Exploring the Effectiveness of Pre-Exposure Prophylaxis (PrEP) Use for HIV Prevention among High-Risk Populations
DOI:
https://doi.org/10.22270/ajprd.v12i2.1333Abstract
Addressing the global burden of HIV requires effective preventative measures that have been shown to have high efficacy rates. PrEP is one of the preventative measures that is effective in preventing HIV. Different clinical trials and population studies have shown PrEPto have an efficacy rate of 40% to 90% when it comes to preventing HIV. Due to its high efficacy, PrEPcan reduce new HIV infections populations considered to be high risk. However, for efficacy to be high, there is a need to increase medication adherence and address the existing barriers that limit uptake. Some of these barriers are lack of knowledge, inadequate access, stigma,lack of trust in service providers, low perception of HIV risk, cost, and fear of side effects. Addressing these barriers can increase PrEP uptake and help in reducing HIV’s risk among high-risk populations. Some of the measures that can be put in place to address these barriers are providing education and training, allocating enough resources, leveraging technology, lowering PrEP costs, increasing insurance coverage, and improving communication among the targeted population.
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References
UNAIDS. Global HIV & AIDS statistics-Fact sheet. 2023. Accessed 2 April 2024. https://www.unaids.org/en/resources/fact-sheet#:~:text=Since%202010%2C%20new%20HIV%20infections,%E2%80%931.7%20million%5D%20in%202022.
Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, Goicochea P, Casapía M, Guanira-Carranza JV, Ramirez-Cardich ME, Montoya-Herrera O. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine. 2010; 363(27):2587-99.doi:10.1056/NEJMoa1011205
McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, Sullivan AK, Clarke A, Reeves I, Schembri G, Mackie N. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. The Lancet. 2016; 387(10013):53-60.doi:10.1016/S0140-6736(15)00056-2
Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, Tremblay C, Le Gall JM, Cua E, Pasquet A, Raffi F. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. New England Journal of Medicine. 2015; 373(23):2237-46.doi:10.1056/NEJMoa1506273
Chou R, Evans C, Hoverman A, Sun C, Dana T, Bougatsos C, Grusing S, Korthuis PT. Preexposure prophylaxis for the prevention of HIV infection: evidence report and systematic review for the US Preventive Services Task Force. Jama. 2019; 321(22):2214-30.doi:10.1001/jama.2019.2591
World Health Organization. (WHO). guidance on pre-exposure oral prophylaxis (prep) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV: Recommendations for use in the context of demonstration projects. 2012. Accessed 2 April 2024. https://iris.who.int/bitstream/handle/10665/75188/9789241503884_eng.pdf?sequence=1
Hillis A, Germain J, Hope V, McVeigh J, Van Hout MC. Pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM): a scoping review on PrEP service delivery and programming. AIDS and Behavior. 2020; 24:3056-70.doi:10.1007/s10461-020-02855-9
Centers for Disease Control and Prevention. (CDC).New HIV diagnoses and people with diagnosed HIV in the us and dependent areas by area of residence, 2021. 2023. Accessed 2 April 2024. https://www.cdc.gov/hiv/basics/statistics.html
Centers for Disease Control and Prevention. (CDC). Estimated HIV incidence and prevalence in the United States, 2017–2021.HIV Surveillance Supplemental Report, 2023; 28(3).
UNAIDS. HIV and gay men and other men who have sex with men. 2023. Accessed 2 April 2024.https://thepath.unaids.org/wp-content/themes/unaids2023/assets/files/thematic_fs_hiv_gay_men.pdf
UNAIDS. HIV and sex workers. 2023. Accessed 2 April 2024.
