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EMIS 2017 Journal Articles 2017

Estimating the ‘PrEP Gap’: how implementation and access to PrEP differ between countries in Europe and Central Asia in 2019

Eurosurveillance, 2019; 24(41) (doi: 10.2807/1560-7917).

Authors: Rosalie Hayes, Axel J. Schmidt, Anastasia Pharris, Yusef Azad, Alison E. Brown, Peter Weatherburn, Ford Hickson, Valerie Delpech, Teymur Noori, the ECDC Dublin Declaration Monitoring Network.

Abstract

In 2019, only 14 European and Central Asian countries provided reimbursed HIV pre-exposure prophylaxis (PrEP). Using EMIS-2017 data, we present the differ-ence between self-reported use and expressed need for PrEP in individual countries and the European Union (EU). We estimate that 500,000 men who have sex with men in the EU cannot access PrEP, although they would be very likely to use it. PrEP’s potential to eliminate HIV is currently unrealised by national healthcare systems.

This article is copyright of the authors or their affiliated institutions, 2019

Available FREE online

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EMIS 2017 Journal Articles 2017

From HIV-testing to Gay Health Centres: A Mapping of European “Checkpoints”

HIV and Viral Hepatitis (Conference), Malta 2017 – PS2/04; (doi: 10.13140/RG.2.2.26988.77441)

Authors: Axel J. Schmidt, Dirk Sander, Teymur Noori

Abstract

Background

In Europe, HIV/STIs are concentrated in certain vulnerable groups, above all, men who have sex with men (MSM). For this reason, targeted HIV testing interventions are paramount. In 2002, a community-based HIV testing service using rapid HIV-tests was established in Amsterdam and given the name “Checkpoint”. Since then, the concept of community-based centres (CBCs) for HIV-testing and other sexual health services has spread throughout Europe, and many such centres have been established using the name “Checkpoint” (CP). Over the years, many centres have offered more comprehensive services regarding gay health, including testing for other sexually transmitted infections (STIs), counselling on drugs use, vaccination, and even provision of HIV treatment. The aim of this study to map community-based (and other) sexual health centres targeting gay and other MSM in Europe.

Methods

In preparation of the second round of the European MSM Internet Survey (EMIS-2017), the EMIS-Network, consisting of more than 80 academic, governmental, and non-governmental organisations, was contacted by e-mail (08/2015) to identify “Checkpoints” and other sexual health centres for gay men throughout Europe. 56 centres were identified and 54 responded. Representatives for the centres were asked for the exact address of the centre, the year it opened (as an HIV-testing / gay health centre) and the current opening hours per week.

Results

Community-based centres (CBCs, N=44) were distinguished from traditional clinics/private practices (“clinics”, N=10), although such binary classification is not always clear-cut. The label “community-based”, in this context, involves ownership and/or decision power by a collective of gay men. The proportion of gay men among employees was 67% in CBCs and 41% in clinics. CP Riga and Odense had no gay men employed, while CP Amsterdam, Aarhus, Bern, Copenhagen reported less than 50%. The majority of CBCs (68%) and clinics (80%) had gay physicians employed or closely attached.

Recommendations

The list is still incomplete, especially NHS services (UK) and clinics offering gay-friendly HIV-testing are missing. However we believe we covered all comprehensive sexual health services for MSM in Europe that fall into the upper right quadrant of Figure 2. The added value of maintaining up-to-date listing of CBCs is their use in online mapping services and integration in geolocation-based dating-apps targeting MSM. Experience with the European HIV-Testing-Week has shown that reaching out to MSM through push notifications with a spectrum of HIV services and opening times of Checkpoints is both cost-effective and accepted by the community.

Poster available online