Pre-Exposure Prophylaxis (PrEP) is a new tool for preventing HIV transmission and has sparked considerable discussion and debate in many communities. In 2012, based on evidence that PrEP is safe and effective, the World Health Organisation (WHO) recommended that countries consider daily oral PrEP as an additional prevention strategy for HIV-negative partners in serodiscordant couples, as well as men and transgender women who have sex with men. The WHO did not recommend promoting PrEP among people who inject drugs in its 2014 Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations, due in part to human rights and other concerns raised by community representatives, many of which are detailed below.
As this new tool begins to be used, it is essential that affected communities be meaningfully involved in related policymaking and in any subsequent programme implementation. INPUD therefore researched the knowledge, beliefs, and opinions of people who inject drugs about potential pros, cons, and concerns related to PrEP. With this paper, INPUD aims to amplify the voices of people who inject drugs so that their unique knowledge and perspectives can be taken into account as policies related to PrEP are formulated. This is of vital importance, as many people who use drugs have grave concerns about the ethics, effectiveness, and safety of prioritising broad promotion of PrEP for people who inject drugs—especially in a global context of drug prohibition and limited access to harm reduction services and antiretroviral therapy for people who inject drugs living with HIV.