HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis

Objective: Scaling up pre-exposure prophylaxis (PrEP) is critical to combating the AIDS epidemic, especially among PrEP-eligible men who have sex with men (MSM). This study summarizes the global proportion of PrEP-eligible MSM with PrEP use and highlights the contextual differences in eligibility cr...

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Main Authors: Yuyan Zhao, Huishan Li, Yiting Huang, Ziwei Zhou, Zhuoqian He, Bruce Agins, Jason J. Ong, Huachun Zou, Yangyang She, Hongbo Jiang
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225000979
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author Yuyan Zhao
Huishan Li
Yiting Huang
Ziwei Zhou
Zhuoqian He
Bruce Agins
Jason J. Ong
Huachun Zou
Yangyang She
Hongbo Jiang
author_facet Yuyan Zhao
Huishan Li
Yiting Huang
Ziwei Zhou
Zhuoqian He
Bruce Agins
Jason J. Ong
Huachun Zou
Yangyang She
Hongbo Jiang
author_sort Yuyan Zhao
collection DOAJ
description Objective: Scaling up pre-exposure prophylaxis (PrEP) is critical to combating the AIDS epidemic, especially among PrEP-eligible men who have sex with men (MSM). This study summarizes the global proportion of PrEP-eligible MSM with PrEP use and highlights the contextual differences in eligibility criteria for PrEP across studies. Methods: A literature search was conducted in four databases in July 2023. We determined the proportion of PrEP-eligible MSM with PrEP use and its 95% confidence interval (CI) using a random-effects meta-analysis. Results: 50 eligible studies involving 96,151 PrEP-eligible MSM were included. The overall pooled estimate of PrEP-eligible MSM with a history of PrEP use and current PrEP use was 19.3% (95% CI 13.9-26.2) and 21.8% (95% CI 17.6-26.7) with β regressions indicating an increasing trend. Subgroup analyses showed lower PrEP use among young MSM, and differences in PrEP use by research year, country income level, policy support and WHO region. Variations in eligibility criteria for PrEP were observed across studies. Conclusions: An overall increase in PrEP use among PrEP-eligible MSM was observed, with differences in PrEP use mainly by age. Emphasis on identifying PrEP-eligible MSM, particularly young MSM and removing financial barriers for effective implementation. Global PrEP criteria should be more standardized and based on the latest science.
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spelling doaj-art-7d55f95022db4f0690cce2fffcfde2782025-08-20T03:09:09ZengElsevierInternational Journal of Infectious Diseases1201-97122025-05-0115410787410.1016/j.ijid.2025.107874HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysisYuyan Zhao0Huishan Li1Yiting Huang2Ziwei Zhou3Zhuoqian He4Bruce Agins5Jason J. Ong6Huachun Zou7Yangyang She8Hongbo Jiang9Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, PR ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, PR ChinaDepartment of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou, PR ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, PR China; Department of Medical Statistics, School of Basic Medicine and Public Health, Jinan University, Guangzhou, PR China; Department of Preventive Health Care, The Second People's Hospital of Longgang District, Shenzhen, PR China; HEALTHQUAL, Institute for Global Health Sciences, University of California, San Francisco, California, USA; School of Translational Medicine, Monash University, Melbourne, Australia; School of Public Health, Fudan University, Shanghai, PR China; Department of Stomatology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, PR ChinaHEALTHQUAL, Institute for Global Health Sciences, University of California, San Francisco, California, USASchool of Translational Medicine, Monash University, Melbourne, AustraliaSchool of Public Health, Fudan University, Shanghai, PR ChinaDepartment of Stomatology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, PR China; Corresponding author: Hongbo Jiang, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China.Objective: Scaling up pre-exposure prophylaxis (PrEP) is critical to combating the AIDS epidemic, especially among PrEP-eligible men who have sex with men (MSM). This study summarizes the global proportion of PrEP-eligible MSM with PrEP use and highlights the contextual differences in eligibility criteria for PrEP across studies. Methods: A literature search was conducted in four databases in July 2023. We determined the proportion of PrEP-eligible MSM with PrEP use and its 95% confidence interval (CI) using a random-effects meta-analysis. Results: 50 eligible studies involving 96,151 PrEP-eligible MSM were included. The overall pooled estimate of PrEP-eligible MSM with a history of PrEP use and current PrEP use was 19.3% (95% CI 13.9-26.2) and 21.8% (95% CI 17.6-26.7) with β regressions indicating an increasing trend. Subgroup analyses showed lower PrEP use among young MSM, and differences in PrEP use by research year, country income level, policy support and WHO region. Variations in eligibility criteria for PrEP were observed across studies. Conclusions: An overall increase in PrEP use among PrEP-eligible MSM was observed, with differences in PrEP use mainly by age. Emphasis on identifying PrEP-eligible MSM, particularly young MSM and removing financial barriers for effective implementation. Global PrEP criteria should be more standardized and based on the latest science.http://www.sciencedirect.com/science/article/pii/S1201971225000979Men who have sex with menHIVPre-exposure prophylaxis (PrEP)PrEP-eligibilitySystematic reviewMeta-analysis
spellingShingle Yuyan Zhao
Huishan Li
Yiting Huang
Ziwei Zhou
Zhuoqian He
Bruce Agins
Jason J. Ong
Huachun Zou
Yangyang She
Hongbo Jiang
HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis
International Journal of Infectious Diseases
Men who have sex with men
HIV
Pre-exposure prophylaxis (PrEP)
PrEP-eligibility
Systematic review
Meta-analysis
title HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis
title_full HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis
title_fullStr HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis
title_full_unstemmed HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis
title_short HIV pre-exposure prophylaxis (PrEP) use among PrEP-eligible men who have sex with men: A systematic review and meta-analysis
title_sort hiv pre exposure prophylaxis prep use among prep eligible men who have sex with men a systematic review and meta analysis
topic Men who have sex with men
HIV
Pre-exposure prophylaxis (PrEP)
PrEP-eligibility
Systematic review
Meta-analysis
url http://www.sciencedirect.com/science/article/pii/S1201971225000979
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