On the occasion of the 2019 World AIDS Day, EPI-PHARE has updated data on the use of pre-exposure prophylaxis (PrEP) for HIV by Truvada or generics in France until June 30, 2019.

The figures illustrate the true appropriation of this prevention strategy in France, particularly among men who have sex with men (MSM). However, there is still room for improvement and efforts must continue to ensure that PrEP is as accessible as possible to all the populations concerned in France.

Since 2017, the ANSM has been monitoring changes in the use of Truvada or generics for HIV pre-exposure prophylaxis (PrEP) using data from the National Health Data System (SNDS).

The updated results show that the dissemination of PrEP in France is ongoing and intensifying. Indeed, the number of people aged 15 and over who have initiated treatment with Truvada® or generic PrEP reached 20,478 as of June 30, 2019. After the marked increase in late 2017-early 2018 reported previously, the pace of new initiations has further accelerated over the past year, with nearly 10,000 new users over the period July 2018 to June 2019. The vast majority (80-85%) of users renew their treatment from one semester to the next, suggesting a good level of maintenance of PrEP after initiation.

PrEP users are mainly men who have sex with men (MSM), aged 37 years on average, residing in the Ile-de-France region or in a major metropolitan area, and among whom the proportion of beneficiaries of complementary universal health insurance (free access to healthcare for people with an annual income>50% of the poverty threshold)) is low. Women rarely benefit from PrEP. The regional distribution of PrEP initiations generally reflects the distribution of new HIV diagnoses in metropolitan France, but the use of PrEP has remained rare in the DOM-TOM where new HIV diagnoses are the most numerous.

The initiation and renewal of PrEP are overwhelmingly carried out in hospitals (in 90% and 85% of cases respectively). In accordance with recommendations, the initiation of PrEP is most often accompanied by monitoring of renal function and co-prescriptions of nephrotoxic drugs concern less than 15% of users.