title: Pre-exposure prophylaxis (PrEP) for men who have sex with men in Europe: review of evidence for a much needed prevention tool.
abstract: In many Western countries with good coverage of antiretroviral treatment (ART) programmes the annual number of HIV infections is still high and not (yet) declining among men who have sex with men (MSM). This might indicate that antiretroviral treatment roll-out alone will not turn around the course of the epidemic and that new, additional tools are needed. Antiretrovirals used as prevention tools for people not yet infected with HIV, such as pre-exposure prophylaxis (PrEP) could be such important additional tools. PrEP is a new type of biomedical prevention, which involves the use of antiretrovirals before, during and after (periods of) sexual exposure to HIV. In this review, we will focus on PrEP as a new prevention tool for MSM at high risk in Europe, including its evidence for effectiveness, challenges for implementation, ongoing European demonstration studies; as well as how PrEP relates to other existing prevention tools. In light of European Medicines Agency's recent recommendation for approval of PrEP we briefly review the potential implications.
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Thijs
authors.initials: T
authors.lastname: Reyniers
authors.affiliation: Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, Netherlands.
authors.forename: Elske
authors.initials: E
authors.lastname: Hoornenborg
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Bea
authors.initials: B
authors.lastname: Vuylsteke
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Laga
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000068679:Emtricitabine / Q000627:therapeutic use; D005060:Europe / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D065129:Pre-Exposure Prophylaxis; D012725:Sexual Behavior; D000068698:Tenofovir / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir; D000068679:Emtricitabine
keywords: GAY MEN; HIV; POSTEXPOSURE PROPHYLAXIS (HIV); PREVENTION