Call to action: A roadmap for HIV prevention and PrEP adoption in the Gulf region.

Abstract

Background: Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention for preventing HIV transmission. However, despite its proven efficacy, PrEP uptake in the Gulf Cooperation Council (GCC) countries remains suboptimal due to multiple systemic, legal, and sociocultural challenges.Purpose: This expert opinion review aims to present a strategic roadmap to enhance HIV prevention and support the integration and scale-up of PrEP adoption across the GCC region.Research Design: This narrative review synthesises insights from regional and international literature, expert panel discussions, and public health frameworks to develop practical recommendations for improving PrEP implementation in GCC countries.Study Sample: The review draws upon the perspectives of infectious disease specialists, public health policymakers, and HIV prevention advocates with expertise in the GCC region, alongside selected peer-reviewed and grey literature addressing HIV and PrEP in similar sociopolitical contexts.Data Collection and/or Analysis: Qualitative synthesis of the existing barriers and facilitators of PrEP adoption was conducted. The authors applied a framework-based approach to identify core pillars for effective policy, clinical, and public health interventions relevant to the GCC context.Results: Four strategic pillars were identified: (1) establishing a legal and regulatory framework with national PrEP guidelines; (2) improving risk identification and expanding access for individuals at heightened HIV risk; (3) enhancing healthcare provider education and capacity-building; and (4) conducting culturally sensitive public awareness campaigns. Financial accessibility and patient-provider communication were also highlighted as key to improving adherence and uptake.Conclusions: A coordinated, multi-sectoral approach is essential for advancing PrEP integration into national HIV prevention efforts across the GCC. By addressing structural and societal barriers, this roadmap provides actionable guidance to reduce new HIV infections and promote equitable access to PrEP for at-risk populations.