OBJECTIVES: Pre-exposure prophylaxis (PrEP) for HIV infection is an important intervention for control of the HIV epidemic. The incidence of HIV infection is increasing in the countries of Central and Eastern Europe (CEE). Therefore, we investigated the change in PrEP use in CEE over time. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care for HIV and viral hepatitis infections in CEE. Data on access to PrEP were collected from 23 countries through online surveys in May-June 2017 (76 respondents) and in November 2018-May 2019 (28 respondents). RESULTS: About 34.2% of respondents stated that tenofovir/emtricitabine (TDF/FTC) was licensed for use in their country in 2017, and 66.7% that it was licensed for use in 2018 (P = 0.02). PrEP was recommended in national guidelines in 39.5% of responses in 2017 and 40.7% in 2018 (P = 0.378). About 70.7% of respondents were aware of "informal" PrEP use in 2017, while 66.6% were aware of this in 2018 (P = 0.698). In 2018, there were 53 centres offering PreP (the highest numbers in Poland and Romania), whereas six countries had no centres offering PreP. The estimated number of HIV-negative people on PreP in the region was 4500 in 2018. Generic TDF/FTC costs (in Euros) ranged from €10 (Romania) to €256.92 (Slovakia), while brand TDF/FTC costs ranged from €60 (Albania) to €853 (Finland). CONCLUSIONS: Although the process of licensing TDF/FTC use for PrEP has improved, this is not yet reflected in the guidelines, nor has there been a reduction in the "informal" use of PrEP. PrEP remains a rarely used preventive method in CEE countries.

Belarusian State Medical University Minsk Belarus

Belgrade University School of Medicine Infectious Diseases Hospital Belgrade Serbia

Central Research Institute of Epidemiology Federal AIDS Centre Moscow Russian Federation

Clinic for Infectious Diseases Belgrade Serbia

Clinic for Infectious Diseases University Clinical Center of the Republic of Srpska Banja Luka Banja Luka RS Bosnia and Herzegovina Banja Luka Bosnia and Herzegovina

Department for AIDS Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Sofia Medical University Sofia Sofia Bulgaria

Department of Adults' Infectious Diseases Medical University of Warsaw Warsaw Poland

Department of Infectious Disease Faculty of Medicine University Hospital Center of Tirana Tirana Albania

Department of Infectious Diseases and Dermatovenerology Infectious Diseases Centre Vilnius University Vilnius Lithuania

Department of Infectious Diseases University Medical Center Ljubljana Ljubljana Slovenia

Department of Infectious Diseases West Tallinn Central Hospital Tallinn Estonia

Deptartment of Infectious Diseases and Geographical Medicine UH University Hospital Bratislava Slovakia

Ege University Izmir Turkey

Helsinki University Hospital Helsinki Finland

HIV Center University Hospital Pilsen Czech Republic

HIV Out Patient Clinic Hospital for Infectious Diseases Warsaw Poland

Infectious Diseases AIDS and Clinical Immunology Research Center Tbilisi Georgia

Lviv Regional Public Health Center Lviv Ukraine

Medical School National and Kapodistrian University of Athens University General Hospital ATTIKON Athens Greece

National Center for Disease Control and Prevention Yerevan Armenia

National Centre of Infectious and Parasitic Diseases Sofia Bulgaria

Nicolae Testemițanu State University of Medicine and Pharmacy Chisinau Republic of Moldova

Republican Clinical Hospital of Infectious Diseases of Ministry of Healthcare of Russian Federation St Petersburg Russia

Saint Laszlo Hospital National Center of HIV Semmelweis University Faculty of Infectious Diseases Budapest Hungary

School of Medicine University of Zagreb Zagreb Croatia

Victor Babes Clinical Hospital for Infectious Diseases Carol Davila University of Medicine and Pharmacy Bucharest Romania

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