Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;21(5):1325-1335.
doi: 10.1007/s10461-016-1627-z.

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

Florence M Koechlin  1 , Virginia A Fonner  2 , Sarah L Dalglish  3 , Kevin R O'Reilly  2 , Rachel Baggaley  4 , Robert M Grant  4 , Michelle Rodolph  4 , Ioannis Hodges-Mameletzis  4 , Caitlin E Kennedy  3
Affiliations

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

Florence M Koechlin et al. AIDS Behav. 2017 May.

Abstract

Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990-April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

Keywords: HIV; HIV prevention; Multiple populations; Pre-exposure prophylaxis (PrEP); Systematic review; Tenofovir; Values and preferences.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

All authors declare that they have no conflict of interest.

Human and Animal Participants

This article does not contain any studies with human participants or animals performed by the authors.

Figures

Fig. 1
Fig. 1
Disposition of citations through the search and screening process
See this image and copyright information in PMC

References

    1. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–2599. doi: 10.1056/NEJMoa1011205. - DOI - PMC - PubMed
    1. Fonner VA, Dalglish S, Kennedy CE, et al. Oral tenofovir-based HIV pre-exposure prophylaxis (PrEP) for all populations: a systematic review and meta-analysis of effectiveness, safety, behavioural, and reproductive health outcomes. AIDS. 2016;30(12):1973–1983. doi: 10.1097/QAD.0000000000001145. - DOI - PMC - PubMed
    1. World Health Organization . Guidance on pre-exposure oral prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV. Geneva: WHO; 2012. - PubMed
    1. World Health Organization . Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva: WHO; 2014. - PubMed
    1. World Health Organization . Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: WHO; 2015. - PubMed

Publication types

Substances