HIV Pre-Exposure Prophylaxis (PrEP) Is Coming to Europe, but Are Gay Men Ready to Accept It? Qualitative Findings from Berlin, Germany

Abstract

In 2016, the European Medicines Agency approved the marketing of Truvada for use as pre-exposure prophylaxis (PrEP) in European Union (EU) member states. As individual countries throughout the EU make decisions about whether to adopt PrEP and fund it via governmental insurance, it is vital to understand key populations’ knowledge of and attitudes toward PrEP. In 2015, 20 gay men completed face-to-face audio-recorded interviews, describing their knowledge of and attitudes toward PrEP (mean age 35.9; 35% HIV-positive, 65% HIV-negative). We found that in spite of PrEP not yet having been approved for marketing in Germany, all but one of the participants were aware of PrEP and knew the difference between PrEP and post-exposure prophylaxis (PEP; which is approved for use in Germany). By and large, attitudes were favorable about PrEP, especially among HIV-negative participants. Next, there appeared to be an already high demand for PrEP with several participants going to great lengths to gain access to PrEP; two described intentions to obtain PEP for use as PrEP, one was obtaining PrEP via another country (where it was legal), and a fourth participant was discretely distributing PrEP out of his home. Our findings appear to validate anecdotal evidence suggesting high demand for PrEP and that some are already finding ways to obtain it without governmental approval. Our findings suggest that participants were prepared to see the rollout of PrEP in Berlin, pending its approval.