Belgian HIV-AIDS Pre-Exposure Prophylaxis database

PrEP is the use of an antiretroviral medication by people who are uninfected to prevent the acquisition of HIV. The efficacy of PrEP has been shown in a number of randomised controlled trials including iPREX, Partners PrEP, PROUD and ANRS-IPERGAY. In 2015, the European Centre for Disease Prevention and Control (ECDC) recommended that European Union (EU) and European Economic Area (EEA) countries should consider integrating PrEP into their existing HIV prevention package for those most at risk of HIV infection, starting with men who have sex with men (MSM). This was followed by the World Health Organization (WHO) recommendations that PrEP should be offered as an additional prevention option to all people at substantial risk of HIV infection as part of combination prevention approaches. As a result, several countries in the EU/EEA have either implemented PrEP or are considering options for implementation. Since the 1st of June 2017, PrEP is nationally available in Belgium and reimbursed for people who are at increased risk for HIV acquisition. Belgium is one of the countries in Europe reporting a high HIV incidence, with 8.1 new HIV infections per 100 000 inhabitants in 2019.The epidemic mainly affects two populations: men who have sex with men (MSM) and Sub-Saharan African migrants, most of whom have acquired HIV through unprotected heterosexual contacts. A recent study suggests that ongoing clustered transmission in Belgium is almost exclusively driven by MSM. As the national PrEP program is brought to scale, the need for a robust monitoring system emerges. An effective PrEP program is one in which people in greatest need of HIV prevention are appropriately identified, offered PrEP, and then continue to receive continued support to use PrEP as needed. Monitoring PrEP program implementation is therefore important to (1) track progress in uptake and coverage among the eligible population, (2) estimate impact on the HIV epidemic, and (3) inform the strategic planning of the program (e.g. cost, resources, supply of commodities).