Lessons learned from the experiences of informal PrEP users in France: results from the ANRS-PrEPage study

ABSTRACT

Before January 2016, Pre-Exposure Prophylaxis (PrEP), a new biomedical HIV-prevention tool, was only available in France via ANRS-Ipergay clinical study but informal use was reported outside this setting. PrEPage qualitative study reports profiles and experiences of participants who used PrEP outside of a biomedical trial before this prevention method was authorized. Between March 2015 and February 2016, a cross-section of twenty-four informal PrEP users, mostly MSM, was recruited to complete in-depth semi-structured interviews. While ANRS-Ipergay was still ongoing (2012–2016), participants described their initiation to PrEP, the way they used it and the difficulties they faced to acquire antiretroviral drugs in an environment where PrEP was still not widely known and often criticized. Through the testimonies, different user profiles and motivation toward informal PrEP use emerged: (a) participants who have increasing difficulties using condoms, (b) “opportunists” who tried PrEP without the intention of using it regularly and (c) participants with a risk aversion who sought additional protection against HIV. Participants chose to use PrEP and/or their usual prevention strategies depending on available supplies, type of partners and individual attitudes toward risk. The feeling of living a safer sex life helped participants to outweigh the fear of possible toxicity and drug resistance. Participants’ needs and expectations about PrEP implementation in France were also presented.

KEYWORDS:

• PrEP
• informal PrEP
• France
• qualitative study

Acknowledgements

We gratefully acknowledge support for this research from the French National Agency for Research on AIDS and viral hepatitis (ANRS). We also thank all participants, the steering committee members, AIDES research team and the reviewers.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Agence Nationale de Recherches sur le Sida et les Hépatites Virales: [grant number 95018].