{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:42:43Z","timestamp":1769992963873,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pre\u2010exposure prophylaxis (PrEP) with antiretroviral drugs (ARVs) is a highly effective HIV prevention strategy. Although the European Medicines Agency approved oral PrEP in 2016 and the World Health Organization (WHO) has since recommended simplified and person\u2010centred delivery models, implementation remains inconsistent across Europe. In Greece, national PrEP guidelines were issued in 2022, but public sector access has not yet been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report on informal PrEP use in 2024 among men who have sex with men (MSM) and transgender women (TGW) attending a private sexual health clinic in Athens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 547 MSM and TGW (mean age 36\u2009\u00b1\u20099\u2009years), 308 (56.3%) were suitable for PrEP, 47 were already on PrEP and 134 initiated PrEP using generic formulations purchased online (39.6% daily, 60.4% on demand). Among 181 individuals on PrEP, 79.6% were retained in care, and no seroconversions were recorded over 2423 person\u2010months of follow\u2010up. Sexually transmitted infections (STIs) were diagnosed in 30.3%, indicating elevated HIV risk. Barriers to uptake included cost, online procurement concerns and limited awareness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight the urgent need for formally implemented, accessible PrEP services in Greece. Integration within broader sexual health frameworks, aligned with WHO recommendations, is essential to improve access, monitoring and HIV prevention in high\u2010risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70158","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T10:04:50Z","timestamp":1764324290000},"page":"310-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Informal\n                    <scp>PrEP<\/scp>\n                    use in Greece: The long, hard road to formal programmatic implementation"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5404-746X","authenticated-orcid":false,"given":"Konstantinos","family":"Protopapas","sequence":"first","affiliation":[{"name":"Private Sexual Health Clinic  Athens Greece"},{"name":"Fourth Department of Internal Medicine, Attikon University Hospital, School of Medicine National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-7409","authenticated-orcid":false,"given":"Charalampos D.","family":"Moschopoulos","sequence":"additional","affiliation":[{"name":"Private Sexual Health Clinic  Athens Greece"},{"name":"Fourth Department of Internal Medicine, Attikon University Hospital, School of Medicine National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Kalesis","sequence":"additional","affiliation":[{"name":"Private Sexual Health Clinic  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Mameletzis","sequence":"additional","affiliation":[{"name":"World Health Organization  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization.WHO implementation tool for pre\u2010exposure prophylaxis of HIV infection: provider module for oral and long\u2010acting PrEP. Geneva.2025. Accessed May 6 2025.https:\/\/www.who.int\/publications\/i\/item\/9789240097230"},{"key":"e_1_2_9_3_1","unstructured":"World Health Organization.Consolidated guidelines on HIV prevention diagnosis treatment and care for key populations. Geneva.2016. Accessed May 6 2025.https:\/\/www.who.int\/publications\/i\/item\/9789241511124"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000613"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.118.251009"},{"key":"e_1_2_9_7_1","unstructured":"World Health Organization.WHO recommends injectable lenacapavir for HIV prevention Geneva.2025. Accessed July 22 2025.https:\/\/www.who.int\/news\/item\/14-07-2025-who-recommends-injectable-lenacapavir-for-hiv-prevention"},{"key":"e_1_2_9_8_1","volume-title":"Crisis and the power to transform: UNAIDS Global AIDS Update 2025","author":"AIDS","year":"2025"},{"key":"e_1_2_9_9_1","volume-title":"Differentiated and simplified pre\u2010exposure prophylaxis for HIV prevention: update to WHO implementation guidance","author":"World Health Organization","year":"2022"},{"key":"e_1_2_9_10_1","unstructured":"ECDC.Progress towards reaching the Sustainable Development Goals related to HIV in the European Union and European Economic Area. Monitoring the implementation of the Dublin Declaration on partnership to fight HIV\/AIDS in Europe and Central Asia \u2013 2024 progress report Stockholm 2024.2024. Accessed May 6 2025.https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/hiv\u2010evidence\u2010brief\u2010progress\u2010towards\u2010sustainable%20development\u2010goals\u20102023_11.pdf"},{"key":"e_1_2_9_11_1","unstructured":"European Medicines Agency validates Gilead's marketing authorization application and EU\u2010medicines for all application for twice\u2010yearly lenacapavir for HIV prevention. Gilead Sciences Inc. Accessed July 22 2025.https:\/\/www.gilead.com\/news\/news\u2010details\/2025\/european\u2010medicines\u2010agency\u2010validates\u2010gileads\u2010marketing\u2010authorization\u2010application\u2010and\u2010eu\u2010medicines\u2010for\u2010all\u2010application\u2010for\u2010twice\u2010yearly\u2010lenacapavir\u2010for\u2010hiv\u2010prevention"},{"key":"e_1_2_9_12_1","unstructured":"ECDC.Continuum of HIV care. Monitoring implementation of the Dublin Declaration on partnership to fight HIV\/AIDS in Europe and Central Asia: 2023 progress report. Stockholm.2024. Accessed May 6 2025.https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/hiv\u2010dublin\u2010continuum\u2010care\u2010progress\u2010report\u20102023.pdf"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13458"},{"key":"e_1_2_9_14_1","unstructured":"HIV i\u2010BASE.NICE defers decision on CAB\u2010LA as PrEP needing more information. n.d. Accessed May 6 2025.https:\/\/i-base.info\/htb\/48748"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003432"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)00056\u20102"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(23)00256\u20104"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12528"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103018(23)00256\u20104"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2055\u20106640(20)30317\u20104"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25395"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010021\u201003459\u20107"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70158","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70158","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T13:25:46Z","timestamp":1769952346000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/hiv.70158"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70158","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"assertion":[{"value":"2025-09-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}