It’s been more than 3 years since the US Food and Drug Administration approved the use of Truvada as pre-exposure prophylaxis for HIV (PrEP). Since then mounting evidence has shown that not only is PrEP highly effective at preventing HIV infection but that often it is used most by those who can most benefit from it.
Unfortunately governments in Europe have been slow to act to approve Truvada for use as PrEP and to make it available to people at risk of HIV infection. Despite the clear evidence that PrEP works, European governments and health agencies have been cautious, expressing concern over cost-effectiveness and the complexities of how to provide a method of prevention that requires ongoing support from a variety of very different medical systems.
Recently though patience has been growing thin among advocates and the calls for European governments to take prompt action to make PrEP available have been growing louder and more widespread. Last week I posted about a new statement from the UK’s National AIDS Trust which urged the NHS to “provide PrEP without delay.” Days later the European AIDS Treatment Group (EATG) and the European AIDS Clinical Society released a strongly-worded statement declaring that “access to pre-exposure prophylaxis is essentially and urgently needed across Europe.”
A panel at last week’s 15th European AIDS Conference in Barcelona looked at the subject of PrEP in Europe, and noted that even in France and the UK, where major research projects have been conducted, plans for how to actually implement PrEP are still in early stages.
Panelists also emphasised that in the absence of leadership by authorities informal use is increasing. This is particularly visible in the UK where the import of lower-cost generic versions of the drugs in Truvada is permitted, although in other places such as Germany (and Ireland) this is prohibited. It’s expected that as awareness of and demand for PrEP grows, so will the number of people accessing PrEP outside of formal health care systems, raising concerns about safe and effective use as well inequalities between those who can afford to pay for PrEP and those who cannot.
Several of the panelists at the conference last week also took part in a webinar hosted by EATG and AVAC in September on the same subject. Their talks are well worth listening to for detailed background on the challenges involved in advocating for and successfully implementing PrEP in Europe.
Finally, there’s an open letter from individuals and organisations calling for PrEP to be available and accessible in Europe. If you’re inspired, you can add your name to show your support as well. So far there are only three of us in Ireland who’ve signed—one hopes that more individuals and maybe even some of our community organisations will decide to add their names to the growing list.