INEQUITIES IN PREP ACCESS ACROSS EUROPE FOR MIGRANT WOMEN

Опубликовано: 29th Июнь 2026

We are proud to announce that Mi-Health Europe has contributed to a newly published paper in HIV Medicine.

This multi‑country study across 11 European nations examines how legal status, sex work engagement, and national health financing policies shape inequities in the HIV pre‑exposure prophylaxis (PrEP) cascade among migrant women. Results reveal significant gaps between PrEP awareness, intention, and uptake, highlighting the urgent need for community‑led HIV prevention models and inclusive health policies that decouple PrEP eligibility from documentation status.

Here’s what we found and why it matters for the future of HIV prevention in Europe

1. A gap between wanting PrEP and using it

Many migrant women are aware of PrEP and interested in using it, but far fewer are able to access and stay on it. This gap points to structural barriers, not a lack of demand.

2. Legal status shapes the journey but not in the way you would expect

3. Sex Workers Show Higher PrEP Uptake

Migrant women engaged in sex work had over 5 times higher odds of current PrEP use compared with women not engaged in sex work. This likely reflects targeted outreach and community based prevention programmes reaching this group more effectively than others

4. Reimbursement Policy Makes a Measurable Difference

Migrant women in countries offering full PrEP reimbursement were nearly 5 times more likely to be currently using PrEP than those in countries without full coverage. This is one of the clearest, most policy actionable findings in the study.

5. High Discontinuation

Among women who had ever used PrEP, discontinuation rates were high, highlighting that getting women started on PrEP is only half the challenge. Retention and long term support are just as critical.

6. Condoms remain the preferred method, but interest in PrEP is real

Condoms were still the most preferred prevention method overall (60.3%), followed by female condoms (10.4%) and daily oral PrEP (9.3%). But undocumented women and sex workers were more likely to rank daily oral PrEP above female condoms, and sex workers were the only group to also show meaningful interest in on demand oral PrEP and long acting injectable PrEP. This tells us that demand for biomedical prevention options exists, and is likely to grow as awareness spreads and more formulations become available.

What this means for policy and practice

Our findings suggest that closing the PrEP gap for migrant women in Europe will require more than awareness campaigns. It requires:

• Simplifying legal and administrative pathways to healthcare regardless of residency status
• Investing in retention support, not just initiation, to reduce discontinuation
• Expanding full PrEP reimbursement across all European countries, not just some
• Continuing community led, culturally responsive outreach, especially for the most legally insecure women

By contributing to this research, Mi-Health Europe reinforces its commitment to advancing equitable HIV prevention strategies, supporting migrant women, and promoting evidence‑based policy change across Europe.