Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis

Abstract Background Men who have sex with men (MSM) and transgender women (TGW) have a disproportionately higher risk of human immunodeficiency virus (HIV) infection than other groups. Oral HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool and should be offered to those at higher r...

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Main Authors: Nathalia Sernizon Guimarães, Laio Magno, Gabriel Marinho Bahia Monteiro, Izabel Cristina Neves Ramos, Caroline Tianeze de Castro, Thais Regis Aranha-Rossi, Marcos Pereira, Inês Dourado
Format: Article
Language:English
Published: BMC 2023-11-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-023-08693-z
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author Nathalia Sernizon Guimarães
Laio Magno
Gabriel Marinho Bahia Monteiro
Izabel Cristina Neves Ramos
Caroline Tianeze de Castro
Thais Regis Aranha-Rossi
Marcos Pereira
Inês Dourado
author_facet Nathalia Sernizon Guimarães
Laio Magno
Gabriel Marinho Bahia Monteiro
Izabel Cristina Neves Ramos
Caroline Tianeze de Castro
Thais Regis Aranha-Rossi
Marcos Pereira
Inês Dourado
author_sort Nathalia Sernizon Guimarães
collection DOAJ
description Abstract Background Men who have sex with men (MSM) and transgender women (TGW) have a disproportionately higher risk of human immunodeficiency virus (HIV) infection than other groups. Oral HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool and should be offered to those at higher risk. Identifying demand creation strategies (DCS) and retention strategies (RS) to improve PrEP persistence is essential to control the HIV epidemic. Aim We aimed to identify the (DCS and RS with higher proportions among MSM and TGW. Methods A systematic review and meta-analysis of prospective studies were conducted, with studies retrieved from five databases until November, 2022 following the Cochrane and PRISMA guidelines. The study protocol was registered in PROSPERO (CRD42022323220). The outcomes were DCS and RS for PrEP use among MSM and TGW. Strategies used for users enrolled in the PrEP-recruited (DCS) were classified as face-to-face (peer educator recruitment at social venues, nongovernmental organizations, and parties; direct referrals by health services; friends and/or sexual partners); online (chatbot or peer educator recruitment on social media [e.g., , Instagram or Facebook] or dating/hook-up apps [e.g., Grindr, Tinder, Badoo, and Scruff]); and mixed (face-to-face and online). RS was classified as provider counseling (face-to-face by a health professional; prevention of HIV risk counseling, distribution of condoms, lubricants, and testing for HIV or other sexually transmitted infections); online counseling (text messages, chatbots, telephone calls, social media, and peer educators); and mixed (all previous strategies). Subgroup analyses were conducted for each treatment strategy. Meta-analyses were performed using the R software version 4.2.1. Results A total of 1, 129 studies were retrieved from the five databases. After eligibility, 46 studies were included. For MSM, most DCS and RS were online at 91% (95% CI: 0.85–0.97; I2=53%), and 83% (95% CI: 0.80–0.85; I2=17%) respectively. For TGW, mixed DCS and RS were the most frequent at85% (95% CI: 0.60–1.00; I2=91%) and online counseling at 84% (95% CI: 0.64–0.95) compared to other strategies. Conclusion Critical issues play. Pivotal role in increasing PrEP awareness among MSM and TGW, minimizing access gaps, and ensuring retention of PrEP services. Offering oral PrEP using online DCS and RS can reach and retain high numbers of MSM and TGW, and reduce HIV incidence in these populations.
