A Short History of PrEP — and How It Changed HIV Prevention

PrEP hasn't been around forever — and yet in less than fifteen years, it has fundamentally changed HIV prevention. A short look back.

The early studies

The breakthrough came with the iPrEx study in 2010, which showed for the first time in a large trial that daily use of tenofovir/emtricitabine could significantly reduce HIV risk among MSM. That was a turning point — suddenly prevention wasn't just about condoms, but also about medication.

The approvals

In 2012, the US Food and Drug Administration (FDA) approved Truvada® for the PrEP indication — the first time globally. The European Medicines Agency (EMA) followed in 2016, making PrEP approved across Europe for adults at elevated HIV risk.

PrEP in Germany

In Germany, PrEP was initially only accessible to self-paying patients, as statutory insurers did not cover the costs. That changed on 1 September 2019, when PrEP became a covered service for GKV members under certain conditions (§ 20j SGB V).

This wasn't automatic — it was the result of years of advocacy, scientific communication, and activism, including by the Deutsche Aidshilfe and patient organisations.

Generics made PrEP more accessible

As patents expired, the production of cheaper generic versions became possible. This substantially reduced costs for self-payers and health systems around the world.

Where things are heading

Research hasn't stopped. Injectable PrEP — a shot every two months instead of a daily tablet — has been approved in the US and is under discussion in Europe. This could be an important option for people who find daily dosing difficult.

What it all means

PrEP has helped shift HIV prevention from a matter of willpower to a matter of access. The next challenge is making that access genuinely reachable for everyone.