{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:04:20Z","timestamp":1780121060987,"version":"3.54.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Pre-exposure prophylaxis (PrEP) is an effective and cost-effective strategy for HIV prevention. Spain carried out an implementation study in order to assess the feasibility of implementing PrEP programmes within its heterogeneous health system.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Observational longitudinal study conducted on four different types of health-care setting: a community centre (CC), a sexually transmitted infections clinic (STIC), a hospital-based HIV unit (HBHIVU) and a hospital-based STI unit (HBSTIU). We recruited gay, bisexual and other men who have sex with men (GBSM) and transgender women at risk of HIV infections, gave them PrEP and monitored clinical, behavioural PrEP-related and satisfaction information for 52 weeks. We collected perceptions on PrEP implementation feasibility from health-care professionals participating in the study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 321 participants were recruited, with 99.1% being GBMSM. Overall retention was 87.2% and it was highest at the CC (92.6%). Condom use decreased during the study period, while STIs did not increase consistently. The percentage of people who did not miss any doses of PrEP during the previous week remained at over 93%. No HIV seroconversions occurred. We observed overall decreases in GHB (32.5% to 21.8%), cocaine (27.5% to 21.4%), MDMA (25.7% to 14.3%), speed (11.4% to 5.7%) and mephedrone use (10.7% to 5.0%). The overall participant satisfaction with PrEP was 98.6%. Health-care professionals\u2019 perceptions of PrEP feasibility were positive, except for the lack of personnel.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>PrEP implementation is feasible in four types of health-care settings. Local specificities have to be taken into consideration while implementing PrEP.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0246129","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T01:36:52Z","timestamp":1612834612000},"page":"e0246129","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["Implementation of pre-exposure prophylaxis programme in Spain. Feasibility of four different delivery models"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-2679","authenticated-orcid":true,"given":"Carlos","family":"Iniesta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pep","family":"Coll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Barber\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5969-1059","authenticated-orcid":true,"given":"Miguel","family":"Garc\u00eda Deltoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xabier","family":"Camino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Fag\u00fandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8309-4270","authenticated-orcid":true,"given":"Asunci\u00f3n","family":"D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Polo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Spanish Working Group for PrEP","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"key":"pone.0246129.ref001","unstructured":"Plan Nacional sobre el Sida\u2014D.G. de Salud P\u00fablica Centro Nacional de Epidemiolog\u00eda. \u00c1rea de Vigilancia de VIH y Comportamientos de Riesgo. Vigilancia Epidemiol\u00f3gica del VIH y sida en Espa\u00f1a 2018: Sistema de Informaci\u00f3n sobre Nuevos Diagn\u00f3sticos de VIH y Registro Nacional de Casos de Sida [Internet]. Madrid; 2019 [cited 2017 Sep 28]. Available from: https:\/\/www.mscbs.gob.es\/ciudadanos\/enfLesiones\/enfTransmisibles\/sida\/vigilancia\/doc\/Informe_VIH_SIDA_2019_21112019.pdf"},{"issue":"10013","key":"pone.0246129.ref002","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(15)00056-2","article-title":"Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial","volume":"387","author":"S McCormack","year":"2016","journal-title":"Lancet"},{"issue":"23","key":"pone.0246129.ref003","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1056\/NEJMoa1506273","article-title":"On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection","volume":"373","author":"J-M Molina","year":"2015","journal-title":"N Engl J Med"},{"key":"pone.0246129.ref004","article-title":"Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation","author":"V Cambiano","year":"2017","journal-title":"Lancet Infect Dis"},{"issue":"41","key":"pone.0246129.ref005","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2019.24.41.1900598","article-title":"Estimating the \u201cPrEP Gap\u201d: how implementation and access to PrEP differ between countries in Europe and Central Asia in 2019","volume":"24","author":"R Hayes","year":"2019","journal-title":"Euro Surveill"},{"issue":"10","key":"pone.0246129.ref006","first-page":"656","article-title":"HIV pre-exposure prophylaxis (PrEP) in Spain: political and administrative situation","volume":"37","author":"LM Garc\u00eda","year":"2019","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"pone.0246129.ref007","first-page":"439","volume-title":"Journal of Acquired Immune Deficiency Syndromes","author":"SE Cohen","year":"2015"},{"issue":"11","key":"pone.0246129.ref008","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1001\/jamapediatrics.2017.2007","article-title":"Safety and Feasibility of Antiretroviral Preexposure Prophylaxis for Adolescent Men Who Have Sex With Men Aged 15 to 17 Years in the United States","volume":"171","author":"SG Hosek","year":"2017","journal-title":"JAMA Pediatr"},{"issue":"11","key":"pone.0246129.ref009","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1097\/QAD.0000000000001874","article-title":"Change in sexual risk behaviour after 6 months of pre-exposure prophylaxis use","volume":"32","author":"E Hoornenborg","year":"2018","journal-title":"AIDS"},{"key":"pone.0246129.ref010","unstructured":"AEMPS. Ficha t\u00e9cnica Truvada [Internet]. 2017. Available from: http:\/\/www.ema.europa.eu\/docs\/es_ES\/document_library\/EPAR_-_Product_Information\/human\/000594\/WC500043718.pdf"},{"key":"pone.0246129.ref011","unstructured":"Plan Nacional sobre el Sida. Grupo de Expertos PrEP. Ministerio de Sanidad, Servicios Sociales e Igualdad. 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riesgo","year":"2019"},{"issue":"14","key":"pone.0246129.ref021","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1001\/jama.2019.2947","article-title":"Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection","volume":"321","author":"MW Traeger","year":"2019","journal-title":"JAMA"},{"issue":"14","key":"pone.0246129.ref022","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1097\/QAD.0000000000001185","article-title":"Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men","volume":"30","author":"N Kojima","year":"2016","journal-title":"AIDS"},{"issue":"2","key":"pone.0246129.ref023","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1007\/s10461-018-2252-9","article-title":"Changes in Sexual Behavior and STI Diagnoses Among MSM Initiating PrEP in a Clinic Setting","volume":"23","author":"MA 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EMIS-2017 \u2013The European Men-Who-Have-Sex-With-Men Internet Survey [Internet]. Stockholm; 2019 [cited 2019 Sep 6]. Available from: https:\/\/ecdc.europa.eu\/en\/publications-data\/emis-2017-european-men-who-have-sex-men-internet-survey"},{"key":"pone.0246129.ref031","unstructured":"Spanish Working Group for PrEP. Guidelines for the implementation of PrEP proframs in Spain; 2020 Feb [Internet]. Available from: https:\/\/www.mscbs.gob.es\/ciudadanos\/enfLesiones\/enfTransmisibles\/sida\/docs\/MANUAL_PREP.pdf"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0246129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T01:37:24Z","timestamp":1612834644000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0246129"}},"subtitle":[],"editor":[{"given":"Douglas S.","family":"Krakower","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,8]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0246129","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,8]]}}}