

Results

In total, responses from 34 countries were included in the study (Western Europe n ​= ​12, Central Europe ​= ​12, Eastern Europe n ​= ​6). PrEP was accessible in 30 WHO European countries. More than half of them stated that PrEP was available for all groups at-risk of HIV acquisition (n ​= ​18), while in many countries PrEP was only available to MSM and transgender persons. Two-thirds of country respondents confirmed the availability of a national guideline for PrEP (n ​= ​23), of which six countries had specific recommendations for PrEP in women. The most cited obstacles for PrEP access were lack of information about PrEP, lack of political support, and high cost for the individual. Fifteen country respondents stated that there were specific obstacles for PrEP access for women, such as guidelines prioritizing MSM, women not being seen as a target population for PrEP, and lack of knowledge about which subgroup of women would benefit most from PrEP. Seven countries had made efforts to encourage women’s access to PrEP, most of which were individually based or initiated by local NGOs.

Conclusions

PrEP is an important addition to HIV combination prevention. Women’s access to PrEP in Europe remains limited. Women are often not included in the guidelines or targeted with education or information, resulting in a general lack of information about the use of PrEP for women.

中文翻译：

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为整个欧洲地区的女性提供暴露前预防 (PrEP) 的成就和差距——欧洲调查研究的结果

介绍

使用暴露前预防 (PrEP) 是一种安全有效的预防选择，适用于所有有感染 HIV 高风险的人，无论性别如何。然而，在大多数欧洲国家，PrEP 服务侧重于重点人群，特别是男男性行为者 (MSM)。本研究旨在探索整个欧洲地区女性的 PrEP 可用性和实施​​情况。

方法

2019 年 9 月，向来自 50 个国家/地区的欧洲妇女抗击病毒 (WAVE) 的所有成员发送了一项在线调查。该调查由 19 个问题组成，包括多项选择和自由文本答案。

结果

总共有 34 个国家的回复被纳入研究（西欧 n = 12，中欧 = 12，东欧 n = 6）。30 个 WHO 欧洲国家可以使用 PrEP。超过一半的人表示，所有有感染 HIV 风险的群体（n = 18）都可以使用 PrEP，而在许多国家，只有 MSM 和跨性别者可以使用 PrEP。三分之二的国家受访者确认有国家 PrEP 指南（n = 23），其中六个国家对女性 PrEP 提出了具体建议。获得 PrEP 最常被提及的障碍是缺乏有关 PrEP 的信息、缺乏政治支持以及个人的高成本。15 个国家的受访者表示，女性获得 PrEP 存在特定障碍，例如优先考虑 MSM 的指南，女性未被视为 PrEP 的目标人群，并且缺乏关于哪些女性亚组将从 PrEP 中受益最多的知识。七个国家已努力鼓励妇女获得 PrEP，其中大部分是个人或由当地非政府组织发起的。

结论

PrEP 是 HIV 联合预防的重要补充。在欧洲，女性获得 PrEP 的机会仍然有限。女性通常不被纳入指南或教育或信息的目标，导致普遍缺乏关于女性使用 PrEP 的信息。