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spelling doaj.art-1b18d6e95de44357bb0554ab4228aea42023-11-19T12:29:58ZengBMCBMC Infectious Diseases1471-23342023-11-0123112010.1186/s12879-023-08693-zDemand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysisNathalia Sernizon Guimarães0Laio Magno1Gabriel Marinho Bahia Monteiro2Izabel Cristina Neves Ramos3Caroline Tianeze de Castro4Thais Regis Aranha-Rossi5Marcos Pereira6Inês Dourado7Faculdade Ciências Médicas de Minas GeraisLife Sciences Departament, Universidade do Estado da BahiaFundação de apoio à Fiocruz (FIOTEC) ScholarshipFundação de apoio à Fiocruz (FIOTEC) ScholarshipFaculdade Ciências Médicas de Minas GeraisLife Sciences Departament, Universidade do Estado da BahiaInstituto de Saúde Coletiva, Universidade Federal da BahiaInstituto de Saúde Coletiva, Universidade Federal da BahiaAbstract Background Men who have sex with men (MSM) and transgender women (TGW) have a disproportionately higher risk of human immunodeficiency virus (HIV) infection than other groups. Oral HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool and should be offered to those at higher risk. Identifying demand creation strategies (DCS) and retention strategies (RS) to improve PrEP persistence is essential to control the HIV epidemic. Aim We aimed to identify the (DCS and RS with higher proportions among MSM and TGW. Methods A systematic review and meta-analysis of prospective studies were conducted, with studies retrieved from five databases until November, 2022 following the Cochrane and PRISMA guidelines. The study protocol was registered in PROSPERO (CRD42022323220). The outcomes were DCS and RS for PrEP use among MSM and TGW. Strategies used for users enrolled in the PrEP-recruited (DCS) were classified as face-to-face (peer educator recruitment at social venues, nongovernmental organizations, and parties; direct referrals by health services; friends and/or sexual partners); online (chatbot or peer educator recruitment on social media [e.g., , Instagram or Facebook] or dating/hook-up apps [e.g., Grindr, Tinder, Badoo, and Scruff]); and mixed (face-to-face and online). RS was classified as provider counseling (face-to-face by a health professional; prevention of HIV risk counseling, distribution of condoms, lubricants, and testing for HIV or other sexually transmitted infections); online counseling (text messages, chatbots, telephone calls, social media, and peer educators); and mixed (all previous strategies). Subgroup analyses were conducted for each treatment strategy. Meta-analyses were performed using the R software version 4.2.1. Results A total of 1, 129 studies were retrieved from the five databases. After eligibility, 46 studies were included. For MSM, most DCS and RS were online at 91% (95% CI: 0.85–0.97; I2=53%), and 83% (95% CI: 0.80–0.85; I2=17%) respectively. For TGW, mixed DCS and RS were the most frequent at85% (95% CI: 0.60–1.00; I2=91%) and online counseling at 84% (95% CI: 0.64–0.95) compared to other strategies. Conclusion Critical issues play. Pivotal role in increasing PrEP awareness among MSM and TGW, minimizing access gaps, and ensuring retention of PrEP services. Offering oral PrEP using online DCS and RS can reach and retain high numbers of MSM and TGW, and reduce HIV incidence in these populations.https://doi.org/10.1186/s12879-023-08693-zDemand creation to PrEP accessRetention in PrEP servicesMen who have sex with menTransgender womenPrevention of HIV infection
spellingShingle Nathalia Sernizon Guimarães
Laio Magno
Gabriel Marinho Bahia Monteiro
Izabel Cristina Neves Ramos
Caroline Tianeze de Castro
Thais Regis Aranha-Rossi
Marcos Pereira
Inês Dourado
Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis
BMC Infectious Diseases
Demand creation to PrEP access
Retention in PrEP services
Men who have sex with men
Transgender women
Prevention of HIV infection
title Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis
title_full Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis
title_fullStr Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis
title_full_unstemmed Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis
title_short Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis
title_sort demand creation and retention strategies for oral pre exposure prophylaxis for hiv prevention among men who have sex with men and transgender women a systematic review and meta analysis
topic Demand creation to PrEP access
Retention in PrEP services
Men who have sex with men
Transgender women
Prevention of HIV infection
url https://doi.org/10.1186/s12879-023-08693-z
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