On the occasion of World AIDS Day, the EPI-PHARE Scientific Interest Group (ANSM-CNAM) updates data on the use of pre-exposure prophylaxis (PrEP) for HIV by Truvada or generics in France until June 30, 2024. The figures highlight a decline in the progression of PrEP use over the last year. Prescription by general practitioners, which has become the majority, has not allowed the dissemination of PrEP to all categories of the population who could benefit from it.
Since 2017, the EPI-PHARE Scientific Interest Group (GIS ANSM-CNAM) has been monitoring the evolution of the use of Truvada® or generics for HIV pre-exposure prophylaxis (PrEP) using data from the System. National Health Data (SNDS). The report published today provides an update of this monitoring until June 30, 2024. In addition, it provides new information on the characterization of the use of PrEP depending on whether it is prescribed in the city or in a facility. hospital or CeGIDD.
At the end of June 2024, the total number of people aged 15 and over having already initiated PrEP in France amounted to 103,407, or 18,479 more than at the end of June 2023. The total number of people actually using PrEP (in initiation or renewing) was also on the rise, reaching 59,326 in the first half of 2024, or 6,580 more users compared to in the first half of 2023. Despite this continued increase in the use of PrEP observed since its availability in 2016, the number of new users between July 2023 and June 2024 appears to be decreasing ( -8%) compared to the previous year, showing for the first time a slowdown in the pace of the diffusion of PrEP in France over the last year. This slowdown, observed in many regions, concerns both initiations made in hospitals or CeGIDD (-13%) and those made with city prescribers (-3%).
Since the expansion of first-time PrEP prescription to all prescribers in June 2021, the share of prescriptions given in town rather than in hospital or in CeGIDD has constantly increased, until becoming the majority since second half of 2023. Thus, in the first half of 2024, 52% of PrEP initiations and renewals were prescribed in the city, most often (nearly 9 times over 10) by a general practitioner. People initiating PrEP in the city have a sociodemographic profile very similar to those for whom this initiation is carried out in a hospital or CeGIDD structure, but they are slightly more numerous to have no renewal of PrEP in the 6 months following the initiation (around one in three versus one in four).
Over the last year, the share of users residing in Paris and PACA has continued to decline to the benefit of other metropolitan regions, the greater Paris suburbs and overseas departments and regions. PrEP initiations have also increasingly often concerned women, beneficiaries of Complementary Health Solidarity, and people residing in semi-urban or rural areas. However, the scale of these developments remained limited and in the first half of 2024, PrEP users were still mainly men residing in Île-de-France or in a large metropolis, among whom the proportion of people in precarious situations is low and the level of access to primary care is higher than for the average French person.
In conclusion, these updated figures highlight a decline in the progression of PrEP use over the past year. Prescription by general practitioners, which has become the majority, benefits users with a profile close to those consulting at the hospital or in CeGIDD. All of these results suggest that new measures would be necessary to enable the dissemination of PrEP to all categories of the population who could benefit from it.
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