The Italian PrEPventHIV challenge: a scoping systematic review on HIV pre-exposure prophylaxis monitoring in Italy

The Italian PrEPventHIV challenge: a scoping systematic review on HIV pre-exposure prophylaxis monitoring in Italy


  • Pietro Ferrara Center for Public Health Research, University of Milan – Bicocca, Monza, Italy
  • Vincenza Gianfredi Department of Biomedical Sciences for Health, University of Milan, Milan, Italy


HIV, scoping systematic review, pre-exposure prophylaxis, PrEP, Italy


Background and aim: In Italy, pre-exposure prophylaxis (PrEP) with emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) was authorized for HIV prevention in 2017. This scoping systematic review summarizes current evidence on PrEP implementation in Italy since 2017.

Methods: A systematic search was conducted in relevant databases, using a search strategy built upon controlled vocabulary, cross-referencing of the citation lists from included reports, and hand-searching of surveillance documents. Findings were summarized narratively according to key issues and themes.

Results: A total of 106 reports were retrieved and six met criteria for inclusion in the review, being three journal articles and three surveillance report by the European Centre for Disease Prevention and Control (ECDC). In Italy, users can obtain in PrEP in specific hospital- or community-based PrEP services, under prescription by specialists. Due to drug costs, the access is limited to those who can afford it. Data and indicators on PrEP use and monitoring are limited. The vast majority of users were men who have sex with men. In this population, PrEP knowledge and attitudes were investigated across two reports, finding a medium to high level to knowledge and a scare use (mostly due to high costs). A health technology assessment on the adoption of PrEP in Italy advised that the most cost-containing strategy would be the use of PrEP as an “add-on” strategy.

Conclusions: In conclusion, this scoping review found a relevant evidence gap on PrEP monitoring. Italy needs to implement specific policies and programs for effective and timely delivery of care.


GBD 2019 HIV Collaborators. Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019. Lancet HIV 2021;8(10):633-51. doi: 10.1016/S2352-3018(21)00152-1

Istituto Superiore di Sanità. Infezione da HIV e AIDS – Aspetti epidemiologici. Available at: (Accessed on November 14, 2021)

Adams JL, Shelley K, Nicol MR. Review of real-world implementation data on emtricitabine-tenofovir disoproxil fumarate as HIV preexposure prophylaxis in the United States. Pharmacotherapy 2019; 39:486–500.

European Centre for Disease Prevention and Control. HIV Pre-Exposure Prophylaxis in the EU/EEA and the UK: implementation, standards and monitoring. Operational guidance. Stockholm: ECDC; 2021. Available at:

European Centre for Disease Prevention and Control. Country case studies: ECDC operational guidance on Pre-Exposure Prophylaxis (PrEP) in the EU/EEA and the UK. Stockholm: ECDC; 2021. Available at:

Agenzia Italiana del Farmaco. Determina 10 agosto 2017, n. 1483- Nuove indicazioni terapeutiche del medicinale per uso umano «Truvada» non rimborsate dal Servizio sanitario nazionale. Gazzetta Ufficiale Serie Generale n. 203/2017

Ferrara P, Antonazzo IC, Mantovani LG. The PrEPventHIV gap: a systematic scoping review on HIV pre-exposure prophylaxis implementation in Italy. Giornate della ricerca scientifica e delle esperienze professionali dei giovani, 17-18 dicembre 2020. J Prev Med Hyg 2021;62(1S2):E31-2. doi: 10.15167/2421-4248/jpmh2021.62.1s2

Munn Z., Peters M.D.J., Stern C. et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 2018;18, 143

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021;372:n71

Del Prete V, Mateo-Urdiales A, Bueno-Cavanillas A, Ferrara P. Malaria prevention in the older traveller: a systematic review. J Travel Med 2019;26(7):taz067. doi: 10.1093/jtm/taz067

Gianfredi V, Albano L, Basnyat B, Ferrara P. Does age have an impact on acute mountain sickness? A systematic review. J Travel Med 2020;27(6):taz104. doi: 10.1093/jtm/taz104

European Centre for Disease Prevention and Control. Pre-exposure prophylaxis for HIV prevention in Europe and Central Asia. Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS in Europe and Central Asia – 2018/19 progress report. Stockholm: ECDC; 2019. Available at:

European Centre for Disease Prevention and Control. EMIS-2017 – The European Men-Who-Have-Sex-With-Men Internet Survey. Stockholm: ECDC; 2019 Available at:

Voglino G, Gualano MR, Rousset S, et al. Knowledge, Attitudes and Practices Regarding Pre-Exposure Prophylaxis (PrEP) in a Sample of Italian Men Who Have SEX with MEN (MSM). Int J Environ Res Public Health. 2021;18(9):4772. doi: 10.3390/ijerph18094772.

