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Meta-Analysis
. 2023 Mar-Apr;34(2):135-145.
doi: 10.1097/JNC.0000000000000384. Epub 2022 Dec 23.

What Factors Are Associated With Willingness to Use HIV Pre-exposure Prophylaxis (PrEP) Among U.S. Men Who Have Sex With Men Not on PrEP? A Systematic Review and Meta-analysis

Emiko Kamitani  1   2   3   4   5 , Megan E Wichser  1   2   3   4   5 , Yuko Mizuno  1   2   3   4   5 , Julia B DeLuca  1   2   3   4   5 , Darrel H Higa  1   2   3   4   5
Affiliations
Meta-Analysis

What Factors Are Associated With Willingness to Use HIV Pre-exposure Prophylaxis (PrEP) Among U.S. Men Who Have Sex With Men Not on PrEP? A Systematic Review and Meta-analysis

Emiko Kamitani et al. J Assoc Nurses AIDS Care. 2023 Mar-Apr.

Abstract

Pre-exposure prophylaxis (PrEP), an antiretroviral medication to prevent HIV, is becoming more widely available in the United States since the Federal Drug Administration approved it in 2012. However, PrEP use among men who have sex with men (MSM) is still limited and many MSM who are willing to take PrEP are not on PrEP. We performed a systematic review to identify factors associated with willingness to use PrEP among MSM who are not on PrEP. The majority of the 23 relevant studies had low risk of bias and used a cross-sectional design. Willingness was associated with being Hispanic/Latino (odds ratio [OR] = 1.68, 95% confidence interval [CI] [1.01-2.78]), Black (OR = 1.41, 95% CI [1.02-1.95]), younger (OR = 1.08, 95% CI [1.02-1.15]), having no college degree (OR = 1.37, 95% CI [1.12-1.59]), or low income (OR = 1.21, 95% CI [1.12-1.32]). A higher proportion of MSM who had recent condomless anal sex (OR = 1.85, 95% CI [1.49-2.29]) were diagnosed with sexually transmitted infection (OR = 1.60, 95% CI [1.27-2.01]), or MSM who had multiple sex partners (OR = 1.58, 95% CI [1.07-2.32]) were more willing to use PrEP compared with their respective counterparts. Findings suggest that MSM with racial/ethnic minority status, low-socioeconomic status, younger age, and engagement in HIV risk behaviors are willing to take PrEP but may lack access. Study limitations include the inability to conduct meta-analyses on certain predictor variables due to a small number of studies. This review identified MSM subpopulations who may benefit from interventions increasing PrEP access.

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Conflict of interest statement

Disclosure: . There are no conflicts of interest to report, or financial disclosures.

Figures

Figure 1:
Figure 1:
Flow diagram of included studies
Figure 2:
Figure 2:
Forest plot of pooled odd ratios – Sociodemographic factors associated with willingness to use PrEP
Figure 3:
Figure 3:
Forest plot of pooled odd ratios – Behavioral factors associated with willingness to use PrEP
Figure 4:
Figure 4:
Forest plot of pooled odd ratios – PrEP/HIV perception factors associated with willingness to use PrEP
See this image and copyright information in PMC

References

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