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
Review
. 2025 Mar 19;17(3):e80842.
doi: 10.7759/cureus.80842. eCollection 2025 Mar.

A Systematic Literature Review on Pre-exposure Prophylaxis as a Strategy for HIV Risk Reduction in the Middle East

Mas Chaponda  1 , Ahmed A AlHammadi  2   3 , Ali Alsaeed  4 , Batool Ali  5 , Jameela Al Salman  6   7 , Roaa S Alosaimi  5
Affiliations
Review

A Systematic Literature Review on Pre-exposure Prophylaxis as a Strategy for HIV Risk Reduction in the Middle East

Mas Chaponda et al. Cureus. .

Abstract

Pre-exposure prophylaxis (PrEP) has emerged as a crucial tool in HIV prevention globally, yet its implementation in the Middle East and North Africa (MENA) region faces unique challenges. PrEP is expected to be effective in reducing HIV transmission. However, there is limited comprehensive data about its awareness, utilization, and effectiveness within MENA countries. The region's distinct cultural, social, and healthcare system characteristics create specific barriers that must be addressed. This study aims to evaluate PrEP's value and effectiveness and to develop targeted recommendations for overcoming barriers and expanding PrEP programs to better serve the region's specific needs and populations at risk. We searched PubMed, Scopus, and Web of Science databases through October 2024, using keywords related to HIV, PrEP, and the MENA region. Eligible studies included peer-reviewed clinical research on PrEP use in MENA countries, focusing on high-risk populations. Two independent reviewers screened titles, abstracts, and full texts using the Rayyan software, with disagreements resolved by a senior reviewer. Studies across the MENA region showed varying levels of PrEP awareness and willingness to use, with MSM communities showing higher interest. While PrEP proved effective for HIV prevention when properly used, implementation faced barriers, including costs, stigma, and accessibility. Despite the potential of PrEP implementation in HIV prevention, its efficacy in the MENA region remains unproven due to a lack of clinical studies. Successful implementation of PrEP in this region requires addressing key challenges, including financial accessibility, awareness, stigma, and healthcare integration. Morocco's pilot program serves as a promising example, but broader adoption must focus on improving accessibility and affordability. Future efforts should tailor interventions to meet the needs of at-risk populations, with an emphasis on enhancing adherence and retention rates to ensure effectiveness in diverse MENA settings.

Keywords: hiv prevention; human immunodeficiency virus (hiv); middle east and north africa (mena); pre-exposure prophylaxis (prep); prophylaxis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This study was supported by funding from Gilead Sciences, Inc. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram
Figure 2
Figure 2. Barriers to HIV PrEP in the MENA region.
HIV PrEP: human immunodeficiency virus pre-exposure prophylaxis, MENA: Middle East and North Africa
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Infectious disease modelling of HIV prevention interventions: a systematic review and narrative synthesis of compartmental models. Giddings R, Indravudh P, Medley GF, et al. Pharmacoeconomics. 2023;41:693–707. - PMC - PubMed
    1. UNAIDS | Global HIV & AIDS statistics — fact sheet. [ Nov; 2024 ]. 2024. https://www.unaids.org/en/resources/fact-sheet https://www.unaids.org/en/resources/fact-sheet
    1. World Health Organization | HIV/AIDS. [ Nov; 2024 ]. 2021. https://www.who.int/news-room/fact-sheets/detail/hiv-aids https://www.who.int/news-room/fact-sheets/detail/hiv-aids
    1. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. Fonner VA, Dalglish SL, Kennedy CE, et al. https://pubmed.ncbi.nlm.nih.gov/27149090/ AIDS. 2016;30:1973–1983. - PMC - PubMed
    1. World Health Organization | Pre-exposure prophylaxis. [ Nov; 2024 ];https://iris.who.int/bitstream/handle/10665/197906/WHO_HIV_2015.48_eng.pdf 2015 2 - PubMed

LinkOut - more resources