France was the first country in Europe to fully reimburse PrEP, and the system is genuinely excellent for anyone inside it. PrEP medication costs €0 for French residents with Sécurité Sociale coverage. For people outside the system — tourists, undocumented individuals — there are still routes in.

The Short Version

  • PrEP is free (100% reimbursed) for French residents with Sécurité Sociale
  • Available via GP, CeGIDD, or specialist doctor
  • You need a Carte Vitale — or PASS/AME if uninsured
  • Quarterly monitoring is required (tests covered)
  • Any médecin can prescribe; most refer to a CeGIDD or specialist

Who Can Get Free PrEP

French Residents with Sécurité Sociale

PrEP is prescribed under ALD 7 (Affection de Longue Durée — HIV and related prevention protocols), giving 100% reimbursement. With tiers payant (tiers payant obligatoire for PrEP since 2023), your pharmacy receives payment directly from Assurance Maladie — you pay €0 at the counter.

What you need: Carte Vitale (your green chip insurance card) or Attestation de droits.

No Carte Vitale — Still Have Options

AME (Aide Médicale d'État) — State medical aid for undocumented people who have been in France for at least 3 months. Covers PrEP once established. Apply at your local CPAM (Caisse Primaire d'Assurance Maladie).

PASS (Permanence d'Accès aux Soins de Santé) — Based in public hospitals; provides medical access including PrEP dispensing from the hospital pharmacy for people with no coverage.

CeGIDD — Can initiate PrEP and manage the first prescription regardless of your insurance status. The CeGIDD route is the most accessible starting point for anyone without documents.

Tourists / Short-term visitors: PrEP is not automatically free without French Sécu. However, generic TDF/FTC at a French pharmacy is approximately €60–80/month on a private prescription. AIDES or Le Kiosque can advise on practical routes.

How to Start PrEP in France

Via a CeGIDD (Recommended Start)

  1. Find your nearest CeGIDD at cegidd.fr
  2. Book via Doctolib.fr (search "CeGIDD [city]")
  3. At the appointment: HIV test, STI screen, kidney function, counselling
  4. Prescription issued — take to any pharmacie with your Carte Vitale

CeGIDDs are the most experienced and LGBTQ+-affirming starting point for PrEP in France.

Via Your GP (Médecin Généraliste)

Your GP can prescribe PrEP but may refer you to a CeGIDD or specialist for the initial assessment. Ask:

"Je voudrais démarrer la PrEP. Pouvez-vous me prescrire ou me référer?" ("I'd like to start PrEP. Can you prescribe it or refer me?")

Via a Specialist

Infectious disease specialists and médecins référents at major hospitals (Saint-Louis, Tenon, Bichat in Paris; CHUs elsewhere) manage PrEP. Often the best long-term option if your case is complex.

Quarterly Monitoring

Every three months you need:

  • HIV test (antigen/antibody — 4th generation)
  • STI screening (syphilis, gonorrhoea, chlamydia)
  • Kidney function (créatinine) — tenofovir can affect kidneys
  • Hepatitis B/C (periodically)

In France, your doctor gives you an ordonnance (prescription) for these tests, which you take to a laboratoire d'analyses médicales. Results come back to you and your doctor electronically, usually within 24 hours.

Dosing

France follows the same protocols:

  • Daily PrEP: One tablet every day
  • Event-based (2-1-1): Two tablets 2–24 hours before sex, one tablet 24 hours after, one tablet 48 hours after

Ask your CeGIDD doctor or médecin about which is appropriate for your lifestyle.

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