{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:59:38Z","timestamp":1790805578511,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T00:00:00Z","timestamp":1684800000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In France, oral pre\u2010exposure prophylaxis (PrEP) for HIV prevention has been publicly available since 2016, mainly targeting at men who have sex with men (MSM). Reliable and robust estimations of the actual PrEP uptake among MSM on a localized level can provide additional insights to identify and better reach marginalized MSM within current HIV prevention service provision. This study used national pharmaco\u2010epidemiology surveillance data and regional MSM population estimations to model the spatio\u2010temporal distribution of PrEP uptake among MSM in France 2016\u20132021 to identify marginalized MSM at risk for HIV and increase their PrEP uptake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We first applied Bayesian spatial analyses with survey\u2010surveillance\u2010based HIV incidence data as a spatial proxy to estimate the size of (1) regional HIV\u2010negative MSM populations and (2) MSM who could be eligible for PrEP use according to French PrEP guidelines. We then applied Bayesian spatio\u2010temporal ecological regression modelling to estimate the regional prevalence and relative probability of the overall\u2010 and new\u2010PrEP uptake from 2016 to 2021 across France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HIV\u2010negative and PrEP\u2010eligible MSM populations vary regionally across France. <jats:italic>\u00cele\u2010de\u2010France<\/jats:italic> was estimated to have the highest MSM density compared to other French regions. According to the final spatio\u2010temporal model, the relative probability of overall PrEP uptake was heterogeneous across France but remained stable over time. Urban areas have higher\u2010than\u2010average probabilities of PrEP uptake. The prevalence of PrEP use increased steadily (ranging from 8.8% [95% credible interval 8.5%;9.0%] in Nouvelle\u2010Aquitaine to 38.2% [36.5%;39.9%] in Centre\u2010Val\u2010de\u2010Loire in 2021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results show that using Bayesian spatial analysis as a novel methodology to estimate the localized HIV\u2010negative MSM population is feasible and applicable. Spatio\u2010temporal models showed that despite the increasing prevalence of PrEP use in all regions, geographical disparities and inequalities of PrEP uptake continued to exist over time. We identified regions that would benefit from greater tailoring and delivery efforts. Based on our findings, public health policies and HIV prevention strategies could be adjusted to better combat HIV infections and to accelerate ending the HIV epidemic.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26089","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T06:14:00Z","timestamp":1684908840000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Spatio\u2010temporal changes in pre\u2010exposure prophylaxis uptake among MSM in mainland France between 2016 and 2021: a Bayesian small area approach with MSM population estimation"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1844-7156","authenticated-orcid":false,"given":"Haoyi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Work and Social Psychology Maastricht University  Maastricht the Netherlands"},{"name":"Viroscience Department Erasmus Medical Centre  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8684-2214","authenticated-orcid":false,"given":"Jean\u2010Michel","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases H\u00f4pital Saint\u2010Louis University of Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7646-3667","authenticated-orcid":false,"given":"Rosemary","family":"Dray\u2010Spira","sequence":"additional","affiliation":[{"name":"EPI\u2010PHARE, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM)  Saint\u2010Denis France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-4399","authenticated-orcid":false,"given":"Axel J.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Sigma Research, London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0395-374X","authenticated-orcid":false,"given":"Ford","family":"Hickson","sequence":"additional","affiliation":[{"name":"Sigma Research, London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5877-8526","authenticated-orcid":false,"given":"David","family":"van de Vijver","sequence":"additional","affiliation":[{"name":"Viroscience Department Erasmus Medical Centre  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6607-1993","authenticated-orcid":false,"given":"Kai J.","family":"Jonas","sequence":"additional","affiliation":[{"name":"Department of Work and Social Psychology Maastricht University  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,23]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNAIDS.Fast\u2010track: Ending the AIDS Epidemic by 2030.Geneva:UNAIDS;2014."},{"key":"e_1_2_11_3_1","unstructured":"World Health Organisation.Why the HIV epidemic is not over.2017. 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