Estimating the percentage of European MSM eligible for PrEP: insights from a bio-behavioural survey in thirteen cities

Maddalena Cordioli, Lorenzo Gios, Jorg W. Huber, Nigel Sherriff, Cinta Folch, Ivailo Alexiev, Sonia Dias, Christiana Nöstlinger, Ana Gama, Emilia Naseva, Danica Valkovicova Stanekova, Ulrich Marcus, Susanne Barbara Schink, Magdalena Rosinska, Karel Blondeel, Igor Toskin, Massimo Mirandola

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Objectives This paper aims to estimate the percentage of European men who have sex with men (MSM) who may benefit from pre-exposure prophylaxis (PrEP), applying the three most widely used HIV risk indices for MSM (MSM Risk Index, Menza score, San Diego Early Test (SDET) score) and drawing on a large-scale multisite bio-behavioural survey (Sialon II). Methods The Sialon II study was a bio-behavioural survey among MSM implemented in 13 European cities using either time-location sampling or respondent-driven sampling. Biological and behavioural data from 4901 MSM were collected. Only behavioural data of HIV-negative individuals were considered. Three widely used risk indices to assess HIV acquisition risk among MSM were used to estimate individual HIV risk scores and PrEP eligibility criteria. Results 4219 HIV-negative MSM were considered. Regardless the HIV risk score used and the city, percentages of MSM eligible for PrEP were found to range between 5.19% and 73.84%. Overall, the MSM Risk Index and the Menza score yielded broadly similar percentages, whereas the SDET Index provided estimates constantly lower across all cities. Although all the three scores correlated positively (r>0.6), their concordance was highly variable (0.01

Original languageEnglish
JournalSexually Transmitted Infections
Issue number7
Pages (from-to)534-540
Number of pages7
Publication statusPublished - 2021


  • pre-exposure prophylaxis
  • sexual behaviour
  • HIV
  • preventive health services
  • public health
  • MEN
  • SEX
  • RISK


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