Demedicalisation 'Demedicalisation' was a word much used in the workshop. It was acknowledged that simply for reasons of capacity, expanding PrEP provision would be difficult if every appointment had to involve a doctor (some countries still require a doctor’s permission or presence even for an HIV test). There was a lot of discussion about how PrEP services could be demedicalised to some extent without compromising safety. For instance, kidney function tests probably did not have to happen every three months for people aged over 45 and could be done with a urine dipstick. But there was concern about total demedicalisation – a 'PrEP over the counter' model, as effectively already happens with unlinked online purchase. A UK doctor said that although serious adverse events were rare, there had been a few cases of pancreatitis in the IMPACT implementation study in England. If people were able to start without an HIV test, the small possibility of PrEP use during acute HIV infection giving rise to HIV resistance might become larger.