High uptake of pre-exposure prophylaxis (PrEP) during early roll-out in Belgium: results from surveillance reports
Bea Vuylsteke
A M , Thijs Reyniers A , Catherine Lucet B , Christiana Nöstlinger A C , Jessika Deblonde D , Agnes Libois E , Anne-Sophie Sauvage F , Edwinne Deprez G , Jean-Christophe Goffard H , Sabine D. Allard I , Eric Florence J , Rémy Demeester K , Steven Callens L and Marie Laga A
A Unit HIV and Sexual Health, Institute of Tropical Medicine, Nationalestraat 155, 2018 Antwerp, Belgium.
B National Institute for Health and Disability Insurance, Tervurenlaan 211, 1150 Brussels, Belgium.
C Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria.
D Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
E University Hospital Saint-Pierre, Université Libre de Bruxelles, Rue aux Laines 105, 1000 Brussels, Belgium.
F Aids Reference Centre, University Hospital Liège, Quai Godefroid Kurth 45, 4020 Liège, Belgium.
G Sida Sol, Rue des Fontaines Roland 29, 4000 Liège, Belgium.
H Aids Reference Centre, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.
I Aids Reference Centre, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium.
J Aids Reference Centre, Institute of Tropical Medicine, Nationalestraat 155, 2018 Antwerp, Belgium.
K Aids Reference Centre, University Hospital Charleroi, Chaussée de Bruxelles 140, 6042 Lodelinsart, Belgium.
L Aids Reference Centre, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
M Corresponding author. Email: bvuylsteke@itg.be
Sexual Health 16(1) 80-83 https://doi.org/10.1071/SH18071
Submitted: 6 April 2018 Accepted: 23 August 2018 Published: 30 November 2018
Abstract
Background: Since 1 June 2017, oral pre-exposure prophylaxis (PrEP) could be prescribed and reimbursed in Belgium as prophylactic medication for people who are at increased risk of HIV acquisition. The aim of this study was to determine the uptake of daily and event-driven PrEP in Belgium during the first 9 months of roll-out. Methods: Routine aggregated data on the number of reimbursement requests and the number of boxes of Truvada (Gilead Sciences, Cambridge, UK) delivered for PrEP through the Belgian pharmacies were obtained from the National Institute for Health and Disability Insurance. We also collected aggregated data from seven Aids Reference Centres (ARCs) currently providing most of the PrEP care in Belgium. Results: From 1 June 2017 to 28 February 2018, 1352 requests for reimbursement were approved by the National Institute for Health and Disability Insurance. Almost 98% of those who bought at least one box of 30 tablets of emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg (FTC/TDF) in a Belgian pharmacy were male, and most (67%) were between 30 and 50 years of age. According to data obtained from ARCs, the proportion of those choosing event-driven PrEP initially ranged between 29% and 73%. Conclusions: The uptake of PrEP in Belgium since the start of the roll-out in June 2017 has been high, and almost entirely limited to men who have sex with men, of whom 43% initially prefer a non-daily regimen. A better understanding is needed as to why other populations, such as sub-Saharan African migrants, are not accessing PrEP, as well as the development of a more sustainable PrEP delivery model.
Additional keywords: HIV prevention, implementation.
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