Vaccines (Jan 2023)

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

  • Deniz Gokengin,
  • Dominik Bursa,
  • Agata Skrzat-Klapaczynska,
  • Ivailo Alexiev,
  • Elena Arsikj,
  • Tatevik Balayan,
  • Josip Begovac,
  • Alma Cicic,
  • Gordana Dragovic,
  • Arjan Harxhi,
  • Kerstin Aimla,
  • Botond Lakatos,
  • Raimonda Matulionyte,
  • Velida Mulabdic,
  • Cristiana Oprea,
  • Antonios Papadopoulos,
  • Nino Rukhadze,
  • Dalibor Sedlacek,
  • Lubomir Sojak,
  • Janez Tomazic,
  • Anna Vassilenko,
  • Marta Vasylyev,
  • Antonija Verhaz,
  • Nina Yancheva,
  • Oleg Yurin,
  • Justyna Kowalska

DOI
https://doi.org/10.3390/vaccines11010122
Journal volume & issue
Vol. 11, no. 1
p. 122

Abstract

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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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