PrEP is a new and efficacious HIV prevention method where HIV negative individuals take antiretrovirals to prevent infection. PrEP has been made available and is reimbursed for persons at high risk of HIV infection in Belgium since June 2017. Since it is relatively new, its reach, delivery and use needs to be better understood to optimally serve communities, HIV prevention organisations and healthcare providers. Important questions on whether and how the demonstrated clinical efficacy of PrEP will translate into population-level effectiveness are still unanswered.
The overall objective of PROMISE is to learn how PrEP rollout can be optimised to result in maximum impact on HIV and sexual health.
PROMISE consists of 4 separate, interrelated work packages. Each package has its own specific research questions and research methods.
In work package 1 of PROMISE we examine potential PrEP use of men who have sex with men (MSM) in Belgium. We aim to understand perceptions of the MSM community towards PrEP use, while taking into account norms and sexual culture. This will be done by a ‘respondent driven sampling’ method via internet (WEB-RDS), in collaboration with partners from the Netherlands and Sweden.This part of the research is executed by the University of Antwerp, in collaboration with ITM.
People with a migration background from high endemic regions (e.g. Sub-Saharan Africa, South America, South-East Asia) are overrepresented among the new HIV diagnoses in Belgium, but underrepresented among PrEP users. Work package 2 will gain qualitative insights in the reasons for his imbalance, both on the community and on the individual level. More specifically, WP2 examines the acceptability, barriers and facilitators of the uptake and use of PrEP within migrant communities with an increased vulnerability for HIV.
Work package 3 of PROMISE focuses mainly on the needs of PrEP users. In this work package we study patterns of PrEP use, sexual behaviour and care needs.
Work package 4 of PROMISE focuses on aspects of PrEP care and delivery. Within this work package we examine different options of PrEP delivery, and specifically focus on the Belgian situation. We also study barriers to optimal PrEP care and also possible alternatives for a differentiated model of care for PrEP in Belgium.