PrEP Scale-Up and PEP in Central and Eastern Europe: Changes in Time and the Challenges We Face with No Expected HIV Vaccine in the near Future
Journal
Vaccines
Date Issued
2023-01-04
Author(s)
Gokengin, Deniz
Bursa, Dominik
Skrzat-Klapaczynska, Agata
Alexiev, Ivailo
Balayan, Tatevik
Begovac, Josip
Cicic, Alma
Dragovic, Gordana
Harxhi, Arjan
Aimla, Kerstin
Lakatos, Botond
Matulionyte, Raimonda
Mulabdic, Velida
Oprea, Cristiana
Papadopoulos, Antonios
Rukhadze, Nino
Sedlacek, Dalibor
Sojak, Lubomir
Tomazic, Janez
Vassilenko, Anna
Vasylyev, Marta
Verhaz, Antonija
Yancheva, Nina
Yurin, Oleg
Kowalska, Justyna
DOI
10.3390/vaccines11010122
Abstract
With no expected vaccine for HIV in the near future, we aimed to define the current situation and challenges for pre- and post-exposure prophylaxis (PrEP and PEP) in Central and Eastern Europe (CEE). The Euroguidelines CEE Network Group members were invited to respond to a 27-item survey including questions on PrEP (response rate 91.6%). PrEP was licensed in 68.2%; 95 centers offered PrEP and the estimated number on PrEP was around 9000. It was available in daily (40.1%), on-demand (13.3%), or both forms (33.3%). The access rate was <1−80%. Three major barriers for access were lack of knowledge/awareness among people who are in need (59.1%), not being reimbursed (50.0%), and low perception of HIV risk (45.5%). Non-occupational PEP was available in 86.4% and was recommended in the guidelines in 54.5%. It was fully reimbursed in 36.4%, only for accidental exposures in 40.9%, and was not reimbursed in 22.72%. Occupational PEP was available in 95.5% and was reimbursed fully. Although PrEP scale-up in the region has gained momentum, a huge gap exists between those who are in need of and those who can access PrEP. Prompt action is required to address the urgent need for PrEP scale-up in the CEE region.
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