Paz-Bailey G, Noble M, Salo K, Tregear SJ. Prevalence of HIV among US female sex workers: systematic review and meta-analysis. AIDS and Behavior. 2016; 20:2318-31.doi:10.1007/s10461-016-1332-y
Cohan DL, Kim A, Ruiz J, Morrow S, Reardon J, Lynch M, Klausner JD, Molitor F, Allen B, Ajufo BG, Ferrero D. Health indicators among low income women who report a history of sex work: the population based Northern California Young Women’s Survey. Sexually Transmitted Infections. 2005; 81(5):428-33.doi: 10.1136/sti.2004.013482
Inciardi JA, Surratt HL, Kurtz SP, Weaver JC. The effect of serostatus on HIV risk behaviour change among women sex workers in Miami, Florida. AIDS Care. 2005; 17(sup1):88-101.doi:10.1080/09540120500121011
Brewer TH, Zhao W, Metsch LR, Coltes A, Zenilman J. High-risk behaviors in women who use crack: knowledge of HIV serostatus and risk behavior. Annals of Epidemiology. 2007;17(7):533-9.doi:10.1016/j.annepidem.2007.01.029
Kurtz SP, Surratt HL, Kiley MC, Inciardi JA. Barriers to health and social services for street-based sex workers. Journal of Health Care for the Poor and Underserved. 2005;16(2):345-61.doi:10.1353/hpu.2005.0038
Ruegsegger LM, Stockton M, Go VF, Piscalko H, Davis D, Hoffman IF, Hosseinipour MC, Zalira E, Lungu T, Bula A, Lancaster KE. Stigma, social support, and sexual behavior among female sex workers at risk for HIV in Malawi. AIDS Education and Prevention. 2021;33(4):290-302.doi:10.1521/aeap.2021.33.4.290
Beyrer C, Baral SD, Van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, Brookmeyer R. Global epidemiology of HIV infection in men who have sex with men. The Lancet. 2012;380(9839):367-77.doi:10.1016/S0140-6736(12)60821-6
Baggaley RF, White RG, Boily MC. HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV prevention. International Journal of Epidemiology. 2010;39(4):1048-63.doi:10.1093/ije/dyq057
Meng X, Zou H, Fan S, Zheng B, Zhang L, Dai X, Deng M, Zhang X, Lu B. Relative risk for HIV infection among men who have sex with men engaging in different roles in anal sex: a systematic review and meta-analysis on global data. AIDS and Behavior. 2015;19:882-9.doi:10.1007/s10461-014-0921-x
Margolis AD, Joseph H, Hirshfield S, Chiasson MA, Belcher L, Purcell DW. Anal intercourse without condoms among HIV-positive men who have sex with men recruited from a sexual networking web site, United States. Sexually Transmitted Diseases. 2014;41(12):749-55.doi:10.1097/OLQ.0000000000000206
Wang SC, Maher B. Substance use disorder, intravenous injection, and HIV infection: a review. Cell Transplantation. 2019;28(12):1465-71.doi:10.1177/0963689719878380
Kurth AE, Cleland CM, Des Jarlais DC, Musyoki H, Lizcano JA, Chhun N, Cherutich P. HIV prevalence, estimated incidence, and risk behaviors among people who inject drugs in Kenya. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2015;70(4):420-7.doi:10.1097/QAI.0000000000000769
Jourdain H, de Gage SB, Desplas D, Dray-Spira R. Real-world effectiveness of pre-exposure prophylaxis in men at high risk of HIV infection in France: a nested case-control study. The Lancet Public Health. 2022;7(6):e529-36.doi:10.1016/S2468-2667(22)00106-2
Liu AY, Cohen SE, Vittinghoff E, Anderson PL, Doblecki-Lewis S, Bacon O, Chege W, Postle BS, Matheson T, Amico KR, Liegler T. Preexposure prophylaxis for HIV infection integrated with municipal-and community-based sexual health services. JAMA Internal Medicine. 2016;176(1):75-84.doi:10.1001/jamainternmed.2015.4683.
Jiang J, Yang X, Ye L, Zhou B, Ning C, Huang J, Liang B, Zhong X, Huang A, Tao R, Cao C. Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials. PLoS One. 2014;9(2):e87674.doi:10.1371/journal.pone.0087674
Sidebottom D, Ekström AM, Strömdahl S. A systematic review of adherence to oral pre-exposure prophylaxis for HIV–how can we improve uptake and adherence?.BMC Infectious Diseases. 2018;18:1-4.doi:10.1186/s12879-018-3463-4
Martin M, Vanichseni S, Suntharasamai P, et al. The impact of adherence to preexposure prophylaxis on the risk of HIV infection among people who inject drugs. Aids. 2015;29(7):819-24.doi:10.1097/QAD.0000000000000613
Qu D, Zhong X, Xiao G, Dai J, Liang H, Huang A. Adherence to pre-exposure prophylaxis among men who have sex with men: A prospective cohort study. International Journal of Infectious Diseases. 2018;75:52-9.doi:10.1016/j.ijid.2018.08.006
Aidoo-Frimpong G, Wilson K, Przybyla S. Factors influencing pre-exposure prophylaxis uptake among current users: A qualitative study. Journal of HIV/AIDS &Social Services. 2020;19(3):252-62.doi:10.1080/15381501.2020.1810838
Beach LB, Greene GJ, Lindeman P, Johnson AK, Adames CN, Thomann M, Washington PC, Phillips G. Barriers and facilitators to seeking HIV services in Chicago among young men who have sex with men: perspectives of HIV service providers. AIDS Patient Care and STDs. 2018;32(11):468-76.doi:10.1089/apc.2018.0094
