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Where are we with PrEP use in Central and Eastern Europe? - data from the ECEE Network Group

Purpose: Pre-exposure prophylaxis (PrEP) for HIV infection is an important intervention to stop HIV epidemic. Central and Eastern European (CEE) countries experience increasing incidence of new HIV cases. Therefore we investigated the change over time in PrEP use in this region. Method: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care for HIV and viral hepatitis infections in the region. Data about access to PrEP were collected through on-line surveys. Respondents were ECEE members from 25 countries from the region. We performed two surveys, in March 2017 (76 respondents from 23 countries) and in October 2018 (28 respondents from 22 countries). Results: In 2017, 34.2% of respondents stated that tenofovir/emtricitabine (TDF/FTC) was licenced in the country, while in 2018, this was the case in 66.7% of respondents (p=0.02). PrEP was recommended in national guidelines in 39.5% of responses in 2017 and 40.7% respondents in 2018 (p=0.378). 70.7% of respondents were aware of “informal” PrEP use in 2017, while 66.6% of respondents were aware of it in 2018 (p=0.698). In 2018 in CEE region there were 53 PrEP offering centres (with the highest number in Poland and Romania). In six countries there were no PrEP offering centres. The estimated number of HIV-negative patients on PrEP in 2018 in the region was about 4500. Generic TDF/FTC costs (in Euro) ranged from 10 (in Romania) to 275 (in Slovakia), while brand TDF/FTC costs (in Euro) ranged from 60 (in Albania) to 853 (in Finland). Conclusion: There has been some improvement in licensing processes of TDF/FTC for PrEP, but this has yet not been reflected in guidelines nor has it lead to a decrease of “informal” use of PrEP. PrEP remains rarely used method of prevention in CEE countries.

PrEP ; Central and Eastern Europe

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