From the Guidelines
In Europe, the recommended PrEP medication is tenofovir disoproxil fumarate/emtricitabine once daily, as stated in the 2020 recommendations of the International Antiviral Society-USA panel 1. The most widely available PrEP options in Europe are Truvada (emtricitabine/tenofovir disoproxil fumarate) and its generic versions.
- The standard dosing regimen is one pill daily, taken consistently to maintain protective drug levels in your bloodstream.
- Some countries also approve event-based or "on-demand" PrEP (2-1-1 dosing), where you take two pills 2-24 hours before sex, then one pill 24 hours after the first dose, and another pill 24 hours later, but this is only recommended for men who have sex with men (MSM) 1. To access PrEP in Europe, you'll need to consult with a healthcare provider who can prescribe it after appropriate HIV and kidney function testing.
- Availability and cost vary significantly across European countries - in some nations it's fully covered by national health services, while in others you may need to pay out-of-pocket or through private insurance.
- It's also important to note that PrEP works by preventing HIV from establishing infection in your body when exposed to the virus, but remember it doesn't protect against other sexually transmitted infections, so combining PrEP with condoms provides more comprehensive protection. For men who have sex with men (MSM), a double dose (2 pills) of tenofovir disoproxil fumarate/emtricitabine is recommended on the first day 1, and for those with or at risk for kidney dysfunction, osteopenia, or osteoporosis, daily tenofovir alafenamide/emtricitabine is recommended 1. Additionally, injectable cabotegravir every 8 weeks is recommended (pending approval by regulatory agencies and availability) as PrEP for cisgender men and transgender women who have sex with men 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
PrEP Medications in Europe
- PrEP medications, such as emtricitabine and tenofovir alafenamide, have been studied for their efficacy and safety in preventing HIV infection in high-risk populations, including men who have sex with men and transgender women 2, 3.
- These studies have shown that emtricitabine and tenofovir alafenamide is non-inferior to emtricitabine and tenofovir disoproxil fumarate for HIV prevention, with a lower incidence of HIV infection per 100 person-years 2, 3.
- The studies were conducted in multiple community, public health, and hospital-associated clinics located in regions of Europe and North America, indicating that PrEP medications can be taken in Europe 2, 3.
Availability of PrEP Medications in Europe
- While the studies do not specifically address the availability of PrEP medications in Europe, they do suggest that emtricitabine and tenofovir alafenamide is a viable option for HIV prevention in high-risk populations 2, 3.
- Other studies have discussed the development of new PrEP agents and technologies, including novel oral agents, long-acting injectables, and topical products, which may also be available in Europe in the future 4.
Safety and Efficacy of PrEP Medications
- The studies have shown that emtricitabine and tenofovir alafenamide is well-tolerated, with a low number of participants reporting adverse events that led to discontinuation of the study drug 2, 3.
- However, other studies have raised concerns about the potential risks of long-term PrEP use, including renal decline and bone mineral density decrease, as well as changes to the enteric microbiome 5, 6.