Are there specific populations that may benefit more from PrEP, and how should I approach discussions with them?

Specific populations that may benefit more from pre-exposure prophylaxis (PrEP) include people at higher risk of HIV, such as gay, bisexual, and other men who have sex with men, trans people, cisgender women, young people aged 16 to 24, people with a Black African or Caribbean family background, and those from lower socioeconomic status backgrounds. However, it is important to recognise that not everyone in these groups is necessarily at higher risk, as risk depends on behaviours such as condomless sex with multiple or frequently changing partners ¹.

Approach to discussions with these populations should be sex-positive and non-judgemental, openly communicating to reduce embarrassment and stigma around sex and sexuality. Use tailored, co-produced materials that address specific information gaps and stigma within the target population. Employ peer support to normalise PrEP use and increase trust in services. Ensure that people understand that PrEP prevents HIV only and does not protect against other STIs, so barrier methods remain important ¹.

Raise awareness of PrEP using targeted methods such as social media and collaboration with relevant local organisations or groups, especially focusing on populations where PrEP awareness or uptake is lower. Support local community groups with information resources to help increase trust and awareness. Services offering PrEP should be welcoming and accessible to all eligible groups, ideally co-designed with key populations, without alienating others. Healthcare professionals, particularly in primary care and community settings, should be trained to recognise eligibility for PrEP and to support adherence, regular HIV testing, and STI screening every 3 months ¹.

When discussing PrEP with trans people undergoing medical transition, inform them that no clinically significant interactions are expected between PrEP and common hormones used in transition, and that PrEP use is not expected to affect their transition ¹.