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
. 2021 May;25(5):1490-1506.
doi: 10.1007/s10461-020-02988-x.

The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review

Colleen B Mistler  1   2 , Michael M Copenhaver  3   4 , Roman Shrestha  4   5
Affiliations

The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review

Colleen B Mistler et al. AIDS Behav. 2021 May.

Abstract

Injection drug use is a key risk factor for the transmission of HIV. Prevention strategies, such as the use of pre-exposure prophylaxis (PrEP), are effective at reducing the risk of HIV transmission in people who inject drugs (PWID). Following PRISMA guidelines, a literature search was conducted to identify the current state of the PrEP care cascade in PWID. Twenty-three articles were evaluated in this systematic review. A decline in engagement throughout the stages of the PrEP care cascade was found. High awareness and willingness to use PrEP was found, yet PrEP uptake was relatively low (0-3%). There is a lack of research on interventions to increase engagement of PrEP across all levels of the care cascade in PWID. Implications from the interventions that have been published provide insight into practice and public policy on efficacious strategies to reduce HIV incidence in PWID. Our findings suggest that more efforts are needed to identify and screen PWID for PrEP eligibility and to link and maintain them with appropriate PrEP care.

Keywords: HIV prevention; People who inject drugs (PWID); PrEP care cascade; Pre-exposure prophylaxis (PrEP); Systematic review.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Persons Who Inject Drugs (PWID). 2018. [cited 2020 May 14]; Available from: https://www.cdc.gov/pwid/index.html.
    1. Centers for Disease Control and Prevention. Injection Drug Use. 2019. [cited 2020 Feb 10]; Available from: https://www.cdc.gov/hiv/risk/drugs/index.html.
    1. Kral AH, et al., HIV prevalence and risk behaviors among men who have sex with men and inject drugs in San Francisco . Journal of Urban Health, 2005. 82(1): p. i43–i50. - PMC - PubMed
    1. Green TC, et al., HIV infection and risk of overdose: a systematic review and meta-analysis. Aids, 2012. 26(4): p. 403–17. - PMC - PubMed
    1. Volkow ND and Montaner J, The urgency of providing comprehensive and integrated treatment for substance abusers with HIV. Health Aff (Millwood), 2011. 30(8): p. 1411–9. - PMC - PubMed

Publication types

MeSH terms

Substances