Jaiswal J, Griffin M, Singer SN, et al. Structural barriers to pre-exposure prophylaxis use among young sexual minority men: the P18 cohort study. Current HIV research. 2018;16(3):237-49.doi:10.2174/1570162X16666180730144455
Young I, Flowers P, McDaid LM. Barriers to uptake and use of pre-exposure prophylaxis (PrEP) among communities most affected by HIV in the UK: findings from a qualitative study in Scotland. BMJ Open. 2014;4(11):e005717.doi:10.1136/bmjopen-2014-005717
Nagai H, Ankomah A, Fuseini K, Adiibokah E, Semahegn A, Tagoe H. HIV Pre-Exposure Prophylaxis Uptake Among High-Risk Population in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. AIDS Patient Care and STDs. 2024;38(2):70-81.doi:10.1089/apc.2023.0117
Nabunya R, Karis VM, Nakanwagi LJ, Mukisa P, Muwanguzi PA. Barriers and facilitators to oral PrEP uptake among high-risk men after HIV testing at workplaces in Uganda: a qualitative study. BMC Public Health. 2023;23(1):365.doi:10.1186/s12889-023-15260-3
Hubach RD, Currin JM, Sanders CA, Durham AR, Kavanaugh KE, Wheeler DL, Croff JM. Barriers to access and adoption of pre-exposure prophylaxis for the prevention of HIV among men who have sex with men (MSM) in a relatively rural state. AIDS Education and Prevention. 2017;29(4):315-29.doi:10.1521/aeap.2017.29.4.315
Sun CJ, Anderson KM, Bangsberg D, Toevs K, Morrison D, Wells C, Clark P, Nicolaidis C. Access to HIV pre-exposure prophylaxis in practice settings: A qualitative study of sexual and gender minority adults’ perspectives. Journal of General Internal Medicine. 2019;34:535-43.doi:10.1007/s11606-019-04850-w
Philbin MM, Parker CM, Parker RG, Wilson PA, Garcia J, Hirsch JS. Gendered social institutions and preventive healthcare seeking for black men who have sex with men: the promise of biomedical HIV prevention. Archives of Sexual Behavior.2018; 47:2091-100. doi:10.1007/s10508-018-1211-x
Grace D, Jollimore J, MacPherson P, Strang MJ, Tan DH. The pre-exposure prophylaxis-stigma paradox: learning from Canada's first wave of PrEP users. AIDS Patient Care and Stds. 2018;32(1):24-30.doi:10.1089/apc.2017.0153
Holloway IW, Tan D, Gildner JL, Beougher SC, Pulsipher C, Montoya JA, Plant A, Leibowitz A. Facilitators and barriers to pre-exposure prophylaxis willingness among young men who have sex with men who use geosocial networking applications in California. AIDS Patient Care and STDs. 2017;31(12):517-27. doi:10.1089/apc.2017.0082
Goparaju L, Praschan NC, Warren-Jeanpiere L, Experton LS, Young MA, Kassaye S. Stigma, partners, providers and costs: potential barriers to PrEP uptake among US women. Journal of AIDS & Clinical Research. 2017;8(9). doi:10.4172/2155-6113.1000730
Golub SA. PrEP stigma: implicit and explicit drivers of disparity. Current HIV/AIDS Reports.2018;15:190-7.doi:10.1007/s11904-018-0385-0
Grimm J, Schwartz J. " It's like Birth Control for HIV": Communication and Stigma for Gay Men on PrEP.Journal of Homosexuality. 2018; 66. doi:10.1080/00918369.2018.1495978
Whitehead J, Shaver J, Stephenson R. Outness, stigma, and primary health care utilization among rural LGBT populations. PloSOne. 2016;11(1):e0146139.doi:10.1371/journal.pone.0146139
John SA, Rendina HJ, Grov C, Parsons JT. Home-based pre-exposure prophylaxis (PrEP) services for gay and bisexual men: an opportunity to address barriers to PrEP uptake and persistence. PlosOne. 2017;12(12):e0189794.doi:10.1371/journal.pone.0189794
Mayer KH, Agwu A, Malebranche D. Barriers to the wider use of pre-exposure prophylaxis in the United States: a narrative review. Advances in Therapy. 2020;37:1778-811.doi:10.1007/s12325-020-01295-0
Jackson-Gibson M, Ezema AU, Orero W, Were I, Ohiomoba RO, Mbullo PO, Hirschhorn LR. Facilitators and barriers to HIV pre-exposure prophylaxis (PrEP) uptake through a community-based intervention strategy among adolescent girls and young women in Seme Sub-County, Kisumu, Kenya. BMC Public Health. 2021;21:1-3.doi:10.1186/s12889-021-11335-1
Juusola JL, Brandeau ML, Owens DK, Bendavid E. The cost-effectiveness of preexposure prophylaxis for HIV prevention in the United States in men who have sex with men. Annals of Internal Medicine. 2012;156(8):541-50.doi: 10.7326/0003-4819-156-8-201204170-00001
Blumenthal J, Jain S, Krakower D, Sun X, Young J, Mayer K, Haubrich R, CCTG 598 Team. Knowledge is power! Increased provider knowledge scores regarding pre-exposure prophylaxis (PrEP) are associated with higher rates of PrEP prescription and future intent to prescribe PrEP.AIDS and Behavior. 2015;19:802-10.doi:10.1007/s10461-015-0996-z
Wood BR, McMahan VM, Naismith K, Stockton JB, Delaney LA, Stekler JD. Knowledge, practices, and barriers to HIV preexposure prophylaxis prescribing among Washington State medical providers. Sexually Transmitted Diseases. 2018;45(7):452-8.doi:10.1097/OLQ.0000000000000781
Sullivan PS, Mena L, Elopre L, Siegler AJ. Implementation strategies to increase PrEP uptake in the South. Current Hiv/Aids Reports. 2019;16:259-69.doi:10.1007/s11904-019-00447-4
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