Journal
AIDS AND BEHAVIOR
Volume 22, Issue 4, Pages 1063-1074Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10461-017-1675-z
Keywords
Men who have sex with men; MSM; Pre-exposure prophylaxis; PrEP; Meta-analysis
Funding
- National Natural Science Foundation of China [81373060]
- Six Major Human Resources Project of Jiangsu Province [WSN-015]
- Preventive Medicine Project of Jiangsu Province [Y2013071]
- Science and Technology Program of Nantong City [MS12015125]
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Pre-exposure prophylaxis (PrEP) is a new biomedical intervention for HIV prevention. This study systematically reviews the acceptability of PrEP among men who have sex with men (MSM) worldwide. We searched major English databases to identify English-language articles published between July 2007 and July 2016, which reported the acceptability of PrEP and associated population characteristics. Meta-analysis was conducted to estimate a pooled acceptability, and meta-regression and subgroup analysis were used to analyse heterogeneities. The estimated acceptance from included sixty-eight articles was 57.8% (95% confidence internal 52.4-63.1%). MSM who were younger (4/5 studies, range of adjusted odds ratio (aOR) = 1.39-3.47), better educated (aOR = 1.49-7.70), wealthier (aOR = 1.31-13.03) and previously aware of PrEP (aOR = 1.33-3.30) showed significantly higher acceptance. Male sex workers (84.0% [26.3-98.7%] were more likely to accept PrEP than general MSM. Self-perceived low efficacy, concern about side effects, adherence, affordability, and stigma were main barriers. This review identifies a moderate acceptability of PrEP in MSM. Efficacy, perception of HIV risk and experienced stigma determine its acceptance.
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