ArticleScientific reports2025
The unseen impact of affordability: copayment sensitivity for long-acting PrEP among MSM in six European Countries, October 2023-April 2024.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interest in and Preference for Long-Acting Injectable Pre-exposure Prophylaxis Among Men Who Have Sex With Men, Trans* Individuals, and Cisgender Heterosexual Women: A Global Systematic Review and Meta-Analysis.Journal of acquired immune deficiency syndromes (1999) · 2025Pooled it
- Legal status, sex work engagement and inequities in the HIV pre-exposure prophylaxis cascade among migrant women in 11 European countries.HIV medicine · 2026Article
- Epidemiologic Impact of Prioritizing Long-Acting Injectable Cabotegravir to Men Who Have Sex With Men With Low Pre-Exposure Prophylaxis Use Adherence in the Netherlands: A Mathematical Modeling Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Towards More Accessible and More Inclusive PrEP to Break the Cycle of HIV in France.Journal of the International AIDS Society · 2026Article
- Oral PrEP use and intention to use long-acting PrEP regimens among MSM accessing PrEP via governmental and non-governmental provision pathways, 20 European countries, October 2023 to April 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundLong-acting pre-exposure prophylaxis (LA-PrEP) is approved in Europe with promising HIV prevention potential. Currently, no data are available that examine intention to use LA-PrEP intention when it is not fully covered by healthcare/insurance programs. We investigated how the affordability of LA-PrEP impacts the intention to use LA-PrEP by men who have sex with men (MSM) in six European countries.
methodsWe included 10,592 HIV-negative MSM from an online cross-sectional survey (PROTECT, October 2023-April 2024), with participants from France (n = 1965), Germany (n = 2268), Italy (n = 1707), Spain (n = 1985), the United Kingdom (n = 1218) and the Netherlands (n = 1449). We investigated the intention to use LA-PrEP if one showed interest under different levels of affordability. For those who showed intention to use LA-PrEP when out-of-pocket copayments were required, we explored their intention by different copayments (ranging from < €50/month to €1000 + /month). We used multinomial regression to explore the impact of individual income on their intention to use LA-PrEP across different affordability/copayment scenarios.
resultsOf the included MSM, 59%-79% showed LA-PrEP interest in these six countries. Among them, a consistent decline in the LA-PrEP intention was observed as affordability decreased: from 44%(FR)-91%(NL) at high affordability to 10%(DE)-26%(NL) at low affordability. MSM with a high income showed significantly higher intention under medium and low affordability scenarios in all countries. Among those who showed intention with copayments, a strongly declining intention was observed and reached almost 0% when the copayment exceeded €250/month in all countries. MSM with high income showed significantly higher intention when copayment was under €250/month in all countries.
conclusionsLA-PrEP would be welcomed in Europe if affordable. When LA-PrEP is not fully-covered, MSM with a high income may be the early adopters. However, LA-PrEP may not be affordable for those with a reason to use LA-PrEP once monthly copayments exceed €250, stressing the need for availability under insurance plans, or with limited copayments.
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