Recommendations launched to increase access to PrEP

Following the conclusion of the PrEP UP project, of which GAT was a promoter, recommendations are launched for expanding access to Pre-Exposure Prophylaxis (PrEP) in Portugal, at a historic moment when Ordinance no. 402/2023 of December 4 was published, with a view to expanding access to PrEP. Despite the scarcity and dispersion of data on PrEP in Portugal, the report compiled data on PrEP between 2017 and 2022.

The first approval by a drug authority for an antiretroviral drug that prevents HIV (PrEP) dates back to 2012, but only in 2018 did Portugal formally make prophylactic treatment available in public health services. Based on a diagnosis made, the delay in the introduction and implementation of PrEP in Portugal is denounced.

Among the recommendations, accessibility is one of the key points highlighted by the study. Despite the annual increase in the number of places where PrEP can be accessed, two thirds are in the North and the Lisbon Metropolitan Area. Ensuring equal access to PrEP implies its universality, which is why it is recommended to cover eleven NUTS III regions, which still lack PrEP consultations.

The report reveals the disproportionate knowledge, interest and distribution of PrEP among the key populations tested for HIV, which favors men who have sex with men. Added to this is the lack of medical training to determine PrEP eligibility and follow-up among non-HIV specialists.

Increasing the accessibility, availability, accommodation and acceptability of PrEP will be possible by implementing new models of PrEP provision, the report indicates, as will making the drug available in community-based services.

The report's conclusions and the publication of the ordinance on widening access to PrEP serve as the basis for promoting efforts to make PrEP consultations available at the GAT Checkpoint LX and GAT Intendente services, with the aim of widening access to key populations of sex workers and transgender people, as well as offering a new response to the growing demand for PrEP by men who have sex with men.

Started in 2022, the PrEP UP project studied the opportunities for access to PrEP, with the aim of facilitating and increasing access to PrEP in Portugal. The project, promoted by GAT, brought together political actors, scientific and medical societies and civil society, in a working group made up of Miguel Rocha (GAT Health Director), Paula Meireles (ISPUP Public Health and Epidemiology Researcher), Pedro Carreira (Member of the Board of ILGA Portugal), Pedro Morais (Member of the Abraço Association) and Teresa Branco (Member of the Portuguese Association for the Clinical Study of AIDS).