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Towards More Accessible and More Inclusive PrEP to Break the Cycle of HIV in France
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First published: 29 April 2026
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Conclusions
The current HIV prevention model in France, centred on TasP and oral PrEP, has reached its limits. To reinvigorate HIV prevention, community-led, integrated multidisciplinary care models are warranted. Integrating LAI PrEP into the national strategy may improve adherence and provide greater discretion. Expanding PrEP prescribing to gynaecologists, general practitioners and family planning clinics, supported by specific training and outreach consultations, is also crucial to reach the most at-risk populations, who are often overlooked. Finally, inclusive prevention campaigns are essential to raise awareness and PrEP uptake. Without rapid action, France risks falling short of the UNAIDS 2030 targets.
ABSTRACT
Introduction
Pre-exposure prophylaxis (PrEP) represents a major advance in HIV prevention, but its rollout in France remains limited, particularly among women, migrants and socially vulnerable populations. Despite full reimbursement by the national health system, oral PrEP is still rarely prescribed outside hospital settings, hindered by organizational constraints, inaccurate medical perceptions and persistent access inequalities. In this paper, we discuss the current limits of PrEP implementation in France, identify structural and individual barriers to its uptake and highlight possible strategies to make HIV prevention more accessible for all vulnerable populations across the country.
Discussion
The goal of eliminating HIV transmission by 2030 in France continues to be jeopardized by insufficient PrEP coverage. The current prevention model remains overly hospital-centred and primarily focused on a group of men who have sex with men (MSM), which limits its broader impact. In addition to structural barriers, the insufficient diversity of prescribers and the lack of inclusive communication continue to reinforce inequalities in access.
The arrival of long-acting injectable PrEP offers an important opportunity to ensure greater discretion and better adherence. However, its success will depend on expanding the range of authorized prescribers to include gynaecologists, general practitioners and family planning clinics, supported by specific training and outreach consultations.
Equally critical is strengthening public awareness campaigns and extending them beyond MSM and urban centres such as Paris, to reach diverse populations across the country. Durable improvements in PrEP uptake and retention also depend on close collaboration with community-based organizations, building trust with marginalized populations and participatory approaches that actively listen to individuals’ concerns and lived experiences.
A primary barrier to PrEP use is its exclusive availability in oral form, which leads for some to adherence challenges and premature discontinuation. In France, between 20% and 30% of users discontinue PrEP within 6 months of initiation, particularly among those under 30 years of age and individuals experiencing socioeconomic precarity
Conclusions
France, which is lagging behind its objective of ending the HIV epidemic, has the opportunity to rethink its prevention strategy to address unmet needs and move beyond a hospital- and MSM-centred model. A structural, coordinated and inclusive response is essential to expand PrEP uptake and ensure equitable protection for all populations at risk.
Taken together, these data highlight that priority efforts for PrEP expansion in France should focus on MSM, migrants and cisgender women to support progress towards the objective of eliminating HIV transmission by 2030.
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