Rodger AJ, Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019; 393: 2428-38

Ferrario L, Foglia E, Garagiola E, et al. The impact of PrEP: results from a multicenter Health Technology Assessment into the Italian setting. J Prev Med Hyg 2020; 61(3): E451-E463

Cordioli M, Gios L, Huber JW, et al. Estimating the percentage of European MSM eligible for PrEP: insights from a bio-behavioural survey in thirteen cities. Sex Transm Infect 2021;97:534–540.

Franconi, I., Guaraldi, G. Pre-exposure Prophylaxis for HIV Infection in the Older Patient: What can be Recommended?. Drugs Aging 2018;35, 485–491

World Health Organization. Guidance on oral pre-exposure prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV: recommendations for use in the context of demonstration projects. 2012. Accessed on December 28, 2021

Hershow RB, Gonzalez M, Costenbader E, et al. Medical Providers and Harm Reduction Views on Pre-Exposure Prophylaxis for HIV Prevention Among People Who Inject Drugs. AIDS Educ Prev 2019;31(4).

Cattaneo D, Vinti P, Baldelli S, et al. Differences in tenofovir trough concentrations between branded and generic formulations in people taking PrEP. AIDS 2021;35 (3), 522-524. doi: 10.1097/QAD.0000000000002758.

Cambiano V, Miners A, Dunn D, et al.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. Lancet Infect Dis 2018;18:85-94

Shen, M., Xiao, Y., Rong, L. et al. The cost-effectiveness of oral HIV pre-exposure prophylaxis and early antiretroviral therapy in the presence of drug resistance among men who have sex with men in San Francisco. BMC Med 16, 58 (2018).

Mambanga P, Sirwali RN, Tshitangano T. Factors contributing to men’s reluctance to seek HIV counselling and testing at Primary Health Care facilities in Vhembe District of South Africa. Afr J Prim Health Care Fam Med 2016; 8: e1–7.

Puro V, Palummieri A, De Carli G, et al. Attitude towards antiretroviral pre-exposure prophylaxis (PrEP) prescription among HIV specialists. BMC Infect Dis 2013;13:217

Taramasso L, Riccardi N, Del Puente F, et al. Short Communication: Tenofovir Disoproxil Fumarate/Emtricitabine Fits for All as Appropriate HIV-1 Pre-Exposure Prophylaxis? AIDS Res Hum Retroviruses.Feb 2018.168-170.

Rossotti R, Borghi V, Callegaro AP, et al. Impact of Circulating Resistance-Associated Mutations on HIV Pre-Exposure Prophylaxis (PrEP) efficacy: Modeling from Antiretroviral Resistance Cohort Analysis (ARCA) National Database. Virol J 2016; 83: 48-53

Signorelli C, Odone A, Gianfredi V, et al. Epidemiological assessment of the first COVID-19 epidemic wave in Lombardy. A systematic review. Acta Biomed 2021 Oct 7;92(S6):e2021462. doi: 10.23750/abm.v92iS6.12340.

Balasco N, d’Alessandro V, Ferrara P, et al. Analysis of the time evolution of COVID-19 lethality during the first epidemic wave in Italy. Acta Biomed 2021;92(2): e2021171. doi: 10.23750/abm.v92i2.11149







How to Cite

The Italian PrEPventHIV challenge: a scoping systematic review on HIV pre-exposure prophylaxis monitoring in Italy. Acta Biomed [Internet]. 2022 Jul. 1 [cited 2024 Jun. 13];93(3):e2022164. Available from:

Most read articles by the same author(s)

1 2 3 > >>