Introduction – The Île-de-France region is the metropolitan area most affected by the HIV epidemic, with significant disparities across subregions and departments. It is also home to a large proportion of men who have sex with men (MSM), a group particularly affected by HIV. With a view to assessing the feasibility of ending new HIV infections in Île-de-France by 2030, this article aims to identify the social and geographic factors influencing MSM’s use of HIV testing and PrEP based on their place of residence in Île-de-France. Method – The data used were drawn from the Enquête rapport au sexe (Eras) conducted in the first half of 2023, a cross-sectional, anonymous, self-administered, and voluntary online survey of MSM. Results – A total of 18,525 MSM who were sexually active in the past 12 months and HIV-negative participated in the survey. Among them, 27% resided in the Île-de-France region, including: 51% in Paris, 29% in the inner suburbs, and 20% in the outer suburbs. Among respondents from Île-de-France, 42% met the eligibility criteria for PrEP. Compared to users, non-users were younger, had a lower level of education, and were more likely to reside in the outer suburbs, farther from the gay community. Conclusion – These results highlight the socio-spatial disparities in the uptake of prevention tools by MSM in the Île-de-France region. Initiatives carried out in Paris, both in terms of communication and access, demonstrate their effectiveness in a supportive environment with high uptake. In the outer suburbs, new initiatives could be developed by adapting prevention services and communication to the living contexts of MSM in the region’s suburban areas. It is essential to address socio-spatial inequalities to improve access to testing and prevention for the entire MSM community and thereby advance toward the goals of eliminating HIV.