PrEP in Europe has become one of the most important topics in modern sexual health. Because it has changed the game against HIV, because it belongs to combination prevention (not an all-or-nothing mindset), and because access remains highly unequal depending on the country, the city, legal/insurance status, and sometimes even the clinician.
This article offers a clear, enjoyable overview of what PrEP is (and isn’t), how it’s taken, who it’s for, what European institutions say, and why access is now a public health issue.
PrEP: what are we actually talking about?
PrEP (pre-exposure prophylaxis) is preventive medication against HIV, taken by HIV-negative people before potential exposure. The goal is simple: prevent HIV from establishing itself in the body if contact occurs.
What PrEP does
It dramatically reduces the risk of acquiring HIV when taken correctly.
It comes with regular medical follow-up (HIV tests, STI screening, kidney monitoring, etc.).
What PrEP does not do
It does not protect against other STIs (syphilis, gonorrhoea, chlamydia, etc.).
It does not replace a broader prevention strategy on its own.
PrEP in Europe: proven effectiveness, very different realities across countries
Scientifically, the debate is no longer Does it work? but How do we make it work for everyone?. PrEP in Europe is widely recognised as a major tool for HIV prevention.
But Europe is not one uniform block. Between countries where PrEP is well integrated into care pathways and countries where access remains limited (or marginal), the gaps are real.
What the ECDC highlights
The European Centre for Disease Prevention and Control (ECDC) monitors PrEP implementation and notes that access is improving, but barriers persist: service availability, geographic inequalities, administrative obstacles, stigma, lack of information, and difficulties reaching certain communities.
Who is PrEP for? (And why the answer should stay simple)
The best approach is to avoid rigid boxes and talk about situations.
PrEP may be relevant if youre HIV-negative and you have:
multiple partners
condomless sex (or situations where condoms arent used consistently)
a partner living with HIV whose viral load is not confirmed undetectable
a sex life with intense periods (holidays, festivals, nights out, new connections)
In practice, PrEP in Europe concerns many gay and bisexual men, but not only. The key is clear, non-judgemental information and accessible services.
How do you take PrEP? The most common regimens
Exact guidance can vary by national recommendations, but two main approaches are common.
Daily PrEP (continuous)
One pill every day.
Often preferred when exposure is frequent or hard to predict.
On-demand (event-based) PrEP
A regimen taken around sex, when it’s predictable.
This approach is mainly discussed for certain groups (notably men who have sex with men), depending on local guidelines.
Important: whatever the regimen, PrEP isn’t something to take randomly. Medical support is part of its safety and effectiveness.
Medical follow-up: the most underestimated part (and the most essential)
Talking about PrEP without talking about follow-up misses the point. PrEP in Europe can also be a gateway to better sexual health care.
What is typically monitored
Regular HIV testing
STI screening (and not just one test: sometimes multiple sites depending on practices)
Kidney function (depending on the molecule)
Recommended vaccinations depending on profile (HPV, hepatitis, etc.)
This follow-up is a benefit in itself: earlier detection, faster treatment, fewer complications.
PrEP and STIs: two true ideas at the same time
On one hand: PrEP protects against HIV.
On the other: it does not protect against STIs.
And in the middle is real life: when PrEP scales up, testing often increases, so more STIs are diagnosed, which can look like an explosion. It’s important to be honest: some of the rise observed in certain contexts can be linked to more testing, but that doesn’t cancel out the fact that STIs are circulating.
For Gay Mag, the useful message is: PrEP in Europe is a major breakthrough, but combination prevention is non-negotiable.
Combination prevention: the realistic kit
PrEP (HIV)
Condoms (depending on the situation)
Regular testing
Vaccination where available
Harm reduction (without moralising)
Access: the real political issue for PrEP in Europe
If PrEP were easy to access everywhere, with simple pathways, wed talk less about barriers. But PrEP in Europe is still shaped by inequality.
The most common obstacles
Long waits and too few clinics
Big-city vs rural gaps
Lack of knowledge (including among some clinicians)
Stigma (sex, orientation, PrEP use)
Barriers for migrants, people without stable coverage, or complex administrative situations
France as an example: documented progress
In France, institutional publications (notably via Epi-Phare) have updated PrEP use figures and show growth in initiations, while also noting that momentum can slow and that some groups remain less reached.
New options: towards simpler PrEP?
The big question is: how do we make prevention fit real lives?
Across countries, people are watching:
evolving recommendations
new PrEP formats (including longer-acting options)
broader prescribing settings (clinics, primary care, community services)
The goal is clear: PrEP in Europe that isn’t reserved for people who already know how to navigate the health system.
The words that harm: stigma, PrEP-shaming, and false oppositions
You still hear lines like PrEP encourages risk or people on PrEP don’t protect themselves anymore. These shortcuts are counterproductive.
What we do know:
sexuality isn’t managed through shame
prevention works better when it’s accessible, positive, and realistic
PrEP is a public health tool, not a moral label
To talk about PrEP in Europe in a useful way, we need to leave judgement behind and focus on the practical: access, information, follow-up, testing.
Quick FAQ: the questions everyone asks
Is PrEP dangerous?
Like any medication, it requires monitoring. Institutions stress the importance of baseline checks and regular follow-up.
Can I stop and restart?
Many people use PrEP seasonally depending on their life. The key is doing it within an appropriate medical framework.
Does it replace condoms?
For HIV, PrEP is highly effective. For other STIs, it’s not. Thats why combination prevention matters.
Conclusion: PrEP in Europe is a major breakthrough if you can access it
PrEP in Europe is one of the best examples of what public health can do when it follows science and real lives. It protects against HIV, encourages regular follow-up, and can help reduce new infections.
But its impact depends on one central point: access. Informing people, simplifying pathways, fighting stigma, and strengthening sexual health services is what will make the difference.
Sources (selection)
ECDC, Pre-exposure prophylaxis for HIV prevention in Europe and Central Asia monitoring: https://www.ecdc.europa.eu/en/publications-data/pre-exposure-prophylaxis-hiv-prevention-europe-and-central-asia-monitoring
ECDC (PDF), Pre-exposure prophylaxis for HIV prevention in Europe and Central Asia Dublin Declaration (2025): https://www.ecdc.europa.eu/sites/default/files/documents/HIV-prevention-pre-exposure-prophylaxis-Europe-Central-Asia%20-Dublin-Declaration-2025.pdf
Epi-Phare, Update on PrEP use figures: https://www.epi-phare.fr/rapports-detudes-et-publications/prep-vih-2024/
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