| Abstract [eng] |
Background. Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is the use of antiretroviral medication, taken to prevent the acquisition of HIV infection. World Health Organization (WHO) recommends it as a component of preventing HIV infection. 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). In Lithuania, there is no approved methodology for prescribing HIV pre-exposure prophylaxis, the number of people taking PrEP and the need for prophylaxis are not known. Aim. The aim of the study was to assess the need for and availability of HIV pre-exposure prophylaxis among men who have sex with men (MSM), and to identify barriers to accessing this prophylaxis. Methodology. An anonymous online survey was conducted, respondents were asked questions on their general socio-demographic status, sexual habits and risk behaviours, and HIV pre-exposure prophylaxis. A literature search was performed in the PubMed database. Selected articles were published in 2019-2023 on the topic of pre-exposure prophylaxis for HIV. Results. 51.44% of men surveyed expressed a need for PrEP, more often those who had had sex without a condom, under the influence of psychoactive substances, or with a history of sexually transmitted infections in the last year. 4.33% of respondents currently use PrEP and 4.81% used it in the past. Conclusions. Most men who have sex with men (MSM) in Lithuania are aware of HIV pre-exposure prophylaxis (PrEP), but only a small proportion of them are taking PrEP. Unlike in other EU countries or the USA, antiretroviral drugs for pre-exposure prophylaxis of HIV infection are not reimbursed in Lithuania, and the need for HIV prophylaxis among MSM at risk of HIV infection is not met. In the EU/EEA countries, the number of new HIV infections is steadily decreasing, but the UNAIDS 90-90-90 target has not yet been reached. To achieve a substantial reduction in HIV prevalence, HIV prevention, including PrEP, requires sustained attention. To facilitate the implementation of PrEP in the European region, the ECDC has developed guidelines for PrEP implementation and a standardized PrEP monitoring programme in 2022. Thirty countries in the European region have developed and implemented PrEP guidelines, but fifteen countries, including Lithuania, do not have such guidelines. The development and implementation of national PrEP guidelines in Lithuania should consider the standardized guidelines developed by the ECDC and increase the availability of PrEP to key risk groups. |
