Optimise Prep to maximise impact (PROMISE).

The impact of an HIV infection on an individual's life, family and society is enormous. Worldwide major progress has been made in reducing AIDS related morbidity and mortality by treating HIV infected people with antiretroviral treatment (ART). ART reduces infectiousness, and hence transmission of HIV. However, prevention remains the most important challenge. HIV incidence has been stable or even increased among specific subpopulations such as men having sex with men (MSM) in Western Europe, despite access to ART. An innovative response to further reduce HIV infections is urgently needed, including the development and evaluation of new tools, as well as better tailoring of approaches to key populations. Pre-exposure prophylaxis (PrEP) is such a novel prevention tool, involving ART given to uninfected persons to block HIv HIV transmission. Oral PrEP, mostly used as Truvada (containing Emtricitabine and Tenofovir), has been shown to be efficacious in 11 clinical trials, in different populations and geographical areas. The overall aim of this project is to learn how PrEP roll out can be optimized to result in maximum impact on HIV and sexual health. This question will be addressed looking at 4 interrelated themes each including research objectives (ROs): Among community of MSM (WP 1): RO 1.1 Assess the number of MSM eligible for PrEP in Flanders RO 1.2 Examine whether PrEP is reaching the right MSM – those most at risk – in Flanders RO 1.3 Explore the impact of PrEP on the sexual culture and health of MSM in Flanders Among community of Sub-Saharan African Migrants (WP 2): RO 2.1 To identify and estimate the proportion of eligible PrEP users within the SAM communities RO 2.2 To explore perceived community barriers and facilitators for PrEP acceptability and feasibility RO 2.3 To explore perceived individual barriers and facilitators for potential and actual PrEP use Among users (WP 3): RO 3.1 To differentiate patterns of PrEP use and sexual risk behaviour among PrEP users in Flanders RO 3.2 To describe differences in PrEP care needs among users RO 3.3 To document the frequency and associated factors of syndemics among PrEP Among providers (WP 4): RO 4.1 Describe (barriers to) PrEP care in Belgium RO 4.2 Inventory interventions that could address the most prevalent syndemics among PrEP users RO 4.3 Explore GPs' attitudes towards PrEP and their self-perceived roles in PrEP care. RO 4.4 Inform the development of a model for self-managed PrEP care.

Keywords:PREVENTIVE HEALTH CARE, SOCIOLOGY OF HEALTH

Disciplines:Preventive medicine, Sociology of health

Project type:Collaboration project