High Uptake of HIV Pre-exposure Prophylaxis Among Men Who Have Sex with Men Recruited via Geosocial Networking Applications and Community Outreach in Paris, France.

Despite free access in France, uptake of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) remains insufficient, particularly among younger and migrant subpopulations. This study describes a community-based program linking outreach via geosocial/sexual networking applications and community venues to same-day PrEP access at a sexual health center in Paris. MSM and transgender individuals aged ≥ 18 years were recruited and referred to the Le 190/Le SPOT sexual health center. At baseline, they received HIV/STI testing and, depending on results, initiation of PrEP, post-exposure prophylaxis (PEP), or antiretroviral therapy. Sociodemographic, behavioral, and clinical data were collected at baseline and follow-up (months 1, 3, 6). The primary outcome was PrEP uptake among eligible participants (HIV-negative, not on PrEP, without PEP indication); associated factors were assessed using Firth's penalized logistic regression. Between July 2023 and December 2024, 209 individuals were enrolled; 86% were recruited via apps, the median age was 31 years (IQR 26-41), and 47% were born outside France. Participants reported a median of six sexual partners (IQR 3-15) in the past three months; 73% had been tested for HIV/STI in the past year. Fourteen participants (7%) were living with HIV, including five newly diagnosed individuals. Among 164 PrEP-eligible participants, 118 (72%) initiated PrEP at baseline; 82/118 (70%) were retained at month 6. In multivariable analysis, uptake was associated with reporting ≥ 6 partners in the past three months and HIV/STI testing in the past year. These findings indicate high PrEP uptake among individuals presenting to care after community outreach, including younger and foreign-born MSM typically underrepresented in PrEP programs.